Teen Talk: Teens and Suicide Prevention Month

Teen Suicide
Posted at 10:00 AM, Sep 15, 2014
and last updated 2014-09-15 08:23:35-04

TALLAHASSEE, Fla. (WTXL) -  This week's "Teen Talk" is focused on advice for parents when it comes to teens who may be suffering from depression.

WTXL contributor and family therapist Jane Marks:

1. Only 1 in 5 depressed teens typically receive help and so education and understanding teen depression becomes the first rule of thumb for any parent, teacher or friend who suspects that someone close to them has deep depression.

2. Learn more effective ways of communicating with teens with significant depression.  For a person who struggles with chronic, significant depression, this may mean missing school or hospitalization.  If that is the case, a strong management plan is clearly in order to help in situations that require ongoing medical intervention.  It will require a strong working relationship with the school so that a teen's health can be managed in such a way that they successfully complete the high school experience.

3. Deep depression or significant depression among teenagers is a series of common symptoms; constant irritability and/or sadness, a lack of complete joy, feeling bad about yourself, sleeping too much, frequent unexplained headaches or physical symptoms, dysphoria, weight loss or gain, compromised concentration, helplessness and hopelessness, and thoughts of suicide.

4. Treatment options for teens with deep depression typically include psychotherapy where sessions may last anywhere from 30 to 60 minutes.  This is generally the first rule of thumb for teens and parents who have identified deep depression.   In most cases however, deep depression will require anti-depressant medication so this would be the third issue to look at from a management standpoint.  If your teen requires medication, typically they are referred to a family primary care physician or to a psychiatrist.  Medication can help to reestablish the normal balance of chemicals in the brain.  Classes of anti-depressants used to treat depression include selective Serotonin, reuptake inhibitors, or other atypical anti-depressants and trycyclic anti-depressants.  Finding the right medication is not always an easy solution, sometimes it can take anywhere from 4 weeks to 4 months to get the right combination.  Again, this is working with a healthcare team that you trust.

5. Parents often wonder about the risk of suicide.  Some medications have been linked to risk factors in suicide.  All of this needs to be discussed with both the primary care physician as well as the therapist on board.

6. Parents often ask; if a child is placed on medication, what is the typical time frame?  It has been our experience that at least 9-12 months is necessary for established symptoms to improve significantly.  If a teenager is at risk for significant depression or relapse, maintenance drug therapy may be included but must be followed by major health care providers.

7. Other treatments for depression may include omega 3 fat acids.  A large international study found beneficial effects of omega 3 fat acids like St. John's Wart, certainly these need to be discussed with your primary care physician.

8. Parents or teachers who have identified someone with significant depression also need to make sure that concurrent issues are ruled out.  For example, bullying, physical, sexual, or emotional abuse, a history of parental depression, ethnic and cultural factors, homelessness, refugee status; all of these are factors which contribute to significant ongoing depression.  Another contributing factor is living with a chronic health condition.

9. Remember there are multiple types of therapy so if you happen to choose one type of therapy that does not work, for example, there is cognitive behavioral therapy which teaches your teen to reason through negative thoughts, family therapy is often helpful, group therapy can help teens to learn through the experiences of others.  All of these are options for kids experiencing chronic and significant depression.

10. It is important to support your teen with daily routines.  Schedule family times to help teens to get enough sleep, create healthy diets for their family, watch for signs that the depression is getting worse.  Exercise is not an option; it is a matter of when you are going to do it.  Always check for the risk factors of alcohol and drugs.

11. Should your teen find a successful treatment plan, particularly medication, continually remind them that medications must be taken on a daily basis. Do not ever stop the medication abruptly.  Also talk about the importance of alcohol mixed with medication.  This can sometimes be a very lethal combination, so we stress the importance of drinking and taking medication at the same time.

12. If your teen is depressed in the fall and winter, talk to your primary health care providers about light therapy where a special lamp is often used to help increase the amount of access to light to help in lifting mood.  Particularly if your teen has struggled with depression and is going off to universities up north. Over the years we have found this to be very helpful.

13. Be careful about guilt and blame. Your child did not choose significant depression and you did not cause it.  We do know that depression is very often a inheritable brain disorder which is not always triggered by stressful events and brain changes, so therefore as parents we often feel like if we had done a better job we could fix this.  So we must be patient and develop realistic goals about the management of what indeed for some is an extremely difficult journey.  One of the things we always talk to our patients about is that depression in teens can manifest itself in so many ways, but just as it can manifest in so many ways, we can develop strategies to face whatever it is ahead of us.  Families and friends are remarkable resources for teens and we hope this information we presented today helps with the road you are traveling with regards to teens that are close to you.

Watch Teen Talk every other Monday at 6:30am on WTXL's Sunrise.