and i just want to thank you all for taking this evening to come talk about kind of a heavy subject especially you know i think a kind of a warm spring night so this isn't the most fun topic to talk about but it is really important and so i really thank you for taking this time to to learn and to be willing to be open about something that can be hard to talk about so obviously as kalen said we're here to talk about depression in te children so you might notice a little blue question mark in the corner of the screen whenever you see that it means i'm going to ask you guys questions and hope that you can just feel comfortable shouting it out or raising your hand and sharing there's no wrong answers here  so why do you think we should talk about teen depression you know what brought you here tonight why do you think it's an important topic sh public awareness a little more and we kind of i don't want it to be something that tragic that you know gets people to act but you know to start that dialogue is important and so again coming here tonight can help start the dialogue for you know for yourself and among your really common as like what's teen and what's maybe more and it is hard to tease out sometimes so thank you for sharing and hopefully this presentation will answer some of those questions to try to figure out like how much is normal stress and how much is like kind of tipping the balance to where they might need some extra support  yeah and thank you for bringing up the issue of suicide that is something that we'll talk about today because it can be related to depression so we'll get more into that for sure somebody in the back  yeah exactly yeah hopefully being able to identify a warning signs early and to get kids and teens treatment early can prevent like more serious mental health issues down the road definitely  people you guys are like doing the entire presentation which is great so yeah i mean it sounds like there's a lot of different reasons for why people are here today by a lot of different reasons why it's important to talk about depression so who has depression  i think you know there are many many people that we may know when our own lives or that may be in the public eye that have identified like i do struggle with depression and i think that's really and you know a lot of us may know someone we may ourselves struggle with depression and the more that people are able to talk about it i think it really helps to reduce the stigma of depression and mental health issues so all the people featured here on this slide have you know been publicly open about their struggles with depression and it's great when celebrities that a lot of kids may look up to can be open about their struggles with mental health issues because it reduces that say about like you know if people look up if a kid looks up to like a famous athlete or a famous actor and they can be you know share their story about depression or anxiety or whatever they may be struggling with it can kind of again reduce that stigma and how you know kids who may be so again one of the important reasons to talk about teen depression specifically is that depression is common it's not just an adult issue by the time people reach their mid twenty's twenty percent of teens will have experienced teens and young adults will have experienced depression so that's one in five that's a lot like that's a significant portion of the young adult population that we will have experienced depression by their mid twenty's the good news is that depression is treatable  treatable medical condition and i think that's a really important point to make that it is a medical condition that can be treated just like you would treat diabetes or any other kind of chronic illness more than eighty five percent of teens who get treatment and that's often a combination of like talk therapy and medication do get better and show improvement so we definitely again as somebody a lot of people in the audience share like we want to identify depression so that we can get kids into treatment because it works like that's what i do as a clinician i treat kids with all variety of mental health issues including depression and we know that it works  so it's a it's treatable but the problem is that a lot of teens most teens don't get the help that they need and that can be due to a variety of  reasons it may be undetected somebody may be struggling with depression and we don't know access to mental health care can also be a really huge issue in our society and the way our health care system is structured  so it may be a lack of insurance or a type of insurance that is kind of a barrier to access like the co pays might be too high it could be a stigma in the family or in you know the social circle of that teen where you know treatment isn't seen as a viable option and so the good news about depression is it's treatable the struggle that we're obviously and what families are families for depression awareness tried to do is to reduce those barriers to access  h and what's really important is again getting kids into treatment because the potential effects of untreated depression can be pretty serious so as you can see on these to full of hearing slide there are a variety of affects that untreated depression can lead to substance abuse being one of them some people teens kids adults will self medicate so they might drink or use drugs to try numb or get rid of those feelings of depression and that can lead to a substance abuse disorder on top of that underlying depressive disorder academic failure is a big one not just because of the toll that depression can take on someone can be a really draining mental health disorder where like just the energy to even get up is a barrier so it may be like that just a lack of or