Search for tag: "teen mental health"
What to Do After Your Teen Runs AwayIf your teen has run away from home, the first priority is finding them and ensuring they’re safe. But what should you do after they safely return home? Amanda McNab, MSW, LCSW, suggests the…
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August 12, 2022
Kids Health
Family Health and Wellness
Mental Health Interviewer: It's a situation that no parent ever wants to deal with, but their teen has run away. Once you have located your teen and got them back home, what do you do next? How can you make sure to resolve whatever is going on and why they ran away in the first place? To help us understand the situation and what steps to take next, we're joined by Amanda McNabb. She is the quality improvement and training manager at the Community Crisis Intervention and Support Services with Huntsman Mental Health Institute. Amanda, it is a situation that really I think most parents fear sometimes. And when it happens, what do you tell parents, and what is the first step that they should do when they get their kid back? Amanda: Usually, when a parent is dealing with a situation in which a teenager has run away, one of the things that we really suggest is having another support system with them. So maybe having a mediator, a family friend, somebody who can come in and help keep the emotions that are going on at a minimum so that the conversation can happen about why. A lot of families will then just say, "Don't do it again. This isn't good. Now you're going to be in trouble." And they don't really focus on what was the reason behind the idea of running away for that teenager. Interviewer: What are some of the common reasons that they would run away? I mean, I know that every family is different, but with all the amount of people that you interact with, there have got to be some common threads. Amanda: Absolutely. And those common threads can run from just a teenager who doesn't like the rules in the house and wants to have some extra freedom or things like that. It may be that they're dealing with a lot of pressures and feel like between school and home and friends and everything else that's going on, they just can't handle it and need to get out of the situation. There may be some concerns about gender identity or feeling accepted for who they are. And that may be another reason that a teenager might leave the home or leave the situation. The teenager also could be dealing with mental health, depression, anxiety, maybe thoughts about suicide. And the idea of running away is the first step towards "What do I do with my mental health itself?" Interviewer: So Step 1, get a mediator, get someone in between, calm down some of the, I'm sure, very high-intensity emotions that are happening in that situation. What are some strategies and next steps that we can share with parents who are trying to help identify what is going on with their teen or with their home situation and where can they go next? Amanda: I think in the beginning, as you said, being able to calm down and really bring those emotions back down to where everybody can actually communicate with one another. When we're in a high emotional situation, we're not often listening to the other person. We're not having a true conversation. We're always thinking about, "How am I going to respond?" Or with teenagers, it's, "Okay, how am I going to hold this person to consequences for their actions and their behavior?" And instead, we really want to focus more on, "Okay, what is going on in this situation? How can I try to see their perspective?" With teenagers, and really adults, we each have our own perspective on the situation, which doesn't always match up with somebody else. So we want to focus in on really being able to use those reflective listening skills and those active listening skills to communicate and say, "Tell me more about what's been going on," so that we can come to a positive conclusion and hopefully make things better. Sometimes with that piece, we really will say to families and parents, "Call the crisis line." We are here not just for suicide or major mental health concerns. We are here for crisis. And when a family has a teenager who's run away, I define that as a crisis. That is something that is creating a lot of discord and emotional upheaval for a family. And so we're here to try to walk you through those next steps or be able to intervene and say, "Maybe we need to do a mental health assessment on the individuals involved to make sure that everybody is in a safe place to have those conversations." Interviewer: So with a service like the crisis line with the Huntsman Mental Health Institute, for some people, this might be the first time they are reaching out to a service like this. What can they expect when they call that phone number? Amanda: When they call, usually, you will get ahold of one of our certified crisis workers who will then just ask, "How can I help you today? What is going on that made you call in?" And once we've started to define what's happening, what's the situation, what is the actual need in the moment, and sometimes that need is just, "I need to vent. I need to talk about what's going on," or it could be, "I have questions about what resources are available to me," then we can start to collaborate together with the caller and say, "Okay, here's what may be available. Here's what may be an option." And it doesn't always have to be the parent. It can also be the teenager. The teenager is always welcome to give us a call or use our SafeUT app or anything like that to reach out to one of our crisis workers and say, "I'm struggling with what's going on. I need help." And hopefully, they get a warm reception and are able to feel comfortable talking about some of those issues that maybe they haven't been able to bring up with other people before. Interviewer: Now, who is the crisis line for and does it cost anything? Amanda: The crisis line is for anybody and everybody. It is free to the consumer. We are here 24/7. Same with our SafeUT app, which is just a texting way of getting hold of the crisis workers. And it really is for parents, teenagers, anybody who's seeking that extra help. Interviewer: So for a parent who is dealing with a runaway and it's time to figure out what's going on and heal together, what is the number to get in contact with the crisis line? Amanda: Parents can reach us at 1-800-273-TALK, or the national number at 988. Interviewer: Just 988? Amanda: That's all it is.
If your teen has run away from home, the first priority is finding them and ensuring they’re safe. But what should you do after they safely return home? Amanda McNab, MSW, LCSW, suggests the steps parents should take to understand why your teenager ran away in the first place—and start to rebuild the relationship in a healthy way to prevent future runaways. |
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What to Do if You Suspect Your Child Is Using DrugsSubstance use in children can start as early as middle school. While experimentation is common in teens, it's important as a parent to know how to have conversations that can prevent abuse and…
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March 17, 2022
Kids Health
Mental Health Interviewer: What should you do if you suspect your child is doing drugs? It's a scary moment for any parent. I mean, how do you know for sure? What's the best strategy for talking to them about it? How much can you do on your own and when should you see a professional? I'm going to answer those questions with our expert today, Dr. Mary Steinmann. She's a psychiatrist who specializes in child and adolescent psychiatry. Dr. Steinmann, let's start at the beginning here. We're going to cover a lot of ground today. But what is the first thing a parent should consider if they have a reason to believe that their child may be using some sort of a substance? Dr. Steinmann: So I think there's definitely a difference between experimenting with substances and actually developing a substance use disorder. And so it can actually be fairly normative or expected behavior in children and adolescents to be curious about or experiment with substances. But we also know that using substances can really place individuals at risk of developing later substance use disorders. So it's something that we want to take very seriously and be able to help parents identify signs in their own children that may warrant additional questioning or additional evaluation or perhaps even getting additional help and support and resources. Interviewer: Yeah. So if experimentation can be normal . . . I would imagine as a parent, as soon as I saw my kids or had the idea my kids were using drugs at all, I would be like, "Oh, they've got a problem." But you're saying that that's not always the case? Dr. Steinmann: That's right. It's definitely concerning behavior. It's not something that parents need to be complacent with. I think it's important to actually dissuade substance use and to talk to kids about the dangers of substance use and the potential consequences of substance use, because there are a lot of them. Kids don't tend to think about long-term risks very much. Their brains aren't hardwired to think about long-term consequences until, honestly, sometimes their 20s. And so that's where I think it's helpful for parents to kind of take a role of, "These are the rules in our house. This is what our views are. These are what our values are. Here's what's acceptable and unacceptable behavior for our house. But I am also here and open to answer questions or listen to what you have to say. Or if you find yourself in trouble, intentionally or unintentionally, I am here for you." Interviewer: So I'm a little confused. If you suspect that your child is using a substance and maybe . . . I don't know. Do parents generally have a good idea if it's early on? When you said, "Don't be complacent," do you just kind of sit back until you start seeing a problem develop, or do you jump right in as soon as there's some sort of substance use and say, "I understand this is just a natural thing. If you ever want to talk about it, we should"? I mean, I don't quite understand that differentiation. Dr. Steinmann: I think a lot of the differentiation depends on families, right? So there are some families where even alcohol use or smoking is not a practice in the home, and so there might be a different baseline for a family addressing substance use and experimentation and how they approach that topic in their children, versus maybe a family where there is recreational alcohol use, or occasional nicotine use, or what have you. And so there are some baseline cultural differences that I think go into play. We certainly want to educate our kids up front about what the dangers are, and say, even if you're comfortable as a parent, "This is kind of my own experience with using substances," talking about responsible use, if that is a value in your home. And in other homes, that might not be acceptable at all. But kind of laying down, "This is what our family values here, our baseline. I understand you may be tempted to experiment with things. Here are my concerns about that." And then also knowing your child and knowing their baseline and being able to identify if they're starting to behave differently, if they're starting to hang out with a different peer group, knowing what their peer group is and who their friends are. Having those consistent expectations is really important, but then also providing that guidance, that education, "This is what we value in our family." That may be no substance use whatsoever. That may be, "This is the concern I have about you using substances right now as an adolescent." And that's the stance I tend to take as a child and adolescent psychiatrist. It's, "I'm concerned about the effect that any substance has on your developing brain. I understand you might be tempted to use. I discourage that, but I am also here if you have questions," and not to shut down that conversation prematurely. If curiosity develops, if they're like, "Well, I see you drink all the time. Why can't I?" being prepared to kind of have those discussions so that then that increases your chances of having your child actually be honest with you if and when they start down that path, and being available to support and guide and eventually seek help, if needed. Interviewer: So it sounds like if you suspect your child is using substances, and maybe they're just at the point where they're just kind of experimenting, that's a great invitation to have a conversation at that point? Dr. Steinmann: Exactly. And even before use. I think sometimes we overestimate the age at which kids may actually be exposed to substances in schools, but we may be having these conversations too late sometimes and setting those expectations too late sometimes. And so being aware that a lot of times, by middle school, kids are already exposed to peer groups or other folks who use, and maybe thinking about this for themselves. We may be wanting to even have those conversations earlier, depending on the environments in which our kids socialize. Interviewer: And it sounds like a parent's kind of mindset is super important for this first conversation from the standpoint that I think . . . Well, first of all, what are some of the reactions that you see parents have