The Arizona Republic

Know the warning signs

Learn about teen depression and suicide, and talk to your kids

- Dr. Ankur Desai Special to Asbury Park Press | USA TODAY NETWORK

Death by suicide is on the rise and this appears to be closely correlated to the increase in depression in teens and young adults, based on CDC research.

ASBURY PARK, N.J. — The television series “13 Reasons Why” and celebrity deaths such as Anthony Bourdain and Kate Spade have pushed the topic of suicide to the forefront for many Americans, but especially for teens. ● Death by suicide is on the rise and this appears to be closely correlated to the increase in depression in youths and young adults, based on the latest research from the Centers for Disease Control and Prevention (CDC). In fact, suicide was the second leading cause of death in young people ages 15 to 34, and the third leading cause of death in youths ages 10 to 14. This makes it one of the most prevalent health issues facing young people today. ● Untreated depression is a significan­t risk factor for suicidal behavior and suicide attempts. Do you know the warning signs?

The impact of the media and technology

When high-profile suicides occur close together, like in the case of Bourdain and Spade, teens become more aware of the trend. Coupled with the Netflix series “13 Reasons Why,” which follows the story of high school student Hannah Baker’s suicide, teens may develop the impression that suicide is an acceptable solution.

Twenty to 25 percent of youth will experience a mental health disorder in their lifetime, with most mental health disorders beginning in childhood or adolescenc­e, according to the National CoMorbidit­y Survey: Adolescent Supplement.

The “virtual world” can give us a false sense of connectedn­ess through apps like texting, Facebook, Snapchat and Instagram. Excessive amounts of screen time and use of social media doesn’t provide children with the opportunit­y to form and develop live, in-person relationsh­ips. Social media provides a false lens through which to filter reality from our lives.

As an extreme example, a seemingly innocuous social gaff can be shared and amplified on social media instantly, resulting initially in embarrassm­ent and potentiall­y to social isolation and feelings of loneliness and hopelessne­ss. These feelings could develop into a larger depressive episode with more serious implicatio­ns.

Despite having some of the stiffest anti-bullying laws in the country, New Jersey teens still can feel bullied. As recently as the summer 2017, a 12-year-old Rockaway Township middle school student took her life after being harassed at school and online through texting, Snapchat and Instagram.

Recognizin­g the signs of depression

One in four adolescent­s will experience mental disorders that are severe enough to cause significan­t functional impairment. Recognizin­g the signs of depression is critically important to ensure that your child gets the services and support that he or she needs.

The potential signs of depression and anxiety, include:

❚ Changes in energy level

❚ Changes in appetite

❚ Changes in concentrat­ion, which could result in a decline in academic performanc­e

❚ Avoiding school and social events that is distinctiv­ely out of character to previous behavior

❚ Negative thoughts about themselves, the world around them, and the future

❚ Loss of interest in activities which he or she previously enjoyed

❚ Suicidal thinking and non-suicidal self-injurious behaviors, such as cutting

❚ Substance use and experiment­ation

❚ Increased irritabili­ty

❚ Change in sleep patterns

❚ Physical complaints with no clear medical cause or etiology

If you notice any of these signs, be careful not to attribute it to “teens being teens.” As a parent, caregiver or wellwisher, it’s important to identify when there is a change from baseline emotional and behavioral functionin­g. Ask your child what’s bothering her. Try to be proactive and preventive by opening the lines of communicat­ion and keeping them open. Remember, you are the parent, not your child’s friend.

It’s important to communicat­e and be aware of your child’s on-screen and off-screen life. There’s a fine line between being a “helicopter parent,” who intrusivel­y hovers over their children, and being an accessible, interactiv­e parent who provides space but is knowledgea­ble about what’s going on in your child’s life. Your child may be hesitant to talk at first and just provide one-word answers. That’s OK.

It’s not about the words that are exchanged; some of best interactio­ns will be through shared experience­s while working on something together or trying to complete a task together. Once you’ve establishe­d a level of comfort and trust, your child will talk when they are ready. They may even choose to talk to another trusted family member. Be open and supportive about whoever she chooses to confide in.

Should we go to the ER?

Once you understand more about the issues your child is facing, seek support services, whether it’s through your primary care physician, religious group, friends, family, community services or school resources.

If he or she is threatenin­g self-harm or harm to someone else, a visit to the local emergency department is necessary. Hospitals are staffed with skilled mental health profession­als who can help ensure your child stays safe. A recent study in the journal Pediatrics found that the numbers of kids being admitted or seeking help in the emergency department or hospital for suicidal ideation or attempts have almost tripled from 2008 to 2015. The rate of increase was highest among adolescent girls.

Be mindful of the potential risk factors and protective factors associated with suicidal ideation and behavior:

❚ A past history of suicide attempts ❚ A history of non-suicidal self-injurious behaviors

❚ Substance use

❚ Recent interperso­nal conflicts Protective factors, or qualities that can help a child cope with depression, include having a supportive family and social network and having a strong sense of religious or cultural identity. Once the child gets the support she needs, discuss a “safety plan” and the coping mechanisms that will be implemente­d if she becomes depressed again.

Suicide is preventabl­e by knowing the signs and being observant. Be mindful and attentive to any emotional changes that you may notice, and take steps to get your child help and support.

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GETTY IMAGES It’s important to communicat­e and be aware of your child’s on-screen and off-screen life.

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