inability to be motivated enough to do your schoolwork or it could be like missing school if kids are really depress unable to even go to school that don't not only takes a toll on their mental health it takes a toll on their academics like they could miss out on a lot of learning bullying is it's really common for not only those who have been bullied or are bullied but also who are the bullies there may be an underlying depressive disorder there oftentimes somebody who is a bully or engaging in bullying behavior is actually were bullied themselves at one point in their lives  that's something we'll talk about a little more eating disorders again ten arise from depression or somebody who's struggling with an eating disorder can become depressed so there they are into can legally and again suicide is the second easing leading cause of death for the young teen and young adult population that's behind accidents that's the number one cause so again i'm treated to pressure and ten lead to suicide or any of these issues it doesn't mean it will but it's just kind of highlights the importance of detecting and getting kids and obviously we're here to talk about teen depression but it's important to note that depression is not an adult mental health issue  almost half the cases of depression that maybe you know arise later in life start by the time person is fourteen years old so again this is an adult disorder it's you know what effect people of all ages i think somebody mentioned you know what's or was here to question like well how do i know if it's like you know a teenager just being seen moody or how do i know if it's something more the really key main factor is time one of the key factors is time in trying to distinguish between what's like a bad day and what's the pressure and the symptoms of depression and need to last for at least two weeks consistently so it's a it's a prolonged change from how a teen normally is so it's not like oh you know my teens you know having a bad day or having a bad week it's like i've noticed significant changes in the way that they've been acting and behaving and it's lasted for at least two weeks consistently you know again as we said it's a medical condition it lasts longer than just normal teen and it's a change for that teen and interfering with the teen's life so you'll see you know signs of depression that kind of permeate throughout someone's life it's not just at school or at home if someone's really experiencing depression you're likely to see signs in all different realms of their life so depressing can be caused by other number of different things there is a genetic  not to say that if there's a family member that has experienced depression that you know is a written script for their kids not at all but there is a genetic component component that's good to be aware of and also i think personally i think it kind of  strengthens that notion of this is a medical issue and that it kind of can reduce stigma to like if a teen is feeling embarrassed or feeling ashamed of a mental health disorder they may be diagnosed with it's helpful to say like listen this isn't your fault this is a medical condition and there's a genetic component you are genetically kind of primed to be you know to potentially develop a depressive disorder again it's not just genetics if someone's experience different life circumstances like abuse or trauma that can definitely significantly impact someone's chance of developing into present disorder i guess and also stressful life events like  loss of a family member a loss even and it doesn't have the a death it can be a loss of like an identity or a las of a place that someone moves and they were really identifying with their old spot their old home that could be considered a lot and i remember the signs of depression i know of but a lot of people want to know like ok well what does that look like so what do you think again the question mark what do you what comes to mind when you think of a teenager with depression you've seen in the media are just in your own leaping too much if you let are you guys like saw the slides before would be too much or too little yes definitely lack of appetite yeah eating changes right it could be lack of appetite or could be eating much more than they normally do for not caring and kind of goes for the loss of interest in things that they once cared about totally losing confidence in themselves yet negative self talk we can talk more about that too like the conversations they're all mine everything is like clouded over everything's negative sorry something in the back said your inability to pick it in a bowl or movie yes definitely that's something i think a lot of the times can be especially prevalent in the teen population that irritability and moodiness as a symptom of depression i think a lot for me at least when i was learning about depression i thought of like you know the brain cloud over your head and it's like you're sad and that could definitely be what depression looks like but it could also be irritability and like quick to anger for sure us like thought the sides are good enough i'm honestly everything that you just said the two key signs again the two key diagnostic indicators of depression are that depressed irritable sad or kind of feeling feelings of empty mood that last for again at least two weeks and that decreased interest or lot loss of interest in things that once brought them pleasure so they never were a runner and they're like why are they running that's not but if they used to love to run and they've suddenly stopped like cold turkey and there's no really no explanation there's no injury or anything it could indicate depress d what adults might notice from these two main sides are you know like feelings of