when they find out their kids are using drugs? I can imagine there could be some anger that is probably born out of fear, because drugs can be detrimental to somebody's life. There's probably the thought that only bad kids do drugs. Are there some other reactions you see? Or what do you see? Dr. Steinmann: Fear is a big one. And I love what you just said as far as anger often being born out of fear. Anger is a very reactive emotion. We all get angry over a lot of things. But if we dig deep, a lot of times it does come from that fear, either because we're terrified of . . . We just want the best for our child. We want them to grow up to be the best version of themselves that they can be, and there are serious consequences to problematic and ongoing substance use. There can be dangers to even intermittent substance use. And so fear is a very, very common and normal response to parents. Also, that anger component of fear or fear that gets manifested as anger tends to be the emotion that then puts our kids on the defensive and shuts them down. And so even though it's a completely valid emotion and an understandable one as a knee-jerk response on the parents' end, it may be the one that we want to kind of work on our own response to continue to invite that conversation instead of making the child feel that they're a bad kid because they thought of going to a party with their friends or even tried to ask a question or to get clarification for themselves or to seek help. Very often it's that fear of anger and punishment that keeps kids from seeking help. Other common responses I get are often, "Only bad kids do that." And I think probably what parents often mean by that is the behavior is certainly concerning and undesirable, but that doesn't mean our child is a bad kid. There's a difference between the behavior and who someone is as a person, and sometimes kids can overly internalize that. And so, if a parent's response is, "Well, only bad kids do that," or, "My kid possibly can't do that," that's a form of denial that probably needs to be addressed, especially if you're starting to see telltale signs of substance use or behavior changes. And we can talk about that in a little bit. Or it can be, "Well, why are you judging my friends? They're not bad people. I know who they are. You don't," which can also raise defensiveness and unwillingness on the part of the child to engage more in that conversation. Interviewer: Let's say a parent has suspected that their child is using a substance. They've had the conversation, they followed your advice, but then they start noticing, like you mentioned, some personality changes or they start becoming more concerned that it is escalating to a different level. Is that the point that you would get your child help, or is there another intervention that a parent would do first? Dr. Steinmann: I think there are a couple different routes to go. So we have that conversation. Maybe we were lucky enough to have that conversation upfront before use even started, and the conversation had exactly the effect that we intended to have, which is to deter use. That's kind of the best possible scenario. "Hey, let's talk about the dangers of this." The kid acknowledges, "Yep, that's not a behavior that is good for me," and we move on. Maybe experimentation happened, and then I think it's important to have the conversation potentially of, "What was that like for you?" Understand what drives a behavior. We don't tend, as human beings, to engage in behaviors that don't work for us, especially in the short term in teenagers. And so some may admit, "Hey, I've been really stressed out and I tried alcohol," for example, "and it helped me to feel better." Wow. As a parent, I would want to know, "Well, what's been stressing you out? Is there something else that's healthier that we can kind of engage in? Because, once again, I have my concerns about kind of going this route to address stress and manage stress. Are there different things that we can work together on to help you out with?" and seeing if we can get to the underlying driver of that behavior. If the behavior continues despite, "Hey, we have a house rule we don't smoke, we don't engage in underage drinking, we don't engage in any forms of substance use" . . . which again is my stance, really, as a physician, because I'm concerned about that brain development . . . and the use continues, then we might need to consider additional types of interventions and understanding what's underlying that continued substance use. I'm also going to be keeping a close eye on function. Function is really, in psychiatry and in medicine and mental health, what we look for to really start to make that distinction of, "What's the difference between substance use and a substance use disorder?" And when we say the word "disorder," what we really mean is there is some impairment in academic functioning, in relationships, and that could be friends, family, etc. Are we engaging in additional risk-taking behaviors? Are we putting ourselves in safety risk by result of use? Are there legal consequences? Are we carrying vape to school, for example? All of those things would be red flags for more serious problematic use and possible disorder that might warrant additional treatment. Interviewer: When a child is using a substance, is there generally some other underlying cause? Is it really truly just kind of a symptom of something else going on? I mean, either experimentation out of curiosity or an underlying condition, or are there other reasons? Dr. Steinmann: It can be all of the above, honestly. What can start as experimentation can then kind of just spiral out into use for other reasons. Some people may never engage in use but may find themselves starting with symptoms of anxiety or depression and then are just trying to find a way out of feeling that way. And they may have tried other things or talking to friends or things like that, or hear that, "Well, taking this has helped for me. Maybe it would help you too." And so it can sometimes be a chicken-and-the-egg type of scenario, honestly. Interviewer: All right. Sounds like we have two steps so far. A parent suspects their child is using a substance, they have a conversation because it's just experimentation. Then that behavior continues, they have another conversation again asking this time, "Is there something else going on?" or, "Why are you using it?" or, "How does it make you feel?" reiterating the rules or the policies in the household. What would be the third step if it continues on past that point? Dr. Steinmann: I would say then it's probably time to get some external support and some help. And honestly, it's never too early to get external help and support. Again, if this is just a conversation that, for any reason, a parent might struggle to have with their child or not know how to approach it, it is perfectly fine to seek out professional help to help learn how to have that conversation. And there are a lot of other internet resources that are available if you don't have the ability to talk to somebody. But I would seriously then consider looking at other resources, including a therapist or a primary care physician. Not all cases of substance use disorder have to go directly to a psychiatrist, just like not all cases of depression and anxiety need to go to a psychiatrist. Sometimes talking with external supports, such as your child's pediatrician or primary care provider, someone that has an established relationship with them and knows them, can be a good middle-ground next step to get additional support before jumping into subspecialty options, although those are definitely certainly available. Interviewer: Is there a negative message given to a child when you say . . . because there's a certain weight to saying, "All right. We've got to go to the psychiatrist now." You know what I'm saying? For this problem. That comes with a whole bunch of other stigmas. Dr. Steinmann: It can. And unfortunately, getting mental health care and having mental illness needs is still really stigmatized in our society. I think that's why I generally recommend starting out with primary care if someone is having questions. Now, granted, there are times where you would want to bypass primary care. For example, if your child has been absolutely refusing to go to school or you're noticing that they're skipping school a lot or they're getting suspended or even expelled for issues related to substance use, or you're concerned that there's an imminent safety risk, such as heavy use or heavy binge use or physical consequences from that, or you suspect a really severe underlying driver for substance use, including depression or anxiety, perhaps even things like suicidal thoughts, or if you suspect another serious mental illness, those would be things that would be quite appropriate to go up to a higher, more specialized level of care. It can take a while to access the mental health system as well, and you don't want to get stuck in the lurch while your child is really struggling, especially if their imminent safety is on the line. Interviewer: When you talk about substances, drug use, what does that entail for you as a physician and a psychiatrist? Dr. Steinmann: That's a great question. I think a lot of times, when we talk about substance use, our minds automatically go to the hard stuff like heroin or cocaine or methamphetamine. We also think about alcohol and nicotine and marijuana, which are a little more readily available. But there are also, especially with teenagers . . . Think about access and what you're more likely to be able to get a hold of or afford. Or what are the underlying concerns that might be problematic in teenagers, such as anxiety or depression? This is another great example of a misperception, actually. Sometimes we think, "Well, my child is very high functioning and they do great in school. They can't possibly have issues with substance use." But I work with a lot of teenagers and young adults who may have some mild ADHD or anxiety who are very high performers and may feel compelled to be even higher performing. And so they may actually get wrapped up in overuse or misuse of cognitive enhancers, like caffeine or prescription stimulant medication. And so having an idea of kind of the breadth of things that can be misused or abused is important. It's scary and it can be overwhelming to think about, but it's important to, again, think about those underlying drivers of behavior and the type of direction that might lead even into substances we might not typically think about as being abusable. Interviewer: And some of these ways of talking to the children about substance abuse might be kind of against a particular parent's parenting philosophy. We are all raised in our own ways by our own parents, and a lot of times, that's the way we raise our children. Is this evidence-backed stuff? Should somebody just go ahead and use their instincts instead going into this conversation? What are your thoughts on that? Dr. Steinmann: I think that parents are the experts on their children, and so using your instinct can be a very powerful tool. If you are noticing that your child is not acting like themselves, I do think it's important to ask more questions and probe. And again, by asking, you're kind of almost opening the door to, "I'm interested, I'm curious about you. I care about you." Sometimes the hardest thing we can do, as parents, is to open the door to conversations that we might not be comfortable having, but by doing that, we're actually modeling for our kids that it's okay to talk about these things, that maybe their assumption that we're going to blow our stack or over-assume might be unfounded, that we want to be and try to be safe people to talk to because we have their well-being at hand. I liken it in some ways to talking about suicide, for example, and suicide prevention. There's significant data that shows that simply asking about suicide does not increase the risk of suicidal behavior. And I think the same is very true for substance use. Just because you're asking doesn't mean that you are giving permission or suggesting that they should engage in that behavior. All asking does is signaling your child that, "Hey, I'm aware that this is a problem and I want to be a person that you can rely on and trust to talk to about it." Interviewer: For a parent listening to this interview that wants to go on to get some more information, what are some good reliable sources that they could go to online to get some help framing this or figuring out the approach or whether or not they should be concerned at this point? What do you recommend? Dr. Steinmann: For reputable sources on the internet . . . because you're right, there are a lot out there and it can be really overwhelming to kind of weed through and find the best sort of reputable information. I really like the Substance Use Resource Center through the American Academy of Child and Adolescent Psychiatry. The Substance Abuse and Mental Health Administration, or SAMHSA, also has a lot of good resources. And something that I found fairly recently as a resource, that I thought was very parent-friendly type of language, is through the Child Mind Institute. And they have various questions about how to talk to your teen about substance use for parents who may not be sure on how to start that conversation.
