Guest Columnist - Diane Weaver
Normal Teenage Angst or Something More Serious?
It happens in communities throughout the country. A teen takes his or her life and the reaction is, "How could we not have seen the signs?" Parents often see their teens struggling but chalk it up to normal teenage angst. So how can parents or others involved in the teen's life tell what is normal and what is cause for serious concern? And how do we intervene to prevent a tragic outcome like suicide?
First, it is important to know the facts about suicide. Adolescents are a particularly vulnerable group, with suicide being the third leading cause of death in teens. While girls attempt suicide with more frequency than boys, boys complete suicide at a higher rate. The most important thing to know, however, is that suicide is highly preventable.
Signs of Suicide
The old phrase “it takes a village” is particularly true when it comes to protecting our teens from suicide. Often, a teenager’s friends are in a position to notice signs of suicidal crisis before anyone else, including parents. Thus, it is critical that we educate teens about signs they may see in a friend and the importance of involving an adult immediately. Keeping a secret about a friend who shows signs of suicidal thinking is never the right thing to do.
Eight out of 10 young people who take their own lives give some warning to a friend or family member. Most young people who die by suicide don’t really want to die. They perceive that they are a burden to others, but deep down they want someone to lead them to help. It is important for parents and teens alike to recognize the warning signs of suicide. These include:
- A sense of hopelessness about the future
- Drastic changes in personality or behavior
- Uncharacteristic impulsiveness, recklessness or risk-taking
- Expressions of rage, uncontrolled anger, aggressive behavior
- Preoccupation with death, dying or suicide through writing, talking or artwork
- Giving away prized possessions
- Loss of interest in personal appearance
- Increased use of alcohol or drugs
- Withdrawal from friends, family and society
- Extreme anxiety or agitation; inability to sleep or sleeping all the time
- A recent severe stressor, such as a real or anticipated loss of a relationship, unplanned pregnancy, victim of bullying or family conflict
- A previous suicide attempt or exposure to another’s suicidal behavior
- Verbal signs such as:
- “I’m so tired. I don’t feel like I can take this any longer.”
- “I don’t want to be a bother anymore.”
- “I want you to know something, in case something happens to me.”
Any of these signs should be taken seriously and asking questions in a non-judgmental manner is important. Parents should be persistent and allow for expression of feelings. Contrary to popular belief, asking directly if the teen is considering suicide does not “plant the idea,” but more often provides a sense of relief. Being able to talk openly is the first step to getting help.
The Link Between Depression and Suicide
An estimated 90 percent of all suicides are the result of untreated or undertreated depression. Depression affects nearly 2 million teens in the United States. Unfortunately, experts say only one in five depressed teens gets the help they need.
Parents need to learn what the symptoms of depression look like. This is complicated because a depressed teen doesn’t always exhibit outward signs of sadness. Sometimes in depressed teens, symptoms of irritability, aggression or rage are more prominent. Sometimes the teen that seems to “have it all” is inwardly crumbling under the weight of the expectations of others.
While the teen years are tough and some angst is to be expected, most teens balance this with good friendships, success in school, activities outside of school and the development of a strong sense of self. Ups and downs are a normal part of teen behavior, but signs that there may be cause for concern can include:
- Withdrawal from friends or activities
- Changes in normal eating or sleeping patterns
- Lack of enthusiasm, energy or motivation
- Poor performance in school
- Sadness or hopelessness
- Anger or rage
- Indecision, lack of concentration or forgetfulness
- Restlessness or agitation
- Substance abuse—either drugs or alcohol or both
- Feelings of guilt, poor self-esteem or being unable to satisfy ideals
- Risky behavior, i.e., sexual promiscuity or trouble with the law
- A preoccupation with death
It is important for parents to realize that, like other medical conditions, depression is sometimes genetic and tends to run in families. So, if there is a family history of depression and a teen is struggling, this could mean that the teen is depressed.
What Parents Can Do
It is important to speak up right away if you suspect a teen is suffering from depression. This simple step alone can open the door to conversation and allow the teen to express his feelings. Even if the teen is not suffering from depression, your concerns still need to be addressed. Sometimes teens are reluctant to open up and may claim nothing is wrong.
