Nancy S. of Brooklyn Center had always enjoyed weekly visits from her older grandchild, Kaylee*. But in the weeks following the girl’s entry into fifth grade, Nancy began to notice some troubling behavior. At first, her granddaughter seemed to be increasingly emotional, often bursting into tears at the slightest provocation (“What do you mean you don’t have peanut butter cookies for me? You ALWAYS have them!”). Then, she began to tell fabulous, fanciful tales that she insisted were true (“My best friend and I are going to be backstage at the concert, really.”) Finally, Nancy began to notice physical changes, as her granddaughter’s weight plunged, and the girl began to look unhealthy and frail.

“I honestly didn’t know what to do,” Nancy says as she remembers that difficult period. “At first, I kept telling myself that it was just a phase. Then I tried talking to Kaylee, but she brushed me off and said everything was fine, and that she was happy that she’d finally been successful at dieting and becoming ‘less of a pudgeball,’ as she put it.”

Although she was reluctant, Nancy decided her only recourse was to talk with her son, Kaylee’s father. “I called him at work, so he would be alone,” she said, “and as soon as I started to talk, I began to cry. At first, he said that I was probably just exaggerating, but the more we talked, he finally admitted that he’d started to notice the same changes too. He agreed to go right away to his human resources manager’s office, to check into the mental health benefits that his company offered.” Nancy reports that Kaylee began treatment with a counselor, who also prescribed some medications that seem to have helped. “She’s more like her old self again,” Nancy reports, “and I’m so glad that I spoke up, even though I was really worried about interfering.”

Overly coddled?

For many grandparents, speaking frankly about mental health issues is a very uncomfortable situation, both as a parent of an adult child and as the grandparent of a grandchild who seems to be having a hard time emotionally. Sometimes, grandparents need to confront their own conviction that kids today are overly coddled through what they consider to be just part of the normal wear-and-tear of growing up. But Pam Solomon, In-home Crisis Stabilization program coordinator and therapist at the Washburn Center for Children, a Minneapolis-based community health center, says, “Most grandparents have no ideas of the pressures that today’s kids are facing. They can be the victim of relentless bullies not only at school, but online. Many of them are coping with parents’ divorces and step- and blended families. And the economic situation has had a big impact on kids, who often feel panicked or out of control over events in the adult world.”

The lifestyle and concerns of today’s children seem light years away from what grandparents experienced in their own younger years. It can be a challenge for a grandparent to detect what is typical accepted behavior for this generation, and what is an indicator of a mental health concern. Often a child is sending out the sort of subtle cues that only a loving grandparent, who has the time to focus on the child and a long lifetime’s worth of experience, might notice. While it’s true that every child might exhibit some of these behaviors from time to time, it’s the length and severity that indicate a potential cause for concern:

• Extreme moods, especially sadness, withdrawal or lethargy
• Intense feelings and sudden bursts of anger, aggression or crying
• Sleep issues
• Difficulty concentrating
• Telling lies and/or stealing
• Food and eating issues, and/or unexplained weight loss or gain
• Indications of substance abuse

Notes and observations

If a grandparent does notice some of these signs, what’s the best way to make sure that a grandchild gets needed help? The first step is to increase your level of observation, and take some notes. It’s much more effective to know that, “Max cried three times over the weekend, always when he mentioned school,” than to simply think back on the weekend and say to yourself, “Max seemed sad.”

After you’ve gathered some observations, the first step should be a conversation with the grandchild, says Margaret Shoemaker, a school-based mental health therapist at Washburn Center for Children. She has 40 years’ experience in her field and now is a grandparent herself, and her advice is that a face-to-face talk with child about what’s going on might give you some insight into the situation. “Be sure to start off speaking about your own feelings,” she says. “Try saying something like, ‘I’m feeling scared about some of your behavior recently,'” Sometimes, the child will acknowledge the issue, but there is also the possibility you will be rebuffed. Shoemaker suggests a gentle suggestion such as, “What do you think about talking to Mom or Dad about this together?”

While it may seem intimidating to raise the issue with your own adult child, she urges grandparents that they can be successful if they focus on a humble, not blaming, attitude. Again, she suggests using words about how you are feeling, like, “I feel apprehensive about something I see happening with this child and I need to share it with you.” She says to be very specific — refer to those notes and observations you’ve been making. And offer a gentle suggestion like, “Would you consider calling a mental health professional about this?” Like Nancy, the grandmother who was worried about Kaylee’s behavior, you may encounter resistance or defensiveness at first. “Keep at it and keep that attitude of humility,” says Shoemaker. “This is your grandchild we’re talking about, so it’s worth it.”

If your grandchild does begin to receive treatment, be aware that your support is needed now more than ever. Be sure to praise any progress or improved behavior that you notice. And just doing what a grandparent does best — offering lots and lots of unconditional love — can help a child who is struggling.

*Names have been changed for this story.

This article first appeared in the September 2012 issue of Minnesota Good Age.