Substance use in children can start as early as middle school. While experimentation is common in teens, it's important as a parent to know how to have conversations that can prevent abuse and protect your kids' development. Learn about the strategies that can help parents speak with their teens about the consequences of substance use and identify the best time to intervene with professional help. |
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How to Identify and Discuss Self-Harm in TeensAs a parent, if you suspect your child may be engaging in self-harming behaviors, you may not be sure what to do to help. Psychiatrist Dr. Thomas Conover explains how to identify signs of self-harm,…
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March 01, 2022
Kids Health
Mental Health Interviewer: You've noticed some signs that your child is engaging in self-harm which can be scary and confusing as a parent. So what do you do? Dr. Thomas Conover is a psychiatrist board-certified in both child and adolescent psychiatry and general pediatrics at Huntsman Mental Health Institute. Find out how to identify if your child is engaging in self-harm, how you should respond, and resources for help and treatment. What is Self-harm? Dr. Conover: Self-harm is any deliberate attempt or act to injure oneself. So the term is pretty straightforward, but self-harm includes, from a psychiatrist's standpoint, both non-suicidal self-injury, which is any self-harm that's inflicted without any intent to die and also suicide attempts. Suicide attempts are a form of self-harm, and the difference between the two as we define them is whether the person who's inflicting injury on themselves means to die by doing it. Interviewer: When I hear self-harm, I tend to think of cutting. Is that the only type of self-harm, or are there other types? Dr. Conover: Making cuts and scratches on oneself is the most common type of self-harm. We sometimes see teens do other forms such as burning themselves deliberately or hitting themselves, striking themselves with a fist, or headbanging. Those are other forms that are fairly frequently seen. There are numerous other less common acts, but cutting or scratching on oneself is definitely the one that we see most frequently in emergency rooms or psychiatric specialty care. Why do Teens Engage in Self-harm Interviewer: What leads to that type of behavior? Dr. Conover: We don't know the exact reasons why any individual might engage in self-harm. You know, for each teen, it may be different. Some of the reasons may be a distraction or relief from some other thought or emotion. Sometimes it may be kind of the cliché or proverbial cry for help, you know, trying to express some emotion or demonstrate distress that is too difficult for the teen to articulate in words. Those are two of the most common reasons teens engage in self-harm behavior. How Do Parents Discover Their Children Are Engaging in Self-harm? Interviewer: Have you experienced the teen talking about self-harm before engaging in it with any of your patients? You said that self-harm is a form of communication and could indicate to a parent that I want to have a conversation about something with you, I don't know how to do it, so I'm doing it this way. But could it happen in terms of words before behaviors? Dr. Conover: It certainly can. It may often be expressed to someone other than the parent, a friend or acquaintance, somebody that the teen is communicating with over texts or social media. And that's often a way that parents discover that their teen is either thinking about or engaging in that behavior. One warning sign and one piece of good advice for any parent of a teen is to monitor the teen's social media use and texts with some frequency because sometimes that's who they may try to talk about. Now, if a teen is coming to a parent or other trusted adult and expressing thoughts that they may harm themself, I would say, while that's a concerning situation, it's certainly a situation where at least the teen feels trusting enough and supported enough to bring that up verbally before doing it or even after doing it. And in some sense, in that situation, the teen and their caregiver are a step ahead of where they might be if the self-harm thoughts or behavior are completely concealed. Recognizing Self-Harm Interviewer: Is it generally pretty easy in your experience for parents to recognize if their teen is engaging in self-harm? Dr. Conover: I don't think it is, but I think the barriers to recognizing it are complex. One of the main barriers is that no parent wants to think that their child is experiencing distress that would lead them to deliberately harm themselves or attempt suicide. And so a certain degree of conscious or unconscious denial is a huge barrier to recognition. So I think to anybody who is listening to a podcast like this, to anybody who wants to know more about teens' mental health, I think having awareness is a way to bring that barrier down. As much as a parent doesn't want to think that their child might be experiencing that distress, some awareness and a level of openness to the possibility brings that barrier down. Supervision and support is another thing that brings that barrier down. When a parent pays attention to their teenage child, when a parent knows what they are doing, who they're hanging out with, who they're communicating with, when a parent inquires actively and openly with their teen in a way that lets the teen know that they're caring and concerned, those are also things that bring down the barrier and make it more likely that the teen might talk to the parent about such behaviors. How to Talk to Teens About Self-harm Concerns Interviewer: I would imagine if somebody is listening to our conversation right now and they found it via an internet search, they probably should trust their instincts. Would you say that's a safe thing to say? Dr. Conover: If the parent has suspicion or concern, they should not dismiss that. The most direct first step is to initiate a conversation. Initiating a conversation about self-harm needn't be accusatory. It shouldn't be because that's a sure-fire way to have a teen shut down in conversation for a parent to approach them and say, "Are you cutting yourself? You should never do that," implies a judgment or seems like you're interrogating. A better opening line might move from the general to the specific: "You know, some teens might even think about hurting themselves or even hurting themselves on purpose when they're feeling upset or distressed. Have you ever thought of doing something like that?" You know you can hear the difference when you're saying, "Hey, this is not something that you alone might have thought of or done. This is not something that I'm expressing any judgment about. I'm just saying it's something that people might do, And I'm wondering if that's something you've ever thought about." Asking about thoughts is a little bit of a softer entry too. Because the teen doesn't necessarily have to confess, "Oh, yeah, I did cut myself once." Maybe they're not ready to say that, but they might be ready to say, "Well, yeah, you know, I've known some people who have done that, or I've heard that people do that, or I've even thought about it myself." And then the conversation can proceed from there. It doesn't have to be accusatory or judgmental, and it shouldn't be, but is it going to be a difficult and crucial conversation? Absolutely. There's no way to make that kind of an inquiry easy. Interviewer: You bring that up with your teen, you ask them if they've ever thought about it, but there are obvious signs that something, you know, is going on. Is that the point that you say, "Well, I couldn't help but notice that on your arm there are scratches or on your legs, there's bruises?" Dr. Conover: Yeah. Being gentle in inquiry is important, but we don't have to take it to the point of absurdity, right. You know, if what the parent is concerned about is something concrete like, "I found a text where you said to your friend that you were thinking of hurting yourself, or when we were at the beach last Saturday, and you were wearing your shorts, I noticed that you had some cuts on your leg." I think that it's fair for a parent to start with the concrete thing that the parent observed. That's reasonable. Again, not being accusatory or judgmental, right? Not, "What on earth are those that I saw on your leg during our trip to the beach?" Interviewer: Yeah. "What are you doing to yourself?" Dr. Conover: "Who does something like that?" Exactly, right? But just saying, "I noticed this, or I found this, or when I was looking at your texts from last week, I saw something that concerned me." I think that mustering some calm and then inquiring with the child is perfectly appropriate. And I think that does point to signs that a parent may look for. You know, it is my experience that most often it isn't the case that the teen will come to a parent and simply say, "I'm thinking about this, or I'm engaged in this behavior." It would be nice if they did. It's a good sign about the parent and child's communication if a child can openly state that. However, I often see parents discovering signs that this might be happening. Signs that one might look for include finding items that someone might use to harm themselves in a place where you wouldn't expect to find that thing, like a kitchen knife in a bedroom, or old-fashioned razor blades, you know, that you might use to peel paint or do things like that hidden somewhere in a child's room, pieces of glass or metal. Certainly, if any of those items look like they've been used because they have, you know, blood or something that looks like that on them. So finding items that a youth might use to harm themselves, that's one very common sign that parents might first come upon. A very common way is through monitoring social media or texts. I think it's very important to note that monitoring social media and texts should be given and what I advise parents to do before they let kids use those technologies is to set down a very clear contract and expectation that they will be monitoring their activity because that's necessary and it also avoids the conflict that would arise if a parent was monitoring those things without having set that expectation. When Should a Parent Seek the Help of a Professional About Self-harm Concerns Interviewer: When a parent recognizes these signs, and they have addressed them with their teen, and they've started out the way that you've recommended, being very non-accusatory, talking about the physical things that you're seeing as opposed to passing judgment and you get that conversation going, you had mentioned that sometimes self-harm is a way of communicating that there's something else going on. I love keeping that in mind. I think as you're having this conversation is ultimately the point then to get to what the actual problem is that's causing the symptom of self-harm or is that the time you would want to involve a professional, or where would you go from that point? Dr. Conover: An older view in mental health was that deliberate self-harm or suicidal thoughts or acts were always secondary to some other problem or a symptom of another disorder, and that you would need to treat the disorder in order to treat the self-harm behavior or the suicidality. To an extent, that is true, but a more current and up-to-date view is that while self-harm and suicidal acts can be associated with another problem like depression, or trauma, or abuse being two of the most common, they do constitute a problem in and of themselves. I don't think that a parent is best served to then become the behavioral health provider or a detective, right? You know, to say, "I'm going to get to the bottom of this. I'm going to get to the bottom of this and find out what's ailing you and what's causing this problem you're having." That's not something a parent wants to pursue on their own. I think the first step of asking your child, "Hey, what's going on? I noticed this, or I noticed that. I'm concerned about you." That is definitely the parent's job. The parent's next job is then to help their teen by seeking some additional help and support. Self-harm thoughts, self-harm behavior, those are always a concern and virtually always merit some further support, whether that be through seeking some crisis services, or counseling, seeking some outpatient therapy, getting some additional support from a medical provider like a primary care doctor or other practitioner who maybe already knows the family and the child as a first step are what I would advise if that first conversation happens, really, no matter how that conversation goes, because a parent can do the right thing and ask the question, but the teen may still respond with denial. And I don't think that I would be giving good advice if I