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Ages & Stages

Generally speaking an adolescent’s first experience with the death of someone close to him will come with the passing of an elderly relative such as a grandparent or a great-aunt or -uncle. (That, or a beloved pet, which can be equally traumatic.) In general, adults may not know what to do or say to help comfort a distraught teenager. When the deceased is a friend, sibling or parent, they are even less prepared to tend adequately to the child’s grief.

A Teenager’s Understanding of Death

By the age of twelve, a youngster’s comprehension of death approaches that of an adult. At five, she may have thought of death as a deep slumber from which the person would eventually awaken, like the princess in Sleeping Beauty. Now she realizes that death is permanent. At seven, she may have believed that only grandmas and grandpas and other elderly folks can become ill and die—but not little kids or their parents. Now she understands that death can occur at any age.

Having the intellectual capacity to grasp the implications of death doesn’t necessarily equip teenagers to cope emotionally with the tragedy. Adolescents typically appear to feel grief more intensely than adults, especially if one of their parents has died. The Adolescent Life Change Event Scale (ALCES), which mental-health specialists use to help quantify the events that are the most stress-inducing in teenagers, ranks a parent’s death as the number- one cause of adolescent stress. Second is the death of a brother or sister, followed by the death of a friend.

The months or years before the mother or father got sick may have been a rocky period, as often happens when a child becomes a teenager. In this situation, the son or daughter may shoulder tremendous guilt. “I should have told my father that I loved him, when I had the chance.” A young girl’s memory of the night she wished her mother dead following an argument could haunt her for years to come. Angry rages may be directed at everyone from God (for allowing this to happen), to the medical profession (for not being able to prevent it). She may even harbor resentment toward the deceased for, in her eyes, having abandoned her. Bear in mind that the teenager who loses a parent is also subconsciously mourning the end of the childhood she’d led up until now.

Because adolescents are so sensitive about how the world sees them, they may feel self-conscious or outright embarrassed by displays of grief and struggle to suppress their emotions. This can also be a means of protecting themselves or their grieving parents. Try not to take offense if your youngster seems indifferent or makes callous remarks tinged with black humor. There is no “right way” or “wrong way” to mourn. For the time being, her way of coping is to harden her heart. Grief is also frequently expressed in one of the following ways:

  • Depression
  • Changes in conduct or acting-out behaviors
  • “Perfect” behavior
  • A decline in academic performance
  • Refusing to attend school
  • Turning to alcohol or illicit drugs to numb the emotional pain
  • Seeking solace through a sexual relationship
  • Overeating or under-eating
  • Sleeping more than usual or not getting enough sleep
  • Physical symptoms

“Becoming concerned about physical symptoms is quite common. When someone close to them dies, they may wonder if they too have a medical problem,” explains Dr. Morris A. Wessel, a retired Connecticut pediatrician and cofounder of the first hospice facility in the United States.

Dr. Wessel, who continues to work in a child-guidance clinic in New Haven, recalls one teenage patient from many years ago who came to his office specifically for a heart checkup. “She said that her grandfather had recently died of a heart attack. I listened to her chest and took her blood pressure and so forth, and informed her that her heart was in tiptop working order.

“She said quietly, ‘I knew there was nothing wrong with my heart. But I needed to hear you tell me that.’ ” According to Dr. Wessel, all physical complaints should be taken seriously. There is evidence to suggest that prolonged sadness and depression can suppress the immune system, and thus lower a youngster’s resistance to infection.

Another possible reaction to a loved one’s death can mislead parents into assuming their teenager is coping well. That reaction is: no apparent adverse reaction at all. In fact, the youngster may excel in school or perhaps immerse himself in sports or hobbies. What may really be at work here is a defense mechanism known as sublimation. The youth is subconsciously attempting to channel his strong emotions into a more socially acceptable outlet. And he may rivet his attention solely to areas where he feels comfortable, as a way of regaining control over a world that has been jolted out of orbit.

The problem is, when we don’t confront grief, we postpone indefinitely the day that we are ready to go on with our lives. For some children, months or years may pass before they allow themselves to feel the full impact of a loved one’s death.


Last Updated
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.