hopelessness this preoccupation that life is meaningless like well what's the point you know doesn't matter again i realize  blue is hard to read so i can say it's kind of a lot of people were talking about change in sleep patterns or eating patterns of either sleeping too much or too little eating too much or eating too little i think of feelings of self like a lack of self wor like inappropriate guilt feeling like overly guilty when it doesn't really there's nothing to be guilty about and again like someone said that those negative like doubt it really negative self talk that a teen might be thinking and it can come out and some of what they say also things like changes in personal hygiene and physical health give us a team who's usually like really put together like you know does their hair every morning and they start to like show up at school in sweatpants so what we just went over is like the general signs of diagnostic markers of depression and it can again look different in every person you don't have to check every box that we did but two things to really be aware of that might indicate like an urgent need to get immediate health is cutting or other forms of self injury and suicidal thoughts or behaviors so cutting or self injury is not it is separate from or suicidal behaviors sometimes teens in kids may self injure as kind of like our release of these really intense emotions and what i think we'll hear a video in a minute where someone mentions that but what  teens and people who self interest say is that it brings a sense of relief despite the fact that you think we are causing physical pain to yourself but the emotional pain that they're feeling is so so strong that it almost is a distraction from what they're emotionally feeling and it feels like a sense of relief for them so cutting is separate from suicidal behavior that he or sorry cutting yourself injure is separate the intent to die is not there it's more the intent to not feel so terrible but it is very serious because it can have very serious physical health issues obviously they're hurting themselves and so if you start to notice signs of cutting it's really important to address those and we'll talk more about this in a minute but what you might notice is like actual physical wounds that are unexplained or if someone's trying to cover up you know cuts or burns on themselves they might be wearing long clothing even in like hot weather you know if they're wearing the long sweater and it's like ninety degrees outside things like that are signs that there might be some self injury going on and again we'll talk more about that in a minute but that is something to really pay attention to and it's not like all we can get them help in a month it's  suze signs of suicidal behavior something that we should definitely pay attention to my again we'll talk more about this but if you start to hear people talking about death maybe kids giving away important belongings that's something to pay attention to like they don't think they're going to need it anymore you know saying things like oh you'd be better off without me feeling like they're a burden those are definitely signs that they might be feeling suicidal  and there's a lot of different resources out there if you feel like your kid or a kid that you work with is feeling this way you can always call nine one one there's also agencies that are contracted throughout the state to provide emergency service mental health services so for the belmont area it's advocates is the organization there provide twenty four seven care mental health care for people experiencing a mental health crisis including suicid and their phone number is eight hundred six four zero five four three two i honestly encourage people to just put that in their phone like just a habit you may never hopefully never need it but to just have it in your phone for if you're ever in a situation and your feeling stressed because you might have a kid in front of you who's feeling suicidal to have that easy access it's really quick it's easy it's in your phone you don't have to take the time to look it up or you know again you can take a team to any emergency hospital and you can be seen for and about evolution we'll talk more about the phenomena but that's the number to the mobile crisis intervention they can come to you if you're at your home with your at school these services can actually come to where you are with the team you don't necessarily have to drive your teen to a hospital or to their location so it's knife and they respond like immediately and they're open again they're available twenty four hours a day seven days a week  all i would do is cry and with the littlest things against me that my family would do with my sister my father would tease me i just would take it the wrong way and just assume that they were making fun of me in china for me and i would  and my mom thought i was beat i was too unhappy and she was realizing that was affecting me at school and that she needed to do something about it because she knew that it was out of character submit to go away you want this feeling something interesting too i find is that like they said i can be this i can be this so even one person like their depression might look different on a given day so a few special concerns that pay attention to related to depression are bullying self injury and suicide risk again we're going to go a little more into detail in each of these so it's important for and any bowling situation to be aware of underlying mental health issues for both the person being bullied and the bully i know the belmont has like a very extensive i look in their website and there's a very extensive like bullying policy for the schools which is great so i know about you know if there's a bowling