said, "Okay, ask these questions and ask them in a non-judgmental way." And you think they might be hurting themselves and you ask, and they say, "No, mom, I'm not doing that." You can't really close the book on the conversation with just that negative reply if you've seen signs or have a strong suspicion. Interviewer: So the purpose of this conversation is to really have a mutual acknowledgment that this thing is happening. That's the place that a parent wants to get to with their child, expressing concern them so then that they can have a conversation about what we're going to do about it, which is ultimately going to lead to going to a professional to assist at that point. Dr. Conover: That would be the way that I would advise that things would go. Not all teens who deliberately harm themselves make suicide attempts, but there is a strong correlation between the two. So engaging in self-harm without an intent to die is a strong risk factor and has a strong correlation with eventually making a suicide attempt. And so taking it very seriously when there are signs of such behavior or when there is an admission or confirmation of such behavior is really important because ultimately, you know, we're not concerned about the long-term health implications of having a few cuts or scars on your arm or your leg. What we're concerned about is bigger issues of health and wellbeing and ultimately safety and preventing any very serious injury or death. Resources for Parents Concerned about Self-Harm Interviewer: Do you have resources that could go beyond this conversation that could help a parent that finds themselves in the situation where they have to have this conversation? Dr. Conover: Resources that a parent might reach out to would include primary care providers. I think that primary care providers are a great first resource for families for a number of reasons. Primary care providers such as a pediatrician or a family practitioner generally have an ongoing relationship with the teen and the family. And so any discussion or decisions that are made will have a lot of context, and that there's a higher likelihood that the teen and family will feel trusting and agreeable to any advice or interventions that a primary care provider can give. Also, unfortunately, we don't have enough mental health providers as far as specialty mental health providers like psychiatric providers and therapists, and so it may be easier and more accessible to start with primary care. At any point where self-harm thoughts or behavior, including suicidal thoughts or suicide attempts are a concern, a parent can always access the crisis services that are available. Here locally in Salt Lake City and in the entire state of Utah, the Utah crisis line is one such resource and the Huntsman Mental Health Institute crisis line, which are actually staffed by the same, very skilled, highly-trained crisis-intervening staff. A parent might question, "Oh, is this big enough of a problem for me to call the crisis line?" As a practitioner, I would always give the advice, don't second guess yourself on whether you think this is a crisis. You are not going to call the Utah crisis line with a question about your child's self-harm or potential suicidal behavior and be told, "Hey, this isn't a problem. Why did you call us?"
As a parent, if you suspect your child may be engaging in self-harming behaviors, you may not be sure what to do to help. Learn how to identify signs of self-harm, provides strategies for how to discuss your worries with your teen, and resources available to help parents in this scary situation. |
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Should I Talk to My Teen if I’m Worried That They’re Depressed?If you suspect that your teenager may be suffering from depression, could talking to them about it make them feel worse? According to Dr. Thomas Conover, as a parent of a teen, communication is key…
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March 09, 2021
Mental Health
Kids Health Interviewer: You've noticed a change in your teenager's mood. They're angry, moody, defiant, irritable, and in addition, their school performance or maybe interest in other activity is significantly decreased. You're worried about depression. Is it okay to talk to them about it, or could it cause more harm than good? Dr. Thomas Conover is a psychologist at University of Utah Health, and what is your advice for parents about how to talk to their teens about these tough topics? Or should they even talk to them about them? Dr. Conover: Communication is a real key. It certainly is protective and helpful for parents to communicate and inquire with their teen as to what's going on and how they're feeling. And that's something that I think most parents strive for but may struggle with. How do I talk to my teen? What do I talk to my teen about? Is it okay to ask? I would advance to say that it's always okay to ask your child about how they're doing. You seem really sad lately. Is there something bothering you? Is there any way I can help? Interviewer: No. I mean you probably have to dig a little bit sometimes, huh? Dr. Conover: You may. I think that there's value in setting an example and leaving the door open by saying those two things. In terms of setting an example, certainly communicating openly oneself is important. Right? So I've talked about various areas of function that a parent might look at for a teen child and use to try to evaluate how serious a problem that they're suspecting maybe. But a parent can show that those things are important themself. Right? A parent can demonstrate that being engage with social activity and self-care and physical activity, you know, which boosts mood, all of those things are important. So a parent may set the stage in their own family by doing those things. It's always okay to ask your child about how you're they're doing. And even though a lot of times teens may seem outwardly like they don't want someone to ask, I think most of the time people who are struggling even in a small way do want someone to ask. I think it's helpful not to badger. I think if you're met with that initial no on a first inquiry, it's good for a parent to perhaps say, "Well, okay. You know, I hear that you're saying that there's nothing about it that you want to talk about. But just know that I'd be happy to talk to you if you do . . . if you change your mind about that, if you do want to talk about." I think that's a tough one. It's a tough balance to strike, because I think if a parent is a concerned at all about their child and they try to make that initial ask, first off that's a hard thing to do. You know, you might be thinking about it all day or all week and then, finally on Friday you say, "Oh, we're sitting at dinner and my kid's actually home with me. I'm going to ask." And then, the first thing that they snap back with this, "No. Everything's fine." And the parent might feel kind of rejected by that and, you know, they might respond by shutting down. Right? Going like, "Oh, well, okay. I guess I shouldn't have asked." I wouldn't advocate for that black and white of a response, nor would I advocate for a parent then saying, "Well, no, I know something must be wrong. I've been watching you all this time, and you just aren't acting yourself. You need to talk to me right now." You know, in most cases, that's not going to be the best approach either. It's, I think, always appropriate to ask and it's always appropriate to maybe give a little space and a little time for the teen to be able to absorb the question and respond. Now, that would be with the exception of a true emergency, and those emergencies do include threats or acts of self-harm or threats or acts of a suicidal nature or serious aggression.
If you suspect that your teenager may be suffering from depression, could talking to them about it make them feel worse? As a parent of a teen, communication is key and it should always be okay to ask your child about how they’re feeling. Learn strategies to talk to your teen about their mental health and how to identify when you should seek professional help. |
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What Are Key Indicators of Depression in Teenagers?As a parent, Identifying signs of clinical depression in your teenager can be quite difficult. Dr. Thomas Conover looks for negative changes in these key areas: school performance, participation in…
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February 16, 2021
Kids Health
Mental Health Interviewer: Are you concerned that your teen might be suffering from depression? Now, sometimes it can be difficult to tell the difference between moodiness and actual depression, and that moodiness can be common in a lot of teens. But psychologist Dr. Thomas Conover says you should look at how your children are doing in what he refers to as key life areas. That's school, extracurricular activities, social, and family life. Dr. Conover, let's just start with school. Why is school performance one of the clues that you use when evaluating children for depression? Dr. Conover: For teens, school is their primary area of function. It's, in my mind, equivalent to holding down a job or a career for an adult, right? And so if an adult is still functioning in their primary vocation, then that's a good sign. Same way for a teenager. If he or she is still doing well in school and not seeing a decrement there, then whatever is going on with the teen, you've got some reassurance that things haven't gone completely south. Interviewer: What about extracurricular activities? Some kids just aren't into school, or don't necessarily perform well in school. Dr. Conover: Well, I look for their performance in school with comparison to earlier performance too. So if you have a kid who was somewhat of an indifferent student and just wasn't that academically inclined throughout their school life, kind of a solid B/C student, then that's what I would be looking for the child to be doing going forward. So I'm not concerned if there's sort of indifferent performance when that's been the norm. It's really looking at, "Has that gone downhill?" Do you have a child who normally got straight As and is now getting Bs and Cs, or a child who normally gets Bs and Cs who is now failing or having incompletes? That would be more concerning in terms of school performance. And for those youths . . . let's say you have a child who's an average student and maintaining that performance, but who is an avid athlete, plays a sport year-round, and is withdrawing from that. That could be a concern as well. So looking at function in the academic realm is important, but there are other areas of function too, right? So other activities are very important to look at. Social function. A normally developing or typically developing teen is a very social creature. It's a time of life where you're learning how to be independent, and you're transitioning in typical development from being reliant on your family as a primary source of your activities and values to your peer group, which in my mind and experience serves as somewhat of a transition to being fully independent. Having your own ideas about things, your own values, your own priorities for your activities. So, in that vein, your typically developing 15-year-old is going to really want to be out there and socializing with peers. A lot of times, nowadays, that does take place over cellphones, social media, and the like. And so it's important to take that into account, that just because a teen isn't going out all the time doesn't mean that they're not socially engaged. But a parent can reasonably expect that their teen is going to be interested in what's going on out there with their peers. And if they're more withdrawn or less interested in that than they used to be, that's a concern. Then there's also family function, and it is normal and expectable to have a teen be less interested or less enthusiastic about certain family activities than he or she used to be. That is normal and expectable. Then I would go back to the idea of, "Well, just how pervasive and intense is it?" Do you have a teen who says, "I don't want to go to family dinner at grandma's this Sunday. My friends are going out. I want to meet up with them," but who ultimately you can cajole and negotiate and get the teen to do it? Or do you have a teen who has a big blowup over that and ends up leaving the house and you don't know where they went? I'm giving fairly stark examples, but the gray area in between can be evaluated. I haven't mentioned the threat of self-harm, or aggression, or worse, suicide. That would be an obvious red flag. If inquiry into a teen's mood or a parent making a request or demand of the teen leads to any sort of threats or acts of self-harm or aggression, then that's something that a parent would want to seek help for urgently.
