What Parents Need To Know About Teenage Emotions And Suicidal Thoughts | Dr. Lia Gaggino | Episode 123

Children’s emotional and physical health are one and the same. The health of the body impacts our emotions and thoughts. Conversely, our thoughts and feelings impact the body. As our teenagers grow up they experience intense emotions and may even have thoughts of suicide. Actually, 17% of high school students have thought about suicide. Fortunately, parents are in a position to help. Dr. Lia Gaggino talks to Sandy Fowler about the essential things every parent needs to know about teenage emotions and suicide ideation in order to keep your child safe. Be sure to listen and share this episode of the Mighty Parenting podcast with every parent you know.

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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 What Parents Need to Know About Teenage Emotions and Suicidal Thoughts:

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

Behavioral health concerns are not necessarily caused by a mental illness. 

Teenage emotions are intense. Parents need to set the stage that it’s okay to talk about your thoughts and feelings.

Parents often wonder why kids do things we consider stupid. It’s because kids brains are under development and don’t work like adult brains. The prefrontal cortex does not fully develop until around age 25.

Teenage emotions are intense and seem to run the show. Since the prefrontal cortex isn’t fully developed, the amygdala often runs the show. The amygdala governs basic emotions and this is often referred to as primal thinking. These emotions are intense. Also, when the amygdala fires it overrides everything else. So when those teenage emotions overflow it’s important to give them some grace.

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.

Teenage emotions can be all over the map and a bad day or a bad week is normal. What you’re looking for is a trend over time. 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 response of 4 says they’re dealing with a lot and definitely need some help. And responding with a 5 is a really big problem.

If your child is experiencing really difficult feelings then it’s important to know where they’re at with those and if they are safe. You need to ask them if they have thought of hurting themselves. This encompasses a range of things including 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 has shown that this will not “put the idea in their heads” or create a suicide attempt.

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. 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.

If you are concerned about your child then it’s essential to remove any firearms from the house. This is the most lethal form of suicide. In 80% of firearm suicides in kids, the gun belongs to the parents. 

Medications are not as lethal as guns but are more common in an attempt. So lock up any medications, especially narcotics. But leave epipens and inhalers out.

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. Safety plans allow people to think through things they can do to help them stay safe even as 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 Mentioned in Show:

A Beautiful Day in the Neighborhood

Inside Out

CALM: Counseling on Access to Lethal Means https://www.sprc.org/resources-programs/calm-counseling-access-lethal-means 

Harvard’s Means Matter tips for parents https://www.hsph.harvard.edu/means-matter/ 

Square Breathing https://sandyfowler.com/coronavirus/ 

Crisis Lines:

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

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.

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