The struggles of kids with mental illness in a sexualized culture

shutterstock_113334331I just had another teen patient hauled off to the hospital following the end of a sexual relationship.

When teens who struggle with mental illness find themselves engaged in sexual relationships, there’s lots of danger involved. As a physician specializing in child and adolescent psychiatry, I should know. Their parents frequently bring them to our practice with the hope that we can help to keep them alive. Some of them experience same-sex attraction and face unique challenges, especially when they struggle to reconcile their biological drives and the messages of the culture with (in many instances) the teaching they’ve been exposed to from their parents and from the church.

There are reasons why we have laws against 14 year olds driving cars, or 17 year olds buying alcohol. We don’t permit this behavior because we question whether kids at that age have the necessary judgment and emotional maturity to exercise such privileges responsibly.

From a developmental standpoint, there are lots of teenagers who aren’t remotely equipped to manage the intensity of emotions that accompany a sexual relationship. Kids who are prone to obsessive thinking may experience great emotional distress from the normal types of ups and downs that occur in any close relationship. Kids with ADHD or other conditions that impact executive functioning (especially self control and emotional self-regulation)…trauma, mood disorders, substance use disorders-are more prone to act impulsively when processing intense emotions. We think the most plausible explanation for the increased risk of suicide among kids treated with antidepressants involves the disinhibition some kids experience while taking these medications.

A couple of years ago, I said the following in a magazine interview on the topic of the advisability of parent-sanctioned “sleepovers” when teens have boyfriends or girlfriends…

“As a society, we don’t ‘accept’ a person’s choice to drink significant amounts of alcohol and get behind the wheel of a car, even though there are presumably times when people have driven while under the influence without doing harm to themselves or others. Given what we know about the potential consequences of sexual behaviour for teenagers, why would we have an ‘accepting attitude’ about that behaviour?”

One of the reasons I feel so strongly that churches need to welcome kids who struggle with mental illness is that Christianity as described in the Bible offers the prospect of a much healthier identity than that put forth by the hopelessly broken culture that Christ came to redeem. As Christians, we’re defined by who we are in Christ…not by the color of our skin, our place of origin, or who we’re sexually attracted to. After all, in 2 Corinthians 5:17, Paul states clearly that if anyone is in Christ, he is a new creation, and in Ephesians 4:24 we’re encouraged to “put on the new self, created after the likeness of God in true righteousness and holiness”.

So…what’s the “morally responsible” thing to do? I think each and every one of us is called to reflect the love of Christ to everyone we encounter, which in my case includes a lot of kids with mental illness who are at much greater risk for serious complications when they experience the intense emotions that result from acting upon their sexual desires. The research suggests that teen sex (both opposite sex or same-sex relationships) leads to a greater risk of suicide. Is it our unwillingness to affirm the risky behaviors that all too often lead to tragic consequences or a hopelessly broken, messed up culture that tells emotionally vulnerable teens that they’re defined by who they’re attracted to and their desirability to potential sexual partners? The same hopelessly broken culture that Jesus came down to Earth to redeem?


KM Logo UpdatedKey Ministry has assembled resources to help churches more effectively minister to children and adults with ADHD, anxiety disorders, Asperger’s Disorder, Bipolar Disorder, depression and trauma. Please share our resources with any pastors, church staff, volunteers or families looking to learn more about the influence these conditions can exert upon spiritual development in kids, and what churches can do to help!

About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
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6 Responses to The struggles of kids with mental illness in a sexualized culture

  1. kbailey374 says:

    I agree with most of what you said. One thing I wonder about is where you said “[w]e think the most plausible explanation for the increased risk of suicide among kids treated with antidepressants involves the disinhibition some kids experience while taking these medications.”

    I have been taking antidepressants for much of my adult life and have not experienced that. Can you explain?


    • drgrcevich says:

      kbailey…Thanks for commenting!

      Here’s what I think is going on…the pathways in the prefrontal cortex that mediate impulse control and emotional self-regulation don’t fully mature until folks are in their early 20s. The disinhibition is less likely to be an issue in adults with mature executive functioning. That’s why the FDA warnings are present in people treated with antidepressants up to age 25. After age 25, the rates of new-onset suicidal thinking/behavior in controlled studies are lower among patients on active drug vs. placebo.

      We were part of a study looking at this issue in kids. If I treated adults (i don’t), I’d be more cautious in using antidepressants in folks with a comorbid condition associated with poor impulse control (borderline personality, traumatic brain injury, patients with combined type ADHD and patients with a history of mania.

      Liked by 1 person

      • kbailey374 says:

        I have quite an extensive history; my first manic episode when I was 25 so I am right on the cusp lol… my dr. won’t use antidepressants especially SSRI’s on me for that reason.


  2. Reblogged this on Anchor Of Promise and commented:
    Mental illness mixed in with sexual relationships is toxic and dangerous. Dr.Grcevich explains how much these young people truly need to know what real love is, the love of Christ to help them in their struggles and fill the need of wanting to be loved.


  3. Pingback: Why are rates of completed suicide soaring among the young? – Adjustment Disorder With Chagrin Valley Features

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