As a parent, Identifying signs of clinical depression in your teenager can be quite difficult. Learn how to assess these situations and when to seek professional help for your teen. |
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Preventing Suicide in TeensSuicide can be a difficult topic to discuss with a teenager, but it is too important to ignore—especially during the COVID-19 pandemic. Teen depression, self-harm, and suicide have seen a rise…
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February 08, 2021
Kids Health
Mental Health Suicide is one of those topics no one wants to talk about, but something that needs to be discussed. This is our topic today on The Scope. Recently, a longtime family friend's daughter, who my kids have grown up with since they were really little, whom we have known since before our 12 year old was even born, acted on an impulse and took her own life. This podcast is dedicated to her. Her parents know I'm doing this podcast in her honor. During her services, her parents spoke about how important it is to bring awareness to the reality of suicide in teens, to talk about it, to talk to your kids about how they can come to you if they're having thoughts of self-harm, that there might not always be the warning signs that people tell you to look for. With teens, their brains are not yet fully developed in terms of executive function skills. So they often can't see that while things may be bad right now, there is hope. And often, in time, things will improve. This is true so much this year with the pandemic. Our teens are not able to do normal teenager things like school functions, dances, hanging out with friends, having their first boyfriend or girlfriend. They have been cut off from interactions outside their families. Teens can only see what is happening here and now. And in their minds, it feels like things will never be the same again. Unfortunately, they're probably right. Things will most likely never go back to the way that they had been. However, there is hope, hope that we are better able to understand COVID and hope that we will be able to bring an end to the pandemic. Hope that within the next year, people can start returning to what we consider normal life. Knowing someone who has completed suicide will rock you to your core. Sometimes there are signs like sadness, wanting to sleep more, or stay away from others more than teens normally do, grades falling and your teen not really caring about school. Sometimes there is a history of mental illness or self-harm, and it gets the better of them. And sometimes, a teen will struggle in silence. They will appear happy and social on the outside, but be suffering within, until one day that wave of suffering overpowers them, and they act on their immediate feelings with fatal results. The more I have spoken to teens and parents of teens, the more the subject of negative thoughts seems to come up. More and more teens are having these thoughts. More and more teens are doing self-harm, like cutting or attempting overdoses. I have about a patient a week lately, where I am having this conversation with them. It's real, it's serious. Teens need to know that we are there for them and that they can come to us, that they have options for help. No, we can't make everything go back to the way it was. No, we can't take their feelings away from them. But we can help them work through their feelings, give them options that are safe, and help them to understand that they aren't alone. We see you, we hear you. You are beautiful and special, and you are loved.
Suicide can be a difficult topic to discuss with a teenager, but it is too important to ignore—especially during the COVID-19 pandemic. Teen depression, self-harm, and suicide have seen a rise as teenagers are cut off from their sense of normal. Parents should know the importance of checking in with your child and helping them process what they are experiencing. |
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Moody Teenager or Depression?Most teenagers experience changes in their mood and emotions during puberty, whether it be trying to isolate themselves in their room, not wanting to do things with the family, or general…
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January 25, 2021
Kids Health
Mental Health Interviewer: Moody teenager or depression? When is the time to seek help? That's what we're going to find out today. Dr. Thomas Conover is a board-certified child and adolescent psychiatrist. He is also board-certified in general pediatrics, and he has taken care of teens with and without depression for over 20 years. Dr. Conover, when a parent comes to you or walks up to you or sees you at a party or something like that, and they say, "Dr. Conover, I've got a question for you. I've got a teenager. I'm a little bit concerned," what kinds of words do they start to use to describe their concern with their teenager? Dr. Conover: You'll often hear about moodiness or irritability, being more isolative than usual, simply not wanting to do things with the family the way that they used to. Those are some of the most frequent keywords that parents who are concerned about their child's behavior or mood as a teenager will say to me. Interviewer: And when you hear those words . . . certainly, when I hear those words, I think, "Well, that's a teenager." Right? So is it a little difficult to determine when to be concerned and when not to be concerned? Dr. Conover: It sure is. Even as a practicing psychiatrist all these years, if I hear a parent say that their teen is moody or irritable, I don't immediately jump to the assumption that he or she is depressed. Interviewer: So then you would, I would imagine, start asking some questions, trying to get a little bit more information. What are some of those questions that you would start to ask to start to make the decision whether or not there was something to be concerned about? Dr. Conover: One question is, "How long has it been going on?" That's a common question in medical inquiry in general. Another is severity. Just how bad of moodiness or irritability are we talking about here? I always think too about how is the youth functioning. That's a really important thing. So particularly, in a casual setting, if a parent just asks me a question about their teenager, a lot of times I'll ask, "How are they doing in terms of their other life pursuits?" So if a youth seems to be more moody and irritable but he or she is still doing all the things that they would normally do, still functioning in school, still recreating with friends, still engaged in other activities, but just kind of crabby, I'm a lot less concerned. Not unconcerned, because there are some youth or adults too who are suffering but still managing to eke out their function because it's that important to them to do well in school, or with their sports, or whatever else they do. But I am often reassured if a teen is still doing the things that he or she normally would do despite the apparent problem with mood. Interviewer: At what point does a parent say, "You know what? We should go talk to somebody"? When does it become something that a parent can help? Because it would occur to me that any of these little symptoms would be something you might want to talk about anyway. If the grades are starting to fall, you might want to approach that topic. If they're defiant a lot more, you might want to say, "I've noticed a change in . . ." Or maybe you don't want to say it like that. Help me out. Dr. Conover: It's always okay to ask your child about how they're doing. And even though a lot of times teens may seem outwardly like they don't want someone to ask, most of the time people who are struggling, even in a small way, do want someone to ask. I think it's helpful not to badger. I think if you're met with that initial "no" on a first inquiry, it's good for a parent to say, "Well, okay. I hear that you're saying that there's nothing about it that you want to talk about. But just know that I'd be happy to talk to you if you change your mind about that, if you do want to talk about it." It's, I think, always appropriate to ask, and it's always appropriate to maybe give a little space and a little time for the teen to be able to absorb the question and respond. Now, that would be with the exception of a true emergency, and those emergencies do include threats or acts of self-harm, or threats or acts of a suicidal nature, or serious aggression. Interviewer: So we have a pretty good idea of some of the different behaviors we might see that might indicate that a teen is depressed or heading towards depression. We've learned that the first step really is to try to talk about it and be genuinely concerned and not force, not corner. If you get met with some rejection, give the teen some space. At what point then does a parent seek professional help if they're just so frustrated, they are convinced something is up, and they just don't know what to do? Dr. Conover: The primary care provider is equipped with enough training and understanding about childhood and teen depression to help to evaluate that and may then refer on to other resources. Interviewer: I feel my approach would be I'd want to find out even more information. Maybe I might want to go to a professional on my own before I take the step of involving the teen in the process, because I'd be afraid that maybe doing that would somehow damage our relationship or cause problems. What's your take on that? Dr. Conover: My take on that is twofold. On one hand, I think it's perfectly reasonable for a parent to seek education or support from other resources themselves. An initial inquiry in that fashion might mean that the parent would do some reading. They might get online and go to a reputable source such as the websites for the American Academy of Pediatrics or the American Academy of Child and Adolescent Psychiatry, both of which have really good information about child and teen development and kind of the presentation of various problems and resources for how to respond. It might take the form of talking to a family member, a friend, a clergyperson, or the parent's own physician. All of those could be things that a parent could do. On the other hand, I do think people may make the mistake of not asking, not saying something, not doing something for fear that it might damage the relationship. And it has very rarely been the case in my experience, even if asking or stating that observation leads to a fight or argument in the short term. Interviewer: As that parent that asked you initially if they should be concerned about their teenager walks away, what would be the last thing that you would say to them? Dr. Conover: "Let me know if there's more help that I could give." You can go off in one direction, make a decision to act, and maybe that initial effort comes up not as fruitful as you had hoped. So I would hope that people would feel open to asking for help again or talking more about it. But it can be an uncomfortable topic. My experience both as a clinician and as a parent myself is that parents want their kids to be happy. They want them to feel okay. And it can be very, very troubling, very sad to contemplate that their child may not feel okay, that they might not be all right. And so it's really hard to ask and really hard to bring up, because you don't want it to be so.