situation in the school there's a really clear protocol that belmont follows which is important both in you know making sure the bullying behavior stops and you know getting getting the person being bullied the help they need but also getting the person i think again doing the bullying like there should be consequences but there's also there could be some underlying mental health issues there as well i'm so to not like overly punish the bully but you know to get the consequences figured out and then  you know get support if needed i think safety issues addressing safety issues at home as well involving the parents of both the aggressor and the person who's being bullied is important and alving the whole  thing i think nowadays with social media a lot of the bullying is happening in a different way than like we might have been used to growing up it's not like necessarily getting our lunch money stolen in the hall maybe it is but a lot of it could be  nasty things being said rumors being spread on social media as well so i think monitoring teens social media use is really important you know i've heard teens talk about like people sort of rumors over instagram and all these things so just to be aware of that again for those who are the perpetrators the bullies there's obviously need to be strong clear behavioral consequences so that that behavior stops and doesn't happen again and to try to develop empathy in the person who's doing the bully so that bullying so they can understand how their actions are impacting another person there might be a lack of empathy there so finding appropriate ways for them to deal with their emotions that don't involve putting another person down is really important and then for those who are bullied they might there might be depression involve they might feel depressed based on how someone's treating them so to get them the support they need whether that be treatment or just social support from their friends and family are important to give them that perspective that things get better like it's not going to be like this forever i think with adolescent brain development the here and now feels like it's going to be like this forever for a lot of kids and to help as a trusted adult give them the perspective of like it's it's not going to be like this forever it's going to get better and to help them hold onto that hope is really important  for non non societal self injury again what we talked about and actually was me me in the video mentioned she said it really quickly but she said cutting she said i would do anything to get that release of my intense emotions and she mentioned mike fincke drinking smoking gun again we specified that it's different from suicidal behavior because the intent is not to die it's to to not feel those intense and it can affect people of any age gender ethnicity it's not like something in the me you know but the media my portray is like affecting a certain population of people it affects people of all ages genders and identities i think cutting a lot of that's the most common form but there are a lot of other identified forms of self injury including labors even ingesting like poisonous substances things like that and again it's just not feel the emotional pain is kind of there the  goal it's common it's more common than we might think and it's just important to recognize so what do you do if you suspect that a team that you know is your child or somebody you work with you suspect they might be self injuring it's really important to you might feel very panicked because it's a scary thing but it's really important to approach them calmly and in private so you know not in front of all their friends but you know talk to them and in person one concern like i've what i found a common language that's helpful is like i've noticed instead of like your you know you're doing this or i think you're doing this it's more like i've noticed these behaviors i've noticed you know you wearing long sleeves and some are i've noticed a change and i'm concerned so i think to to talk to them with empathy and with curiosity so just to ask a question they might deny it and don't push it because it's not going to make them open up just you know if a team says no no i'm not and you still are worried you can say like well you know you can come to me with any at any time with anything that might open the door for a later conversation when the team don't feel ready to talk about it again if they do admit to yes i have been self injuring just ask questions to get more information you know when do you do this how is that helpful what do you usually you know what do you do you know do you cut do you burn what do you do and you're asking those questions to again make them feel comfortable sharing so they know that you're a trusted person that they can rely on and to kind of also assess the need depending on the severity of their injuries they need immediate medical attention or it could be you know more of a let's get you into treatment was someone who hopefully specializes in teens or kids who self injure and kind of engage them in that process like i'm a you know i'm your parent i'm your teacher i care about you it's my job to keep you safe and part of being safe is being physically healthy and mentally healthy let's get you some support around that so that you don't have to feel these feelings and you can have a healthier way of dealing with these some you know a therapist who really is well trained in treating teens with self injury will have a lot of strategies but what you can suggest some suggestions are like snapping a rubber band on a risk like wearing the now last big band around a rest and snapping it  hurts it and it mimics like that release emotional release but it's less damaging than