Diagnosing Mental Illness in Adolescence

There is a measure of wariness in diagnosing mental illness before at least young adulthood – late teens or early twenties. I wonder a bit about the wisdoms behind that, not from any study done but from my own experience.

I was fourteen when I first tried to kill myself. Granted, at the time I was under the intense pressure of some pretty serious abuse, and it may not have been a sign of mental illness so much as a response to the situation I was in. Perhaps at that point I would not have been diagnosably mentally ill.

By age sixteen I was significantly unwell. I swung from massive highs to crippling lows. Sometimes I could cope with anything, including the 27-hour work week I was maintaining in addition to being at high school full-time and wedging a social life in as well. Other times I could barely drag myself through the motions of the day, and walked and worked in automatic mode. It was a long time ago though, and I don’t know if the state I was in would count as mental illness, or whether it was somewhat normal. I’m pretty sure my teachers at the time thought something was wrong.

After my daughter was born, when I was seventeen, my world fell apart completely. I couldn’t cope with the life I had to live, and I spent long stretches of time just crying on the couch. It was more than just being overwhelmed, it was full-blown depression. I don’t remember much of that period of time, but somewhere in the year or two after that I was finally caught by the mental health system and started the long rocky road of treatment.

I wonder what life would have been like if it was caught earlier. Maybe there were signs of deteriorating mental health early on that could have been dealt with in some way, and maybe if that had happened, I would not be as unwell as I am. Maybe I could have learned coping strategies ten years earlier.

I understand the reluctance to pathologise the behaviour of adolescents unless it is very far divorced from normal, but I don’t know if it’s the right thing to do. If twenty percent of New Zealanders will suffer from a mental illness at some point in their lives, then it’s likely that a chunk of them will suffer as they grow up. I don’t know how to catch these kids early, and I don’t know if it would help, but I will always wonder what might have been if it had been possible to catch me early.

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