Questions you should be asking yourself—and your teenager—to help identify if it’s typical teenage moodiness or if you should seek professional help. |
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Depression in Children on the Rise — How to Help Your Child with Their Mental HealthAccording to the National Institute of Mental Health, 3.2 million kids aged 12 to 17 have had a depressive episode in the last year. Pediatrician Dr. Cindy Gellner explains what depression looks like…
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June 15, 2020
Kids Health
Mental Health Depression appears to be on the rise in kids these days. Children younger and younger are being brought in by their parents for it. What does depression look like in children, and how can you, as a parent, help if your child has depression? According to the National Institute of Mental Health, a reported 3.2 million kids aged 12 to 17 years old have had at least one major depressive episode in the last 12 months. This is as of April 2019. I know that, in my clinic, I personally see kids eight and up struggling with depression at least four to five times per week. That is a staggering number when you think about it. There are several theories about why depression is on the rise in kids, starting with social media. Kids are constantly connected these days. And while it's always been the case, especially with teens, that they compare themselves to their peers, they are now having more and more pressure to keep up. Teens turn to social media apps to see what the current trends are, and they measure their self-worth by how many likes they get on their posts. It's a great way to get instant validation, and if they don't get enough likes, or if something isn't liked by a friend they thought would like it, then that reinforces, in their developing brains, that they aren't good enough, or that their friend really doesn't like them. Kids also see a lot of negativity in the world in the media. Online, on TV, they see the violence in the schools, movie theaters, terrorist attacks, and they can feel like they have no sense of security. Finally, the pressure to be perfect, to be successful, to be the absolute best at everything they do, that's a lot for a kid. That's a lot for an adult. The bar is held so high sometimes it feels impossible to reach. Also, with teens and their out of whack hormone levels, it was thought that that was the main reason for their moodiness. Then, in the 1980s, mental health providers started realizing this wasn't completely the case. Kids can have true depression, and it started becoming okay to diagnose them more appropriately. So while it seems like there is a huge increase in depression cases, it might also be that depression has always been there, and we are just now open to seeing it and diagnosing it. So what are the signs of depression in kids? A lot of people expect depressed kids to be sad, but that's not really how it presents in kids and teens especially. It can present as fatigue, as anger, or ADHD-like symptoms. It can be a change in how they're eating, too much or too little compared to what they normally do. It can present as your teen completely stopping doing things they once loved, like sports or hanging out with friends, instead choosing to be alone. Finally, it can present as self-injury. This is one of the most common ways it presents in girls. Cutting with sharp objects or using erasers to burn their skin are two methods I see often in clinic. Rarely does depression first present with attempted suicide. But when attempts are made, boys choose the more lethal method than girls. If you think your child might have depression, try to talk to them. It can be scary for them to admit if they are. They may not want to disappoint you by having those feelings. Make sure that they know that you are there because you care about them and you want to make sure that if they are depressed, you are there to help them out. Next, make an appointment with them to be seen by their pediatrician. We have several screening tools to get objective information from the teen and can take it from there to discuss their feelings and options for treatment, including medications or therapy, depending on the situation. Please remember that your pediatrician is not a therapist though. We need to refer them to behavioral health specialists for long-term therapy and sometimes even for medication management, depending on how complex the situation is. I always tell my patients' parents, "You wouldn't want a psychiatrist managing your child's asthma. I'm much better at that. Similarly, a child psychotherapist or psychiatrist is much better at managing your child's mental health issues, because that's what their training is in." Finally, if your child or anyone you know is in an immediate crisis and you need to speak to someone urgently about suicide prevention, call the National Suicide Prevention Hotline at 1-800-273-TALK. That's 1-800-273-8256.
What depression looks like in children and how you as a parent can help your child’s mental health. |
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Helping Children Through the COVID-19 PandemicIt's a stressful time for many of us, even children. With most children having been sent home from school, stress and anxiety can run high. Child psychiatrist Dr. Benjamin Chan talks about what…
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April 06, 2020
Kids Health
Mental Health Interviewer: It's certainly a stressful time for many of us. But what about kids? Dr. Benjamin Chan specializes in child and adolescence psychiatry at University of Utah Health. What can parents do to help their kids during the COVID crisis? And, I mean, I guess, first of all, do children feel the stress as well? Dr. Chan: Incredibly so, especially when most children have been sent home from school. Children, like us, crave structure. They crave routines. And those routines have been upended during the past few weeks. And no child or teenager will tell you, "Hey, I want more routine." They will tell you they want more iPad time, more screen time. But all children and teenagers crave routine. They seek it out. They flourish. They do really well with it. So I like to use the example, when I was a child, of a chore chart. For me to get my allowance of, like, $10 a week, I had to do X, Y, and Z on my chore chart. Now, I remember, there were physical little tokens I had to do, take out the trash, wash the dishes, take the dog for a walk, clean my bedroom. And I got my allowance. So my advice to parents is to create structure within their home. Kids, teenagers will respond to that structure. So even if it has to be, like, a physical manifestation of a chore chart: when people should get up, what time should they have screen time, what time should they work on homework, what time should they call a friend on a phone, what time should they go outside for a walk. People, kids, teenagers will respond to that. Interviewer: Dr. Chan, are there some warning signs that parents should look for to help indicate that, maybe, something isn't right and they do need to do something? Dr. Chan: They should look for teenagers who seem very sensitive or frustrated. Anger is very common. And, again, that is very normal, but where I get very concerned is if that leads to a deterioration of their functioning. If they seem to be in their bedroom for an extraordinarily long time, if they are not communicating their feelings as much, if they are not finishing their workbooks at home or they are refusing to call their best friend on the phone, that's something I would recommend that parents should really keep an eye on is a deterioration in their functioning. Interviewer: All right. And that would be a good time to check your child's routine. And don't forget to include a little bit of work, a little bit of play, some socialization, of course, appropriately physically distanced. And if you continue to have trouble and your child is struggling, don't be afraid to talk to them about what is going on and involve a professional to help you get your kids back on track, if necessary. |
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My Child Has an Eating DisorderWhile there are no clear answers as to what causes eating disorders, they can cause serious and potentially dangerous health problems with your child. Pediatrician Dr. Cindy Gellner discusses how…
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May 14, 2018
Diet and Nutrition
Kids Health Dr. Gellner: If your child has been diagnosed with an eating disorder, you will need to know how your child's health will be affected. I'll tell you what you need to know on today's Scope. I'm Dr. Cindy Gellner. Announcer: Keep your kids healthy and happy. You are now entering The Healthy Kid's Zone, with Dr. Cindy Gellner on The Scope. Dr. Gellner: No one is really sure what causes eating disorders, but they are very real problems and they show up usually when kids are between ages 13 to 17 years old. And this is when there's a lot of physical and emotional changes, not to mention academic and peer pressures. Athletes and dancers are particularly vulnerable to eating disorders as they try to maintain a certain weight. Eating disorders are serious medical illnesses. They often go along with other problems, such as stress, anxiety, depression, and substance use. Eating disorders can lead to the development of serious physical health problems. The body goes into starvation mode when someone has anorexia. This causes hair loss, periods may stop in girls, soft hair called lanugo can grow all over the skin (it's the same kind of soft hair that's seen on newborn babies), teens may have concentration problems, anemia, and brittle bones. For a person with bulimia, the constant vomiting and lack of certain nutrients can cause damage to the stomach and kidneys. Tooth decay, especially on the molars, from recurrent exposure to stomach acids, can happen too. And so can swollen cheeks from the salivary glands permanently expanding from throwing up so often. They can have loss of periods in girls and loss of potassium, which can lead to heart problems and even death. It's not only a teen's physical health that will be affected. It's their mental health as well. Kids that become so obsessed with their weight, monitoring their food intake and exercise, it's so hard to focus on anything else. They're in a constant state of stress about food and what their body looks like. They start withdrawing from friends and family, and their whole world starts to fall apart. Eating disorders can be treated, but the process is long and hard. Counseling is a very important part of getting better. Doctors, mental health professionals, and dietitians will all be involved. The first step to recovery, though, is for a teen to reach out to someone they trust. If they're not ready to talk to a parent, they may reach out to a friend or a teacher. Remember that eating disorders are very common among teens, and support from those they trust most will be needed to help them survive. Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com. |
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How Do I Know if My Child Has an Eating Disorder?In the United States, 1 out of 100 teenagers will struggle with an eating disorder. If your child is starting to develop one of these disorders, it’s important to get professional help.…
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May 07, 2018
Kids Health