cutting even like drying on your wrists with a marker if that's where they tend to self injure just little strategies that you can use that you might say like what can what can we do instead that's a safer option that will help you know not feel these intense feelings but that won't lead to more serious injury if you you know we're talking about non two acetyl self injury but with depression especially untreated depression suicide is something that could arise from a teen feeling depressed there used to be a mess or there probably isn't cause it's a kind of a common myth that like i don't want to ask as i don't want to put that idea in their head research has found that that does not happen asking the question are you thinking of killing yourself does not there's no harm to it it does not have d n a teens head so it can be a really scary question to ask like as a clinician i'm scared to ask i still feel uncomfortable asking the question but if a teen is thinking about it it provides an opportunity for them to talk about it if they're not thinking of it doesn't it doesn't plant that idea that suddenly blossomed so again research has shown that that's a really safe question to ask someone that you you're worried about a teen that you think might be considering suicide and you just ask it and we can go over more how to do that  there we kind of talk about what things that might be cause more sorry depression might be caused by some of the risk factors these are more risk factors for teens who might be at risk of considering suicide and again none of these are like a prescription like if they've experienced this or definitely to be suicidal not at all it's just good to be aware of muslim and read all of them but again underlying mental health conditions like depression are definitely a big risk factor a history of trauma or abuse a lot like what kaylan mentioned a loss of relationships like a break got a loss of a friendship i'd ask for sure of somebody important to them  and i also want to definitely know local clusters of suicide and exposures to others who have died by suicide there's a lot of media coverage nowadays of suicide teens even like searching reasons why things like that it's a it's more commonly talked about in the media now and i think depending on how it's talked about it can be a good or a bad thing so i think just if there's a recent suicide either for someone the kid knows or someone that the kid somehow can connect to so it might be a suicide that it's kind of publicized in the media of someone two thousand miles away that a teen has never met but if they somehow identify with that person in some way like wow they were my age while they played sports too while they are a musician too something any kind of personal connection they may feel that could increase their risk of thinking of suicide as an option again it doesn't plant the idea in their head but if someone's already feeling very depressed and have thought about suicide having that connection point can gives them a kind of tip the balance a little bit  to say like you know for them to sign might be an option so i think it's really important to monitor our kids exposure to the media and to think about the way in which we talk about it doesn't mean to shelter them from those conversations but but to support teams in having a conversation about suicide and you know what does that mean to you if they see it on the news talk about it be brave enough to open up that conversation as a parent or teacher or someone you know like a kid you know well to talk about that and let them ask questions honestly i don't have numbers but by and large if a kid is really honestly feeling suicidal and somebody a trusted adult in their lives ask d in a compassionate concerned way most of the time they are honest it's rare that they would lie the problem is most people don't ask because they either don't don't detect the signs or  they're afraid they're afraid to ask because and that's not a bad thing it's it can be scary to ask but most of the time teens are honest if they are really feeling suicidal and somebody asked them the direct question they usually do answer especially again if it's with an adult that they trust  one thing i will say and i've learned this recently is ask are you thinking of killing yourself don't ask are you thinking of hurting yourself because they could say no because in reality they don't want to be her they want the feelings the bad depressed feelings to stop and the only solution that they can think of is to die they can't think of any other they don't want to hurt themselves they don't want to hurt they may not want to hurt they may we just want those those bad feelings to stop food by asking the question you think you're hurting yourself it's a softer way to ask it but it doesn't get directly at it they could say no i don't want to hurt myself but in their heads but i want to die so to be again to have the courage to just to name it and to say are you thinking of killing yourself is the the best most direct way to do it and again most of the time i'll be honest and if they're not they'll say not like what now you know like it's not again it won't plant that idea they will be honest i'd say the majority of so again some some warning signs we talk about warning sides of suicide or of depression but these are kind of one could be warning signs of someone who's considering suicide  again obviously talking about death wanting to kill themselves or even a morally gentle like wishing it could just all be over what's the point talking about being a burden to other people feeling guilty  increasing substance use like drugs or alcohol looking for ways to kill themselves either online by looking about looking up like how to buy a gun things like that were