What Parents Can Do About Behavioral Issues and Teen Suicide | Dr Lia Gaggino | Episode 195

Parents can do more than they realize to help their teen deal with the roller coaster of emotions that come with the teenage years. As our kids grow and their brains develop, they experience large feelings. Their limited skill set for managing emotions paired with the extra pressure of the pandemic has exacerbated behavioral health issues and increased teen suicide. Mighty Parenting podcast host Sandy Fowler interviews Dr. Lia Gaggino to find out what we need to know about behavioral health and teen suicide. They discuss what’s happening, why, and share steps parents can take to help their teenagers.

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A Favorite Quote from the Show: 

When you have concerns about your child’s emotional and mental health you’ll want to keep close tabs on how they’re feeling. However, your child may not want to talk about their feelings. A simple way to check in without being overly demanding is to ask them if they’re sad, mad, or worried. Then ask how intense that is on a scale of 1 to 5 where 1 means not at all and 5 means they want to punch a wall.

High Points From Our Conversation on Teen Suicide:

One third of medical visits are for behavioral health and mental health concerns.

There’s a continuum of behavioral health concerns. This does not necessarily mean your teen has a mental illness. 

It’s essential we show our children it is good to talk about their thoughts and feelings. Teenagers experience intense emotions and they need a safe place to express themselves.

Our children’s brains are still developing through age 25. During this time their executive function (prefrontal cortex) is underdeveloped and the primal portion of the brain (amygdala) exhibits a greater level of control. This can lead our teens to make poor decisions and take unfortunate action.

When the amygdala fires off it overrides higher thought processes, allowing the teen to be greatly impacted by the intense emotions they feel. It’s important to understand this and give our teens some grace while they develop more emotional skills as their brain develops.

When you have concerns about your child’s emotional and mental health, you’ll want to keep close tabs on how they’re feeling. However, your child may not want to talk about their feelings. A simple way to check your teen’s emotions without being overly demanding is to ask them if they’re sad, mad, or worried. Then ask how intense that is on a scale of 1 to 5 where 1 means not at all and 5 means they want to punch a wall.

It’s perfectly normal for our teens to have a bad day or a bad week. Remember, their emotions are intense and they’re all over the map too. Don’t worry about isolated incidents but rather look for a trend. 

Answering 1-2 is normal. If they are at 3 half of the time or more then it’s time for some coaching, counseling or therapy. A trending response of 4 says they’re dealing with a lot and definitely need some help. And regularly responding with a 5 is a really big problem.

It’s important to know if your child is safe when they are dealing with big feelings. This means not only knowing where they are but also asking if they have thought of hurting themselves. This includes things like burning and cutting.

Kids do not necessarily include suicide in this group so it’s important to ask about that specifically. “A lot of times when people are having feelings like you are they think of killing themselves. Have you ever thought about that?” [Research shows that asking someone if they’ve thought about attempting suicide does not give them the idea/push them to attempt suicide.]

If they answer yes then the first thing you want to do is check your own response. Hearing this is highly upsetting for a parent but your child will open up more if you stay calm:

1. Check your response
2. Have you made a plan?
3. (If yes) What does it look like?
4. How likely are you to do that?

17% of high school students have thought about attempting suicide.

The most common method for attempting suicide is medication so it’s important to lock up any medications, especially narcotics. However, leave epipens and inhalers out.

While firearms are used less often than pills it is the most lethal form of suicide.  In 80% of firearm suicides in kids, the gun belongs to the parents so get your guns out of the house if at all possible. If it’s not possible then lock them securely and do not let your children know how to access them.

There is a myth which says that if people want to kill themselves they’ll find a way. Actually, suicidal thoughts come and go. Restricting access to means kids can use to attempt suicide allows them the time they need to move past the thought.

Words we can use when our child opens up to us:

• I’m so sorry you’re having so much pain.
• Thank you for telling me. | I’m so glad you told me.
• I will help you get through this. We’ll find a way to get past the pain.

If your child expresses suicidal thoughts then it’s important to create a safety plan. A safety plan shows them how they can stay safe until a suicidal thought passes. Remember,  suicidal thoughts come and go.

If you have an embedded mental health professional at your doctor’s office then you can turn to them or contact a mental health professional. You can also contact a crisis line. They are trained to walk you through this moment. Either your child can call/text or you can call/text on their behalf: 

• Call 800-273-TALK (8255)
• Text 741-741
• Chat https://suicidepreventionlifeline.org/chat/ 

When our kids answer the 1-5 question with 3, 4, or 5 over a period of time that means they need to learn some emotional wellness skills.

Anxiety is very common in teens today but it is also very responsive to therapy, especially CBT (cognitive behavioral therapy).

One anxiety reducing activity is square breathing also called box breathing. Simply visualize a square/box and “see” a dot moving up the left side as you breath in to the count of 4. Then visualize the dot moving across the top as you hold that breath to the count of 4. Then visualize the dot moving down the right side as you exhale to the count of 4. Lastly, the dot moves across the bottom as you hold the emptiness to the count of 4. Repeat 3 times or longer. A few minutes of this is very helpful.

You’re always going to have worried thoughts. What you can control is what you do with it. Behavioral health coaching can help give you tools.

Resources:

A Beautiful Day in the Neighborhood

Inside Out

CALM: Counseling on Access to Lethal Means 

Harvard’s Means Matter tips for parents 

Square/Box Breathing  

Crisis Lines:

• Call 800-273-TALK (8255)
• Text 741-741
• Chat 

Mighty Parenting Tackles Teen Suicide Prevention | Sandy Fowler and Judy Davis | Episode 86 

Our Guest Dr. Lia Gaggino:

Dr. Lia Gaggino has been a general pediatrician for 31 years, the president and vice-president of the Michigan Chapter, of the American Academy of Pediatrics, and has served as Chair of the AAP National Nominating Committee.

Her personal passion has been children’s mental health, adolescent health, and suicide prevention knowing that the emotional well-being of children is at the core of their health. She serves as faculty for the Zero Suicide Institute, has worked with Substance Abuse and Mental Health Services Administration (SAMHSA) to create a practical guide to youth suicide prevention in the primary care setting, and was a content expert for The American Girl The Caring and Keeping of You – The Body Book.

To learn more or connect with our guest visit https://www.facebook.com/DrLiaGaggino/.

Our Sponsor:

Sandy Fowler: Are you stressed but don’t have time to deal with it? I get it. Grab my complimentary lesson at http://sandyfowler.com/notime to find out how to start feeling better today.