Mental Health Dr. Gellner: Eating disorders are quite common, but they're sort of a taboo subject to talk about with teens. How can parents recognize the signs of an eating disorder in their teen? I'll help you figure that out on today's Scope. I'm Dr. Cindy Gellner. Announcer: Keep your kids healthy and happy. You are now entering the Healthy Kids Zone with Dr. Cindy Gellner on The Scope. Dr. Gellner: First, I need to define just what an eating disorder is. Eating disorders aren't picky eaters or teens trying to change their eating habits or exercise daily to become more healthy. Eating disorders are extremes in how teens think about food, eating, and being active to the point where it becomes all-consuming. One or 2 out of every 100 teens in America will struggle with an eating disorder. Every year, thousands of teens start down the path of having an eating disorder because of how they perceive their bodies. The most common eating disorders are anorexia and bulimia. Teens with anorexia have a true fear of weight gain and a distorted view of their body. They think they are overweight, when, in fact, they can be dangerously underweight. They eat very little and exercise excessively. Counting calories becomes almost an obsession as they try to eat as little as possible. Bulimia is similar to anorexia in that calorie restriction is the main goal. But these teens may eat and eat and then try to compensate by throwing up or exercising all the time to prevent gaining any weight. This is different from having a day where you pig out and then work extra hard at the gym the next day. For someone to be diagnosed with bulimia, they need to be doing this regularly at least once a month. For several months, bulimics often eat large amounts of food in secret, even taking food out of the trash to eat it. They feel powerless to stop eating until they are so full and then they will go vomit everything back up. Some bulimics use excessive amounts of laxatives to make everything go right through them so the calories don't stick. Although anorexia and bulimia are very similar, teens with anorexia are usually very thin, but those with bulimia may be normal or even overweight. Teens who have these conditions often have intense fear that they are or will become fat even though they are normal-sized. There are some signs to look for in someone who has a true eating disorder. Anorexics may look very frail, be obsessed with weight and portion control, and only eat certain foods and not because of a medical issue like a food allergy. They also may exercise excessively. And they may also water load, which is where they drink a lot of water before going to a doctor's appointment so they seem heavier than they are when they're weighed. Bulimics will make excuses to go to the bathroom right after eating, regularly buy laxatives, only eat diet foods unless they're binging, and spend most of their time working out. Both anorexics and bulimics often withdraw from social activities which involve food. These are tough diseases to diagnose and treat. If you think your teen may have an eating disorder, talk to your child's pediatrician to investigate further. Announcer: Have a question about a medical procedure, want to learn more about a health condition, with over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com. |
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Signs Your Child Might Be Using Drugs and AlcoholMany indicators of drug and alcohol use are the same as typical teen behavior, or depression and anxiety. Pediatrician Dr. Cindy Gellner reviews some important signs to look for that could signal…
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August 28, 2017
Kids Health Dr. Gellner: Drug and alcohol use in adults seems to be on the rise, and that means more kids are being exposed to substance use. How do you know if your child might be using drugs or alcohol? We'll discuss some signs on today's Scope. I'm Dr. Cindy Gellner. Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kid Zone" with Dr. Cindy Gellner on The Scope. Dr. Gellner: We've all heard the ads about teens and peer pressure about using drugs and alcohol. They've been around for years as public service announcements. Kids, teens especially, are faced with peer pressure to be cool, and that means making the choice to use or not to use when their friends offer them drugs or alcohol. Figuring out if your child is using can be a challenge, as many of the signs are also those of typical teen behavior, and of depression and anxiety. Behavior changes are one of the first things to note. Are they hanging out with the same friends they've always had, or do they have new friends whose behaviors you question? Are they chewing gum or mints all the time to cover up breath odors? Do they go out every night, lock the doors more, or make phone calls in secret? Have their sleep patterns changed, where they have periods of extreme high energy followed by long periods of catch-up sleep? Mood changes are common in teens due to hormones, but if your child has extreme mood changes, seems overly hostile or hyperactive compared to their norm, that could also be a red flag. Hygiene is also a challenge for teens, in general, but if your child completely lacks any effort to keep clean, their clothes have odd odors as opposed to normal teenager body odor, or they want to wear long sleeves, or pants even, when it's hot outside, perhaps in an effort to hide track marks, pay attention. School changes can be one of the biggest signs that there's a problem. A child who normally doesn't miss school is all of a sudden ditching classes, not keeping up with assignments, or the teachers are calling with concerns about your child's behavior or performance. Finally, look around the home. Are prescription medications disappearing, alcohol bottles getting less full, money missing from your wallet? Does the car smell odd, or strange wrappers and trash are left behind? The first thing you should do if you suspect drug or alcohol use is to have a conversation with your teen, and tell them you want them to be completely honest. Be prepared if they say yes, they're using, and don't fly off the handle. Keep calm and let them know that you are by their side to get them help. If they say no, they're not using, don't assume they're lying. This may be the time to talk to your pediatrician about getting help with a mental health provider. Announcer: Want The Scope delivered straight to your inbox? Enter your email address at thescoperadio.com, and click "Sign Me Up!" for updates of our latest episodes. The Scope Radio is a production of University of Utah Health Sciences. |
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What You Can Do to Help Your Child with AnxietyMore and more children are being treated for anxiety. The kids with these problems seem to get younger and younger each year. What can you do as a parent to help your child struggling with anxiety?…
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November 07, 2016
Kids Health
Mental Health Dr. Gellner: Every year, it seems more and more children are coming in to see me and other pediatricians because of anxiety issues. And the kids are getting younger and younger. So what do you do if you have an anxious child? I'll give you some tips on today's Scope. I'm Dr. Cindy Gellner. Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kid Zone" with Dr. Cindy Gellner on The Scope. Dr. Gellner: A lot of parents have concerns that their child is developing anxiety. Their child will stress over everything and no matter what they say, nothing seems to be able to calm their child down. Some anxiety is okay. We all have fears. But when this anxiety starts causing a lot of problems, that's when they should come to us. Some parents want anxiety medications for their children. Others do not. Medications really should be a last resort, as many are not really safe in young children, often not approved use until age 12. And like any medications, they come with their own set of side effects. So how can you help your anxious child before things get out of hand? There are some things you can try before resorting to medication. I'm going to give you some suggestions that could help change your child's fear-based thinking on both the conscious and subconscious level. First, let your child know it's okay to feel afraid at times. But don't act too worried. Anxiety gets worse if your child feels anxious about being anxious. Remind your child how strong they are. This will help them believe in themselves. Explain that their anxiety is their body's automatic response to fear because their body thinks they're in danger. Sometimes the body gets tricked and it thinks it's in danger when it really isn't in danger. And that's just the brain's way of trying to protect them. Have your child close their eyes, focus in the moment. Have them tell you what they're hearing or smelling and pay attention to their breathing. Tell them slow, deep breaths remind the brain that they are safe. Give them a pillow or stuffed animal or even a box of tissues and tell them to grab it and throw it as far as they can. This can help release the high energy they have. Teach your child that panic attacks are temporary and they have the skills to make it through them. Remember, if you make a big deal about it, this will make it bigger for them and it only serves to increase the anxiety. Figure out what your child is really afraid or anxious about. Once you understand this, you will understand what they need to help feel better. You will be able to better explain the difference between fears that help and keep us safe and fears that hurt and only cause more anxiety. Teach your child to ask, "Will worrying about this do any good?" If the answer is no, then it's a fear that hurts. Finally, teach your child relaxation and self-calming skills. I call this their toolbox for when they get anxious. Once they learn how to calm down their fears, remind them that they can do anything. If your child's anxiety is still keeping them from enjoying the things that children should enjoy, talk to your pediatrician about helping to find a good therapist. By coming to a pediatrician, we can help with figuring out some things to help your child initially. But if things are too complicated, we can find exactly who you need to see and get you a referral to a mental health specialist that will work with your child and do exactly what your child needs. Tell your child that this is someone that they can talk to that will help with their feelings. And remind your child every day, "You can do this." Empowering them to be in charge of their feelings will give them the courage they need to face their fears. Announcer: Thescoperadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at thescoperadio.com. |
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What to Do When a Teen's Anger Spirals Out of ControlMood swings and confused emotions are common in growing teenagers. Anger is a normal emotion, but how your teen handles it is what matters. When a teen becomes really angry, there is often another…
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July 18, 2016
Kids Health
Mental Health Dr. Gellner: Face it. There are times we all let our tempers flare. But if your teen is more angry than you think they should be, it's time to put the fire out. I'll discuss ways to tame their tempers on today's Scope. I'm Dr. Cindy Gellner. Announcer: Health tips, medical news, research and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope. Dr. Gellner: Your teen walks into the room and you can see it happen: they're volcano ready to erupt. It's true. All those hormones you hear so much about can indeed cause mood swings and confused emotions. Teens are under more stress today than ever as well. They might be also one of those kids who really feel emotions intensely. But no matter what pushes their buttons, one thing is certain, there are times that they are going to blow a fuse. Anger is a normal emotion and there's nothing wrong with feeling mad. What counts is how they handle it. Anger can be a really powerful emotion. So teaching teens how to manage it is sometimes a challenge. It takes plenty of self-awareness and self-control to manage those angry feelings. And these skills take time to develop. Little kids aren't very aware of what they feel. They just act it out in their behavior. That's why you see them having tantrums when they're mad. But teens have the mental ability to be self-aware. They also have the ability for self-control, although they don't' know how to use it. Teens, or anyone, really, when they get angry, there's also another emotion that's the real reason for the strong emotion, such as hurt, guilt or frustration. Help your teen figure out what else is going on. This is a great time to open up a discussion about feelings since teens usually won't open up on any day ending in "Y" unless they're forced to. So there are five steps as a parent that you can tell your teen about that will help them manage their temper. First, have them identify the real problem. Did you just tell them no because they wanted to go out with friends and you said they need to clean their room? What are they really mad at? You, because you're being unfair? No. They're mad because they have to clean their room. Then, help them think of potential solutions. This is where that self-control pause button comes in. Have them stop and think about the reaction, but don't just react out of anger. Ask them three things that they could do. They could yell at you and throw a fit. They could clean their room and then ask if they can go out or they can sneak out and run to their friend's house as fast as possible. Third, they need to