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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.

Dr. Gellner: Unless you've been avoiding all news reports, you know that vaping has become a huge problem in today's teen population. It's a problem both with the number of kids doing it and with what's in the vaping juice itself. I'll talk about why you should talk to your teens about not vaping 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: It's amazing how many times I'm asking questions about a child's tobacco use or exposure and the parents tell me, "Well, we don't smoke around the kids. We vape outside." Or I hear that parents have encouraged their teen to vape rather than smoke cigarettes. Most people know that cigarettes are filled with tobacco and they emit smoke. E-cigarettes or vape pens or mods which are used in vaping don't produce smoke, but more a mist that looks like water vapor.

When someone vapes, the pen basically heats up the juice or the liquid in the device, and then the user inhales the mist. The problem is that vapor is full of tiny cancer- and disease-causing chemical particles. Many parents are like, "Well, we don't use the kind with nicotine or let our kids use the kind with nicotine," which is the addictive substance in cigarettes, so they think it's a safer alternative.

There is one particularly popular vaping product JUUL, which looks like a USB flash drive, so it's easy to carry around and even hide, which is one of the reasons it's the go-to vaping device for middle and high school students. Vape juice also comes in fun flavors like fruit medley, double espresso, blueberry cheesecake, and cotton candy. Unfortunately, one flavor pod can have as much nicotine as an entire pack of cigarettes.

So what's in the vape juice anyways? Well, the main ingredients are either propylene glycol or vegetable glycerin. You've probably heard of propylene glycol before. It's the main ingredient in antifreeze. Yes, the kind you put in your car or that airports use to de-ice planes. In small amounts, the body is able to metabolize it. Too much of this will affect the nervous system, cause seizures, kidney problems or even abnormal heart rhythms.

Vegetable glycerin is a great moisturizer for your skin if put on topically,and it too can be okay to ingest. It's found in a lot of foods under the name glycerol. But inhaling it, the science is still out on that one. It does seem to be the safer of the two ingredients.

Generally speaking, unless you are inhaling a medication specifically designed to go into the lungs, inhaling anything in the lungs other than clean air probably isn't the smartest move.

The biggest toxins in vape juice are in the flavorings. Cinnamaldehyde gives a cinnamon flavor, and it's found in a lot of what we eat that's cinnamon. But note that cinnamaldehyde sounds a lot like formaldehyde. Formaldehyde is what dead bodies are embalmed in to preserve them. Cinnamaldehyde is a known skin irritant, which has been shown to inhibit mucous clearance when inhaled. Then there's o-Vanillin which tastes like vanilla but causes DNA damage. DNA damage leads to cancer. Another example is pentanedione, which gives a creamy or buttery flavor to the juice but has shown to cause lung fibrosis or stiffening of the muscles in the lungs.

Ask any pediatrician and they'll tell you vaping is dangerous and more and more kids are becoming seriously harmed or dying as a result. If you think your child may be vaping, talk to your pediatrician right away so they can help them to quit and learn the facts about how uncool vaping really is.

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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.

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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.

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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.

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