If the teen says nothing is wrong, but has no explanation for what is causing his behavior, parents should trust their instincts. Many teens don’t realize that what they are experiencing is depression, anxiety or some other disorder.
Above all, parents should not ignore the symptoms and hope they will go away. Teen depression tends to come and go in episodes and once a teen has experienced one bout of depression, he is more likely to experience depression again. Left untreated, depression can be extremely serious - even deadly.
If you suspect your teen is depressed, make an appointment with the family physician (or pediatrician) and ask for a depression screening. This simple screening can be done in just 10 to 15 minutes and can indicate if there are symptoms of depression. The physician can then refer the teen for a more thorough mental health evaluation.
Part of the initial depression screening may involve a complete medical exam with blood work to determine if there is any other medical cause for the teen’s symptoms.
Treating Teen Depression
Teens rarely struggle with just depression—depressive symptoms are part of a bigger picture. Often there are co-occurring disorders. For example, teens may be suffering from anxiety and depression. Many therapists report that more and more teens are experiencing anxiety because of academic and social pressure. There may also be substance abuse issues that need to be addressed.
The good news is that teen depression is treatable. Recently published studies show that treatments such as cognitive behavioral therapy (CBT) are highly effective in treating depression in teens. There is evidence that certain antidepressant medications can also be effective for depression that is serious and persistent. Many therapists also work with teens to create a “toolbox” of healthy coping skills.
Tips for Talking to a Depressed Teen
Parenting teens is challenging enough, but parenting a teen who is depressed presents unique challenges for parents. Here are some tips for parents whose teen is depressed:
- Offer support. Let depressed teens know that you are there for them, unconditionally. Let the teen know that you are ready and willing to provide whatever support is needed.
- Be persistent. Don’t give up if the teen shuts you out at first. Be gentle and persistent while being respectful of your teen’s comfort level at sharing his feelings. Emphasize your concern and willingness to listen.
- Listen without lecturing. As hard as it might be, resist the urge to criticize or pass judgment when your teen opens up. Steer clear of offering ultimatums or advice—the most important thing is that the teen is communicating.
- Validate feelings. Don’t try to talk teens out of their depression; instead, validate their feelings. Acknowledge the pain and sadness they feel and let them know that you take their emotions seriously.
How Can Parents Help Alleviate Teen Depression?
There are some effective parenting and communication techniques you can use to help lower the stress level for your teen and help minimize the risk for depression. These include:
- When disciplining a teen, replace shame and punishment with positive reinforcement for good behavior. Shame and punishment can add to a teen’s feelings of worthlessness and burdensomeness.
- Allow teens to make mistakes. Overprotecting a teen or making all his decisions for him conveys a lack of faith in his abilities and can make him feel less confident.
- Set realistic expectations and give your teen breathing room. Don’t expect her to do exactly as you say all the time.
- Don’t force a teen down a path you wanted to follow. Avoid re-living your youth through your teen.
- Work at keeping the lines of communication open even if your teen wants to withdraw.
- Encourage problem-solving by not always telling your teen what to do. Instead, listen closely and help him come up with workable solutions to problems.
For more information on teen depression and suicide prevention, visit www.granthalliburton.org.
Diana Weaver, Executive Director, I AM H•E•R•E Coalition
Diana Weaver has more than 30 years experience in health-related and non-profit public relations, marketing, communications, health promotion and education and medical communications and has helped in the development and execution of several award-winning health campaigns. She has worked in large academic medical centers, health systems, community hospitals and non-profit organizations. Diana has been instrumental in strategic planning and developing health promotion and education programs for several organizations and has served on state committees for the American Cancer Society and the American Heart Association. She is on the Executive Committee of the Texas Suicide Prevention Council, and is co-chair of the 2012 Texas State Suicide Symposium.
Diana is responsible for guiding the operations and direction of the I AM H•E•R•E Coalition, a coalition for teen/young adult mental health in North Texas and an initiative of the Grant Halliburton Foundation.