by  Cynthia Weinstein

Issues for adolescents with Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) fall mainly into three areas: developmental issues, school issues and social issues. Of these, developmental issues are the most crucial and are what distinguish this age group of patients most drastically from adults with CFIDS.

Developmentally, a youngster with this illness (or other debilitating, chronic conditions, for that matter) misses out on specific stages of growth and development.

This presents a specific set of problems for the caregiver. How can you mitigate the effects of these losses? How do you help your child cope with the loss of the "best years of their life"? How can you provide as "normal" an environment as possible? As the caregiver of an adolescent, you serve as a critical role model as you deal with the negative and harmful associations which inevitably occur with doctors, teachers, peers, and family friends and relatives. How can you keep your child from feeling hopelessness and bitterness from these unpleasant encounters?

The changes that occur emotionally and developmentally are very rapid and profound within the adolescent age group, i.e., the difference within a child from the age of 14 to 16, for example is more profound than the difference between 30 and 32. How do you foster a normal progression toward increasing independence? On the one band, the illness forces these kids to a high level of maturity while making them increasingly dependent on their family? How do you cope with "normal" adolescent issues when nothing is normal.

What do you do about the rest of the family? The other sibling(s) who see their brother or sister escape household chores, and monopolize so much of the energy and resources of the family? How can you maintain positive relationships?

Finally, how can you cope with your own pain while watching so much adolescent  energy, potential and dreams vanish into thin air? How can you help a youngster reset goals and plans when the future they face is so uncertain?