Teen suicide: How we can all help teens (and their parents) cope

A current epidemic of teen suicide: How we can all help teens (and their parents) cope

"Suicide is the second leading cause of death in adolescents." Reported by The Journal of Pediatrics in November, 2019, "almost 1 in 5 adolescents are thinking about suicide" and more than 1 in 10 "has a suicide plan." Black adolescents die by suicide at a rate twice that of their white peers, another way that systemic oppression does harm. Since the pandemic shutdowns began in winter/spring 2020, articles and anecdotal reporting from hospitals and treatment centers have grown to indicate an increase in suicide among teens.

This year, a dear friend's teen daughter fell into anxiety and depression. Her journey was intensified and accelerated by the pandemic and its social isolation. I was surprised to hear how quickly she went from a happy, active teen to struggling to get out of bed every day. Not only did she lose regular interaction with peers, teachers, and after school activities, but her parents lost the reliable perspectives of all those adults and friends who might have helped notice that she needed support. When they realized she was struggling, they began to navigate tele-health appointments in a system that was suddenly overwhelmed with lots of teens in crisis.

In my front row seat to their journey I learned a lot about teens and anxiety and depression. As a parent, it has really awakened me to things we all need to know, whether we are parents of, or in communities with teens. Both girls and boys of all ages are struggling with middle- and high-school students particularly vulnerable. Repeatedly, professionals reassured our friends that their daughter was not alone, because teen anxiety, depression and suicide have sharply increased since March. We did not find that reassuring at all.

With many schools opening to a "hybrid" schedule, going back to school might cause anxiety for a lot of kids. This article is to share some things my circle of friends learned through their journey, and to encourage you that, during this time of pandemic and cultural struggle, do not underestimate the risk to our young. Without sharpened focus, we are in real danger of losing many children to this unspoken side effect of the pandemic.

Parents, colleagues and community members, take a look at the resources and indicators here, share articles and reach out to each other. How do we help parents help their kids through this stage?

Teen brains are different

In the course of their teenage years, children's brains almost completely reorganize themselves. Literally. First, the emotional center of the brain becomes much more sensitive, driving intense emotional reactions. Neurobiologist Dr. Frances Jensen, states, "Functional imaging studies have looked at children, adolescents and adults who are given the same emotional stressor, and the adolescents will light up the emotional center-the limbic system-twice as high as children or adults." This means that what makes you sad or angry is likely to hit a teen twice as hard. I cannot even imagine doubling all the emotional distress I've felt during this pandemic.

During this major restructuring of the brain, a second influence cranks up the changes: puberty. With hormones coming online, the combination can make teens very vulnerable to anxiety and depression. Isolation of a pandemic makes for a triple whammy of stressors during a time of great transformation.

In addition, "the prefrontal cortex is one of the last brain regions to mature," the National Institute for Mental Health reports. "This area is responsible for skills like planning, prioritizing, and controlling impulses. Because these skills are still developing, teens are more likely to engage in risky behaviors without considering the potential results of their decisions." We often think of risky behaviors in teens as drinking, sex, and smoking pot but it can also include self-harming thoughts and plans. They don't have the brakes that adult brains have that allow them to think through their consequences or imagine a better future.

Tips for Parents Whose Teens May Be Struggling

Teens take on all kinds of new behaviors as they grow and as their brains change. Many indicators of suicide ideation may look like regular teen behavior, possibly amped up. Before you react, take a moment to consider if there are deeper feelings occurring. Learn the behaviors that are cries for help.

Pay attention, take notice. Your teen could look like they are fine but are masking their desperation. Are they having bigger emotional responses than usual? Sadness, crankiness, even hysterical laughter? Any behavior that has a new edge of "too much" can be a sign to pay attention. Alternatively, take note also if your teen is becoming non-communicative. Insomnia, agitation, or hiding out in their room can be signs your teen may be having feelings they cannot process.

Don't assume. Don't assume their habit of hanging out only in their room is just being a typical teen. They could be falling apart in private, and not know what to do. This is the time to help them find healthy coping tools.

Ask questions. It's okay to ask, "Are you depressed or anxious?" and to ask "Have you thought of harming or killing yourself?" This may feel awkward or scary if you are not used to such conversation, but push past your fear and take time to listen. In a moment of upset, if your teen says, "I don't want to live right now," do more than acknowledge their big feelings. Take it as a red flag and ask the direct questions. There is no harm in asking. You are not going to plant the idea of suicide in their head. Hearing you talk about it thoughtfully can help acknowledge their feelings and help them recognize their first way out of their pain. Teens may pull away from parents for independence, but they also want to be seen and witnessed.

