Adolescence is the passage from childhood to adulthood. It is surrounded by issues of rebellion, independence, heightened self-consciousness, experimentation, dating, driving, and concerns for the future. Teens and their parents share the highs and lows of this often-stormy period, and communication between them is essential to temper the turbulence. This is a challenge for both parents and children, as adolescence, almost by definition, brings parents and children into conflict. The intense emotions and feelings of the teen years are both positive and negative: parents are both heroes and villains, best friends and "police officers," and the source of great affection and great frustration. The boundaries of the child's independence, which were tested in early childhood, are re-tested in adolescence.

The tidal waves of emotions on which teens often ride or by which they are consumed affect those around them. Emotions are infectious. Parents must maintain their perspective and must be sensitive to their child's insecurities, peer pressures, and need for support. The parents must communicate with their children about drugs, smoking, drinking, and sexually transmitted diseases. The key to communication is letting children know that they can feel comfortable talking with their parents. If the parents become too judgmental too quickly, they will harm the trust and openness between them and their children. The balance becomes difficult. Parents need to educate their children and let their feelings be known, but they should try to do it in a positive manner. If teens engage in dangerous or irresponsible activities, parents may need to "read them the riot act," but they should try to pause first instead of reacting in the midst of their own emotional storm. Teens often know when they have done something wrong and are embarrassed and frustrated by their actions.

Adolescence does not need any complicating factors, but epilepsy is just that. In a time of life marked by continuous adjustments to dramatic physical, mental, and social changes, a medical disorder such as epilepsy can upset the tenuous balance. Adolescence is a period of heightened self-consciousness, with exaggerated concerns over physical and social image. Even if it is well controlled, epilepsy can torment a teen, arousing fears of isolation, ridicule, and possible humiliation. Restrictions on activities can further accentuate differences from others.

Caring for teens with epilepsy requires special patience and understanding. For children entering their teens with good self-esteem and a sense of independence, the impact of epilepsy can be minimal. But epilepsy can aggravate or create problems of low self-esteem, dependency, mood or behavioral difficulties in adolescents.

Parents may be overprotective and hesitate to encourage their teens to take responsibility for their own care. If the teen is to make a successful transition into adulthood, however, he or she must learn that the epilepsy is their own and does not belong to the parent or the doctor. Teens need information about their epilepsy so they can make appropriate lifestyle choices and assume responsibility for their seizure medicines, with parental supervision. Using a pill box in which each day's doses are stored separately can help both teen and parent to know whether the prescribed amount is being taken.

Children whose intelligence is at least near average and whose epilepsy is well controlled are able to achieve independence during adolescence and adulthood. Children with more severe physical and mental problems confront a different situation as they mature. Parents of teens who cannot achieve independence in the community must begin to explore the options for their future living arrangements, employment possibilities, legal and financial security, and social and sexual adjustments.

If you or someone you know has a teenager with epilepsy you don't have to struggle alone. There are several resources available to assist you in handling the various aspects of caring for a teen with epilepsy. One such resource is the You Are Not Alone Toolkit-for Parents of Teens With Epilepsy developed by the National Center for Chronic Disease Prevention and Health Promotion and the Epilepsy Foundation. For more links to information about teens with epilepsy please go to: www.epilepsy.com/epilepsy_websites

Topic Editor:James W. Wheless, M.D.
Last Reviewed:10/5/06