How To Help When Far-Away Family Is In Crisis

Got tweens/teens? We’re trying a new advice column here at Alpha Mom to address your questions for the older-kid crowd. We hope you enjoy! And if you have a question to submit, hit me up at alphamomteens[at]gmail[dot]com.

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“Concerned Auntie” writes:

I’m not even sure if I have an actual question that can be answered and made all better (unlikely) or if you can help me wrap my head around things. My nephew was diagnosed with autism when he was around 3 years old (he’s always been in public schools with IEPs and therapies and professionals, etc. etc.). He is now 14 and has started high school, which is understandably nerve-wracking for all kids. His mother abandoned him several years ago, but my brother and my parents are devoted to him. Recently he told his therapist of plans he had to hurt himself, with enough detail and conviction that the therapist told my brother to take him to the ER immediately. They admitted him and are planning on keeping him for at least a week. He struggles with pretty severe anxiety and tends to obsess and is on medication to try to control it. I guess if I’m going to phrase this as a question, it’s what do I do? What can I do to support him and my family? I live across the country and much like when I was told his mother left, I am a big flailing ball of useless.

I want to start by saying that I am so sorry your family is going through this, and also to point out that just wanting to help already tells me you are absolutely not a big flailing ball of useless. I know you feel helpless, being across the country, but if your love for your nephew and the rest of your family is coming through to me in a single email, I know they’re benefitting from it, too. So please start by cutting yourself some slack.

Next I want to tell you that the scenario you’re describing is not uncommon for kids on the autism spectrum. Anxiety and depression love to tag along for the ride when there’s an autism diagnosis, and puberty definitely exacerbates those issues, as does any life upheaval (hello, high school), and even the most verbal and eloquent of kids with autism tend to have what’s called a pragmatic speech deficit. We tend to forget (okay, I tend to forget) that just because our beloved Aspies and Auties can talk endlessly about their interests that they often cannot adequately convey feelings of pain, fear, and frustration in precise and age-appropriate, constructive ways. My own kiddo—now almost 16—still threatens to kill himself with some regularity. The first time it happened, we completely freaked out. Now we know that with him, it’s important communication, but doesn’t necessarily mean he’s in imminent danger. Please understand, I’m not trying to be flippant about this (your nephew’s therapist absolutely made the right call, because any threat needs to be handled seriously), but over the years we have learned that “I want to die/kill myself” actually is his best attempt to communicate “I feel awful and I don’t know why and I need it to stop because I can’t stand it.” Of course I cannot say for sure that this is what’s happening with your nephew, but I hope you can take at least a little comfort in knowing that it’s possible this is, at least in part, a communication issue. [Sidebar: To be crystal clear here, I am speaking from our experience and what I’ve heard is common for kids on the spectrum, but any threat of self-harm requires immediate attention, even if/when it’s been determined that bodily harm isn’t imminent. It’s better to over-react than under-react when our kids are on the line.] And while having a kid go inpatient is scary and concerning, it means he’s safe, and also that he’s on a fast track to sorting out his medications in a supportive environment. So that’s all really positive, even though it doesn’t feel good.

Finally, what strikes me most about your situation is not really issues of autism and self-harm (as you put in the subject of your email, and I say this because your nephew is getting what will hopefully be helpful treatment, already), but that really what you’re wanting is a good answer to the much more general question of “How do I provide useful support to people I love while they’re in crisis?” Sometimes this is even a harder question to answer when the immediate crisis (in this case, your nephew’s mental health) is already being addressed (again, in this case, because he’s in treatment), because we’re left with this “there’s nothing I can do” feeling, especially when we’re far away.

I’ve spent more time than I’d like to admit dealing with one or the other of my kids having a serious health crisis, including multiple hospitalizations. The number one priority, always, was making sure that the kid in question was getting needed treatment, obviously. But once that was handled, I can tell you that it can be tremendously isolating and stressful to be the caretaker of a loved one in extreme pain, and our family was grateful for support in any and all forms. Lots of times when people “don’t know what to say,” they say nothing at all. That feels like abandonment. What I remember most are the people who were just there, and I don’t mean in physical proximity, either—I mean the people who called and emailed and asked how we were or just sent a text that said “Thinking of you today.” Sometimes people dropped off food or took the other kid for a day when we had to head to the hospital, and that stuff was wonderful, too, but it was the people who simply made it clear that they were walking alongside us in love and concern who kept us going.

So: What can you do? You can check in on your parents and brother as often as you feel comfortable (and will feel supportive to them; go ahead and ask if you feel like it’s too much or too little), and let them know they’re on your mind. Ask them what they need (and if they say “I don’t know” or “nothing,” that’s okay, just keep being there). If you want to send a card or a meal or a housecleaning service—if you think that’s something they’d benefit from and appreciate—knock yourself out, but my money is on simply staying in contact being the best support you can offer. If you are close with your nephew (or even if you aren’t, frankly), send him short letters or terrible puns. Send small trinkets he might enjoy (a stress ball, a grown-up coloring book if you think he might like that, a book on his favorite topic, a snack) and keep it light; just include a little note that says you thought he might enjoy and you hope he’s feeling better soon.

As a society, we tend to shy away from mental illness and hope it disappears. That’s not how it works. How it works is that we hopefully get good treatment (therapy and meds) and our community reminds us that we’re loved and valuable and more than the sum of our challenges. Let him know you love him, no matter what. Let his caretakers know you are with them as they handle this, no matter what. It’s okay that you’re far away if you can commit to being present in spirit with them as they walk through this particular darkness. That’s not just enough, it’s everything.

Auntie, I hope your nephew is feeling himself again very soon. Best wishes for your whole family—there’s clearly a lot of love there, and I believe you will all get through this.

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Don’t forget that you can submit your own question to alphamomteens[at]gmail[dot]com.