hurtful behaviors maybe even storing away prescription medications that they might be intending to be used for and overdo things like that withdrawing you know again some of these signs are similar to depression it would be a more elevated asking a teen if they're considering suicide will not cause them to begin considering suicide so it's to have the courage to ask and then to feel empowered if the answer is yes to to get them the help that they need and deserve so if you know if you ask the question to a teen and they say yes get them immediate help don't leave them alone even don't even leave the room there's no need to panic you know you can say thank you for sharing that with me i care about you and i want to get you the help that you deserve you don't have to feel like this and there are trained people out there who are able to help you feel better and we're going to do this together we're going to get through this so again there are a variety of options that emergency services provider the mobile crisis unit which is advocates for the belmont area they are trained clinicians that will come and evaluate a kid where they're at in the moment you could also call nine one one or take them to  so treatment and again we see with that is a heavy topic so i appreciate your willingness to be open to listening to and talking about it we're going to talk about treatment now for not just for kids are feeling suicidal but just kids who are struggling with depression in general good treatment depends on an accurate diagnosis so in order to know how to best serve a child or a teen you need to know what's going on for them is a variety is it depression like physical medical issues might be causing symptoms that mimic depression so those need to be rolled out hopefully by a doctor first and then a clinician if they're getting a mental health clinical evaluation it's an extensive like just questionnaire they ask a lot about family history about developmental milestones about recent changes going on in a kid's life and that typically involves the whole family too so a clinician doing an evaluation would meet with the parents or the caregivers and meet with  teen could laugh like days it could last hours it's pretty comprehensive but it helped the clinician understand what's going on for the kid and be able to appropriately treat the treatment for depression it depends is different for everyone researchers found again a combination of talk therapy and medication is the most usually the most helpful not everyone needs to be on medication but it has been shown research has shown that  and it's safe it can take time to kind of find the right type of medication or the right dosage but to you know to be patient and to really monitor the effects especially when the kids start a new kind of medication  or changes the dosage amount to really monitor that to see what's working and then other kind of more like interventions that teens can do on their own sleep eating and exercise like we hear that all the time that's important for everyone's mental health and that continues to be really important even for kids who are in treatment with a therapist and on medication and we're going to hear about hear from a couple teens about their finally finding the right one that works for me but i absolutely when you're in the state building we're talking about depression today bipolar disorder typically is diagnosed when there's like a mixed mood state so a kid might be experience experiencing periods of depression alongside periods of really elevated mood which is oftentimes a virtual mania and so it's a more of a fluctuation in mood that is prolong it's not like you know having a bad day have a good day the next day but it's more of a prolonged pattern it's again treated with talk therapy and mood stabilizing medication not necessarily antidepressants and a regular sleep cycle is really helpful especially for those diagnosed with bipolar disorder i think families for depression awareness has a lot of information on their website about both diagnoses depression and bipolar disorder if you want more information but just to kind of you might hear this disorder and say well what's the difference depression what we call depression is really you know polar depression and there's also bipolar depression so the unit polar is what we're talking about today and just to be aware that there's another diagnosed as bipolar that change in mood safety might be really depressed for months and then be very very like elevated happy mood states for a long time too so yes all right so we're going to talk now about how to get help so when to get help again if it's an issue of suicidality or self injury it's really important to get help as soon as possible and with suicidal ideas or ideation it's immediately for depression again those symptoms need to last for at least two weeks so if you're noticing a prolonged pattern of behavior that's a change from how the teen normally is then that's when it might be time to get that team some extra support  there are many different professions that provide mental health care to children and teens you might here counselor social worker psychologists licensed mental health counselor a psychiatric nurse practitioner and colleges all of these professions deal with the mental health field and depending on your child and the type of care that you are looking for any of these could serve your child well there is a lack of child psychiatrists in this country and we say that not to discourage you but just to encourage families to get to try to get an evaluation and to try to get an appointment with a child psychiatrist as soon as possible because there is a huge lack of to like that your third is a program now called the pap and i'm trying to think