consider the consequences on each of these choices. Yelling at you will probably get them grounded. Cleaning their room takes work and they may miss out on some fun, but you'll probably let them hang out with their friends and then the bonus is they get to clean room. Sneaking out really ends well. When you do catch them, look out. Next, have them pick a choice that they actually act on. By the time they've really thought this through, chances are you won't be yelled at and they haven't run away yet if they're still they're talking to you. So cleaning the room and getting to the fun is the best choice for all. Finally, after they've made their choice and, hopefully, cleaned their room, then have them think about all that just happened. Did they feel they made the right choice? What did they learn about the decision-making process? Can they make the same positive choices on their own? Be sure to praise them for thinking things through before acting. Sure, these five steps sound like a piece of cake when you put them out there and everyone is calm. The real test comes when your teen is in full hothead mode. Make sure your teen knows that there are other ways to manage their anger too. Lots of research had shown that exercise is a great way to improve your mood and decrease negative feelings because it raises endorphins, those happy hormones in our brains. Listen to music. Have them wear headphones if their musical styles clash with your own. Writing, whether poetry, song lyrics in a journal or in a letter that they plan to rip the shreds and throw away, writing helps release intense feelings so they don't stand inside. Same with doodling. That's why adult coloring books are so popular right now. Some teens find that meditation and deep breathing helps. Sometimes, anger is a sign that more is going on. Sometimes, it's a sign of depression. Sometimes, it's a sign that there is too much stress in your teen's life and they may be overscheduled or pushing themselves too hard. Again, anger is a really strong emotion. It can feel overwhelming at times. Helping your teen learn how to deal with strong emotions without losing control is part of becoming more mature. It takes a little effort, a little practice and a little patience, but your teen can learn how to douse the flames and chill out with help and support from you. Announcer: thescoperadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at thescoperadio.com |
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What Can You Do if Your Teen is a Cutter?Many people today are looking for ways to relieve stress, but don’t know how to do it. Unfortunately, many teenagers are turning to cutting as stress relief and as a way to feel again. Dr.…
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June 20, 2016
Family Health and Wellness
Kids Health
Mental Health Dr. Gellner: It's a disturbing trend, teens cutting themselves. Why? And how can you help your child, if they are a cutter. I'm Dr. Cindy Gellner and we'll discuss this on today's Scope. Announcer: Keep your kids healthy and happy. You are now entering The Healthy Kid Zone, with Dr. Cindy Gellner, on The Scope. Dr. Gellner: Cutting isn't new. But, this form of self injury has been more openly discussed lately. If you haven't heard about cutting, chances are pretty good, that your teen has and might even know someone who does it. It can be hard to understand why a teen would deliberately cut themselves. But parents who are aware of this problem, can really help. That's why we're talking about it today. Many parents don't really understand what cutting is. It's when a person uses a sharp object to make marks, cuts, or scratches on their body, on purpose. Teens usually cut themselves on their forearms, thighs, or belly. Somewhere they can hide with clothing. They might use a razor blade, knife, scissors, a metal tab from a soda can, the end of a paperclip, anything that can injure the skin. And there is a sense of shame and secrecy that often goes along with cutting. So most teens make up excuses on how they were hurt if someone sees the marks. Most people who cut are girls. But guys do it too. And it usually starts during the teen years. The bottom line is that cutting is a sign of a deeper, emotional issue. And if you want to help your teen, you'll need to figure out, what those issues are. The cutting often begins as an impulse. "So and so mentioned it feels good, so maybe I should try it." A teen might give in to peer pressure to try cutting as a way to seem cool, popular, or avoid being bullied by other teens. Regardless of the reasons, cutting isn't a healthy way to deal with the extreme emotions, or pressures, that come with the teenage years. For some, cutting helps them deal with feelings that seem too intense to endure. From the normal teenage heartbreaks, to rejections from friends, dramatic situations, or even the pressure to be perfect. Deep grief can be overwhelming for some. Cutting can be a way of testing whether they can still feel physical pain. Others describe cutting, as a way of waking up from emotional numbness. Many teens discover that once they start, they can't stop. There is a sense of control and relief to see and know where this specific pain is coming from. And a sense of soothing when it stops. It seems to give them a sort of stress relief, from deep painful emotions, or even a high. Endorphins are feel good hormones released during intense physical exertion. But, they can be released during an injury. Unfortunately, cutting is a behavior that tends to reinforce itself. Many teens say they feel addicted to the behavior. Whenever tension builds, the brain craves relief and drives the self injuring teen to seek relief by cutting again. Some would like to stop but don't know how, or feel they can't. Other teens don't want to stop the cutting, it just feels that good. Cutting is often linked to other mental health conditions. Like obsessive compulsive disorder, depression, or bipolar. Other teens struggle with personality traits that attract them to dangerous excitement of risky behavior, or self destructive acts. Some are prone to dramatic ways of getting reassurance that they are loved and cared about. Many teens cut for a long time before anyone else knows. It can take courage and trust, to reach out. If confronted by the cutting, teens can respond in different ways depending partly on the teen, and partly how they are approached by it. Some might deny the cutting, while others might admit to it. But say it's not really a problem. Some might get angry and reject any help. But many teens are relieved that someone knows, cares, and wants to help. Like quitting any habit, cutting can be difficult to stop. And a teen might not succeed at first. It takes determination, courage, strength, as well as support from others, who understand and care, to break this powerful desire to harm themselves. If you find that your child is cutting, please talk to your pediatrician or other mental health provider. Getting to the bottom of the cause of the cutting may take some time. But your child is worth it. Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com. |
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Talking, Treatment, and Making the Home Safe: Ways to Help Prevent Kids From Committing SuicideSuicide is the third most common cause of death from kids aged 10-19. Children and teens suffering from depression, whether it is being treated or not, are much more likely to think about taking…
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October 12, 2015
Family Health and Wellness
Kids Health
Mental Health Dr. Gellner: Suicide is not a topic anyone wants to talk about, but the reality is more and more of our children are exposed to suicide. Many think about it and attempt it. I'm Dr. Cindy Gellner and today we will discuss suicide prevention for your child. Announcer: Keep your kids healthy and happy. You are now entering the Healthy Kids Zone with Dr. Cindy Gellner on The Scope. Dr. Gellner: Suicide is very rare in young children, but it is the third most common cause of death in children from ages 10 to 19. Children are the most likely to consider suicide if they suffer from depression, anxiety disorders, bipolar disorder, or alcohol, or substance abuse. Stressful events can put kids over the edge. They're more likely to kill themselves on impulse than adults are. Many commit suicide within a few weeks of getting into trouble at school, or with the police, breaking up with a girlfriend or boyfriend, or fighting with friends. Other significant risk factors for suicide include previous suicide attempts, a history of disruptive behavior, and little communication with parents, especially with parents who are divorced, or recently remarried. Girls attempt suicide more often than boys do. But boys are much more likely to actually succeed in their attempts. Girls are more likely to attempt by overdosing on drugs or cutting themselves. Boys most often attempt by using guns, hanging, or jumping. Firearms are the most common and fastest growing method of suicide for males and females of all ages in the United States. Having a gun in the house increases the chances that a young person in the home will commit suicide. An upset child or teen may impulsively use a firearm. Using a gun increases the chances that a suicide attempt will be fatal. Other methods are more likely to allow time for second thoughts and getting medical help. This is why gun safety in the home is of utmost importance. Have the weapons and the ammunitions stored in locked containers separate from each other. Signs that your child may be considering suicide include an overwhelming sad or empty mood, loss of interest or pleasure in activities that they once enjoyed, withdrawing from family and friends, significant change in appetite or weight, significant trouble sleeping or oversleeping, very much irritable or restless, losing energy, feeling completely worthless, or having inappropriate feelings of guilt, letting the quality of his or her school work go down, for example, if they were an A student, they're now making Fs, risky behaviors such as abusing drugs or alcohol, or driving too fast, talking or even just joking about suicide, or writing notes or poems about death, and giving away prized processions, or throwing away important belongings. If you are concerned about your child's behavior, ask open-ended questions. If your child knows they can talk to you about their point of view, they'll be more likely to talk to you about important things. Get your child treatment if he or she has signs of depression, or problems with drug or alcohol use. If your child is especially grouchy, worried, withdrawn, or upset more than you would expect based on their age or social situation, get an evaluation as soon as possible by a health care provider and a mental health provider. Ask your child if he or she is thinking about suicide. You will not cause your child to think about suicide by talking about it. What you are doing is showing that you care when you ask. If he or she talks about death or mentions about suicide, do not get mad or pass judgment, just get professional help. Reassure your child that you love him or her. And remind your child that no matter how awful their problem seem, they can be worked out and you are there and willing to help them. Again, removed or lock up any lethal weapons such as guns in your home. Be sure to also keep locked up narcotics and other pills and poisons. Both medications and therapy are useful to treat depression in children and adolescents. The only drug approved for use in children with major depressive disorder is Prozac. And many parents are concerned about giving their child antidepressants. Talk with your pediatrician or mental health professional about this. Untreated depression can be fatal. If your child is depressed, starting on a new antidepressant, or taking a different dose, be aware of any changes in behavior. Never take your child off an antidepressant medication suddenly without talking to your child's pediatrician. With some medications, you must taper off slowly to avoid significant side effects. A type of therapy called Cognitive Behavior Therapy is wonderful to help children learn about depression, teach them specific skills for managing their physical symptoms, negative thoughts, and problem behaviors. If you think your child is suicidal, get help immediately. Talk with your child's pediatrician or mental health specialist. And in an emergency, call the National Suicide Hotline at 1-800-SUICIDE. Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com. |