The child
with a serious medical illness is at risk for developing associated
emotional problems. Unlike a child with a temporary sickness
such as the flu, the child with a chronic illness must cope
with knowing that the disease is here to stay and may even
get worse. Child and adolescent psychiatrists point out that
almost all of these children initially refuse to believe they
are ill, and later feel guilt and anger.
The young
child, unable to understand why the sickness has occurred,
may assume it is a punishment for being "bad." He or she may
become angry with parents and doctors for not being able to
cure the illness. The youngster may react strongly against
pampering, teasing, or other attention. Uncomfortable treatments,
and restrictions in diet and activity may make the child bitter
and withdrawn. To help your child deal with the disease you
need to give them honest, accurate, and age appropriate information
to help them understand.
A teenager
with a long-term illness may feel pulled in opposite directions.
On the one hand, he or she must take care of the physical
problem, requiring dependence on parents and doctors. On the
other hand, the adolescent wants to become independent and
join his or her friends in various activities. When a teenager
with a long-term illness tries to decrease or stop taking
the prescribed medication without consulting with the physician,
this often shows a normal adolescent desire to take charge
of one's own body.
Chronic
illness may cause school problems, including avoidance of
school. This can increase the child's loneliness and feeling
of being different from other youngsters. It is important
for parents to help a child maintain as normal a routine as
possible. They should respond not only to the child's illness,
but to the child’s strengths. Child and adolescent psychiatrists
know that if isolated or overprotected, the child may not
learn to socialize or may have difficulty separating from
parents when it is time to be involved in school or other
activities outside the home. It is often helpful for the child
to be in contact with others who have successfully adjusted
to living with a chronic illness.
In their
prolonged periods of hospitalization and/or rest at home,
children may develop excellence in a hobby or a special talent
such as art, model airplanes, or a foreign language. They
may also try to learn as much about their illness as possible.
Such activities are emotionally healthy and should be encouraged.
Children
with long-term illnesses are often treated by a team of medical
special-ists. This team often includes a child and adolescent
psychiatrist, who can help the child and family develop emotionally
healthy ways of living with the disease and its effects. For
additional information see Facts for Families: Children and
Grief (#8), Children Who Won’t Go to School (#7), Children
and AIDS (#30).
Article
#19 Updated 5/99
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