Parents are constantly explaining things to their kids. It's not always easy though, particularly if a family member is struggling with a mental illness. Making a broken arm clear to them is one thing, depression, an anxiety disorder or post-traumatic stress disorder quite another.
"Many parents shy away from it," says paediatric psychotherapist Anja Lorenz, because "there's no standard procedure" on how to do it. So they've got to use their imagination.
Children, even young ones, usually sense when Mama, Papa, an uncle or grandmother isn't well, Lorenz says, adding that "parents are often surprised at how much kids pick up on."
They notice, for instance, that Mum or Dad doesn't react when spoken to, is quickly irritated or frequently sad, points out paediatric psychotherapist Julia Ebhardt.
What's more, they worry about it, take a lot personally "and feel guilty because their only explanation is that they did something that made Mama or Papa unwell," she says.
This is why it's important that parents provide clarity and explain, to young children too, that an illness is to blame and has nothing to do with the child. The child shouldn't feel somehow responsible.
Who should speak with the child, the person with the mental illness or someone else? This depends on the quality of the relationship, according to Lorenz, who says children normally have a clear preference.
"Simply ask, 'I'd like to talk to you about something that has to do with me. Is that OK? Just you and me, or would you like someone else to be there?'"
The child's age should largely determine the content of the talk and how detailed it is. "Younger children need less information than older ones do," Ebhardt says.
Parents should explain the illness and its consequences in simple, age-appropriate language. "It's good to incorporate the child's current interests, says Ebhardt, "for example a certain character or a topic such as knights, monsters, dinosaurs, football or fairies."
If a knight is depressed, it doesn't show, you might say. But it's as if he's not wearing armour any more. "Or a fairy who has lost her magical powers and interest in being with other fairies," suggests Ebhardt, who encourages being creative and playing off the child's mental world.
In the case of an anxiety disorder, the image of a monster often suggests itself, she says. It pounces suddenly and is very scary. Visualizing an anxiety disorder as a creature helps children to understand and deal with it.
While creative, child-friendly explanations are desirable, parents should take care they're not overly convoluted. "And please don't invent stories as to why Mum or Dad isn't there," Lorenz says - for example if a parent is getting in-patient treatment at a psychiatric clinic.
"The child will realize that something doesn't add up, causing them additional stress and confusion."
The main object is to give the child a feeling of security," Lorenz says. "You should emphasize that Mama or Papa is tending to the problem and already getting help. Otherwise the child may think that they must do something themself." This can ease the child's worry about losing a parent," she says.
For children around 3 years of age and older, parents can also use books as an explanation aid. The books should naturally be suited to the child's age and level of development so as not to aggravate any unease.
"And you should look at and read them together so that you can answer any questions," Ebhardt says.
What if you have the feeling that the mental illness in the family is seriously distressing the child and you need outside help? You can then turn to a family counselling centre, a few of which offer special counselling for children with a mentally ill parent.
In extreme cases, it can be advisable to take the child to a paediatric psychotherapist.