To mitigate against the addictive effect of social media use, turn off all notifications on all of your teens digital platforms (you might consider turning them off on yours as well). Limit their time on devices as much as you can, especially since they are doing so much online for school right now.

In addition, take into consideration the darker drawbacks of an ever present community of strangers in many social media platforms like Tik Tok, Facebook, and Instagram. Regretfully, kids and teens are common targets of predators online. Teens who are struggling, specifically, are frequently targets for people who seek to do harm. They will first appear as caring people who are the "only ones" who truly understand their suffering-heady stuff to a teen who needs independence from their family but is still in need of validation. This "grooming" quickly escalates to texts, phone conversations, video meetings, and eventually in-person encounters.

There are privacy settings and controls to mitigate exposure, but it's important to note they are not failsafe. On many platforms, even with privacy settings on, if a teen makes a post on someone else's timeline, participants can make contact and message them. This happened to our friend. Within hours of making a comment that she was struggling, there were several offers of "help", some from people saying they were teens and some as adult men saying that they had helped lots of girls like her.

It's important to also note that any information is free and accessible on social media. It's easy for teens to gather inaccurate information, or become involved with a community that isn't safe for their well-being. They may also not fully understand the permanence of their own posts and how they can shape how people perceive them for years to come. Take conscious steps to monitor your kid's devices. Let them know you respect their independence and that, as their brains are still forming, you're going to help guide them with learning to discern.

Reduce contagion. Teens are vulnerable to "contagion" of self-harm behaviors and suicidal ideation. Ask thoughtful questions and step in with support if friends of your child are exhibiting cries for help. This is another reason to be cautious about social media where teens might search for answers but then find themselves inundated with more and more algorithm-driven content about anxiety, suicide and depression. It can become a vicious circle that creates a sharp imbalance in what they see, experience, and feel.

Steer teens to supportive people they can talk to. Talk to community leaders you know, teachers, older siblings, spiritual leaders and trusted mentors. Work with a local therapist. If you have insurance through your workplace, your company will likely cover the cost through your benefits. Telehealth with therapists and group counselors have taken the place of many in-person therapy appointments, but can still offer healing to those in need. And outpatient programs can offer more intensive and focused support, again often covered by insurance. If you don't have insurance, many places offer sliding scale rates so that people can get the help they need.

Reduce stigma. Have casual conversations in front of your kids about mental health and suicide. Challenge the idea that wavering mental health is a sign of weakness, as has been perceived by generations before us who have kept it silent. It's the result of a lack of coping tools. Ask them how their friends are doing. Share with them experiences of your own mental health and how you have supported it when you have lost fortitude. Our teens learn resilience from how we manage our own pains and challenges. Seeking and building tools for health and resilience are important paths, both on the way to adulthood and throughout it.

Self-Care for Parents

One of the hard truths behind teen suicide ideation is trouble at home and family stress. Kids don't want to disappoint their parents so they will unconsciously take on more and more of their family's distress. Pressure for parents right now is monumental. It's vital that you take opportunities to restore your own personal bandwidth so you can be the support you are trying to be for your family and work. Meeting life's current challenges is really hard right now. Find ways to take some of the pressure off where you can, and try to add in some levity too.

Acknowledge your feelings. This isolation time can feel overwhelming. If you're working, leading a team, feeding a family now at home all day, there's more to try to take care of. Acknowledge your feelings about the pressure, and model working through it together. Decide what you can let go of and dial down expectations. Identify those family and community resources that support you, and be vocal about the support you are getting.

See your own therapist. This is likely covered in work benefits, and can be the most important support you find while supporting your family. Journal of Sleep Research found that 80% of mothers are reporting higher levels of COVID-related anxiety as well as insomnia. Talking with a therapist can help you not only process the stress you are feeling but allow you to learn new skills for coping with distress, making you more resilient.

Talk to other parents. There are a million new things to take care of but try not to isolate yourself in tasks. Make some phone calls to other parents. Trade advice and encouragement. Find ways to work together to share some of the load. Don't go at this alone.

Ask for support. Call in your single friends, and your outer circle of family as help resources. Ask good friends and family to text your teen to check in, send pictures of memories, ask how they are doing and what projects they've been exploring lately. Remind grandparents to call, send notes, fun comics, and stay in touch. Remembering the people in their lives that love them can go a long way to mitigating the pressure of isolation. Loved ones reaching out can help you as well as your teen. Ask for what you need.

Take timed breaks. When things feel steep, it may sound preposterous to find even a minute for a break. But your brain needs it. Your nervous system needs it. Time yourself for one minute of breathing deeply, putting your thoughts on your breath. Listen to one song long enough to dance around. And cry. Instead of fighting it, I recognized it as one of the ways our body can release built up tension and stress. Let the tears come, and know that they will pass too. Find ways to give yourself more time each day. Insight Timer is a helpful app that hosts free guided meditations, calming music, chimes, and has a paid version for mindfulness courses.

Social Outreach and Life Off Screens

According to psychologist, Dr. Alduan Tartt, one of three things kids are most stressed about is a disappeared social connection. "Social media is not enough," he states. With stakes this high, we've got to consider how to weigh internal strife against the external risk of Covid-19. What's more dangerous, suicide or Covid-19? It's a challenging question, but struggling with it may offer some solutions in the middle ground. How can you expand their social bubble while staying as safe as possible? How can you expand their experiential palette with art, color, nature, action, elements of their week that are not media-based? Reach out and help your teen put texture and relief back into their weeks.

Build structure back into your teen's life. Lack of school made for a challenging spring and summer. My own daughter made the pressure clear to me and her dad when she said, "You guys have your lives all day, your jobs. But I'm sitting in my room trying to figure out what to do with myself." If your kid has begun school virtually or hybrid, this is good news for structure. But who can they be in contact with after or during school in a regular way? Check out Boys and Girls Club programming, and if you're willing, local outdoor groups. In my area, the Wilderness Youth Project maintains social distance and meets outdoors, where kids can both get into nature and be social once a week. Check into programs in your area that can stimulate your teen's need for structure and socializing off screen.

Connect with teachers. Teachers are shouldering a lot right now and it's important that we partner with them in meaningful ways. Encourage teachers to let students go into Zoom breakout rooms for ten minutes of social interaction and catching up with each other. Our brains develop in community. Without opportunities to connect with peers, teens struggle for their identities and their purpose. Share these resources with teachers and schools so they can help their students and parents.

Get outside. Instigate projects. My daughter got into studying crystals and geodes. She does extra chores to save money to buy books about them and to purchase her favorites. A friend's teen saved money to adopt a bearded dragon and its habitat. The teen takes the pet everywhere around the house and neighborhood. Another friend's teen has started baking or helping with cooking dinner every day. It may be hard to get them motivated when they've become dependent on their screens, but their brains need the rest, and three-dimensional interaction.

Teach kids to watch out for each other. In an effort to support everyone as much as possible, the conversation about teen anxiety, depression and suicide should be an open one. Teach teens to check in on friends and classmates, and to pay attention to the indicators. Let them know that it's kind to alert a teacher or parent if they are concerned. Mental health is nothing to be ashamed about. We all carry our heaviest days with us, and find relief in contact and witness. I'm reminded of Dr. Brené Brown's research on vulnerability. As she states in her TED talk, "The two most powerful words when we're in struggle… 'me too.'"

All of these tips have helped my friend's family navigate this difficult time and I am relieved to hear that things have gotten much better. But I also know enough now to recognize that we must remain alert and active, because until this pandemic has passed and we can resume more connected lives, kids under this new pressure are in danger. Now more than ever, we must become that proverbial village that it takes to raise a child. Check in on the kids in your life, and their parents too. You may just offer the lifeline someone has been desperately waiting for.

RESOURCES AND ARTICLES

• More schools are reopening. Here's how to prepare kids for The Return
• Back-to-School Anxiety During COVID
• Research Brief: Latinx LGBTQ Youth Suicide Risk
• Grief at Work: How to Help People
• "If you are thinking of suicide, read this first"
•  "Questions that can save a life"
•  CDC: Grief and Loss (and hotlines)
•  Teens and Covid-19: Challenges and Opportunities During the Outbreak
•  Why Teenage Brains are so hard to understand
•  The Teen Brain: 7 things to know
• Youth Suicides were rising before Covid-19. How should we support kids now?
• Boys and Girls Club of America, national programs by age
• America if Facing a Teen Suicide Pandemic
• Resources for People Grieving a Loved One
• The Social Dilema