of what it stands for like massachusetts coalition for massachusetts child psychiatrist act access project i  prescriptions the kids for four primary care primary care provider who may not feel totally comfortable in that realm they can get some support that way and that kind of helps to make up for that gap so where to find a clinician there are a lot of different ways i think one of the the best places to start is the behavioral health number on the back of any health insurance card so if you have a health insurance card or your family has a health insurance card if you flip it over on the back there is like a behavioral health phone number hotline and they can help connect families to providers in the area that accept that type of insurance so that's a really good place to start you can talk to your pediatrician you can talk to a school guidance counselor or psychologist nurse there might be an adjustment counselor if that applies to belmont also just talking to your contacts like neighbors friends family members who they see that they have any recommendations and then families for depression awareness has a lot of great resources on getting help in trying to find a provider that again is in your area except your insurance and specializes in the type of care that you're looking for i think with depression like you can talk more about those two but depression affects the whole family and that's kind of family for families for depression awareness awareness is like entire kind of philosophy and so if a teen is in treatment it's really important to support the whole family and so getting connected to a support group might be something that's worth doing because as a parent or as a caregiver it can be a lot for you to support your teen so to get yourself support as well is really helpful and if you go on the family aware dot org website the you can find those resources as well resistance a lot of maybe feelings of shame or embarrassment what's important to communicate to them is that you care and it's your job as a parent to keep them healthy and safe and part of that is keeping them mentally healthy and safe and getting them the treatment they deserve  it's important to stress that depression is not their fault it's a medical condition and it's treatable i think inspiring hope is really important and all said to like i like to use person first language and saying like instead of like a depressed teen start with a teen who is struggling with depression or a teen with a depressed depression diagnosis that puts the person first it's and the diagnosis is something that is not who they are as something that they carry as a diagnosis but it doesn't have to stay with them forever hopefully it doesn't you may not be the parent and you may be the trusted adult you may be the trusted teacher coach neighbor aunt who ever or who you have concerns about the teen it's very someone like i've noticed a change i'm concerned about you and i want to get you the help you need to approach that teen and to involve the parents eventually as well as really of reasons some resistance or some hesitation there could be a stigma there could be like a denial of the problem there there is a lot of reasons why people might not be able to accept that their teen needs mental health treatment and so how do you have these conversations therapy to help with what's going on in their lives they need medical attention not time right waiting isn't going to solve anything it's on a phase it's something that needs to be treated for sure thank you i don't want to label my child i think that's a common one worry about the stigma what would you say to a parent is like what i want to label my child i don't want to give them a name a diagnosis they already have it yeah i get naming it doesn't create the problem totally yet also you know to reduce that thing when you would you would seek help for your child if they had any other kind of medical condition so why is it different from mental health totally i can refuse to see that the parent right like it's your job yes exactly it's your role to support your child to be healthy and safe and that objection would not stop you from bringing them to the doctor for a broken leg so it's not shouldn't stop you for yes sorry look at the back of your insurance card totally school counselor yup there's a million people you can ask for sure exactly we discussed all those options earlier i can help you get the support you need i don't want my child to take medication i heard it's dangerous has side effects and hasn't been tested that might be a reaction a parent may have any ideas of what you might say they're valid they won't necessarily need new medication exactly yet totally sorry might try though yeah exactly you might not mean medication and if they do and i depressants have been tested on our very face they've been shown to have very positive effects and again you don't know you don't know what your teen may need and so it's important to get them talking to a professional this is a very brief video of just hearing from parents you've heard to keep from teens but hearing from parents about what their experience is having a teen who's in treatment to network and talk to so many people childhood my dad like a lot of other parents had has a fix it attitude where he just kind of i think in the beginning felt like if he gave the therapist the money the therapist would just fix his daughter and that would be had he would be hands off for him and that's not the way they were he works i've learned through my therapy about the nature of changes slow and even and difficult and that's exactly where mine is  yeah i think again that that point of getting the family support like getting connected to support groups or maybe other parents who are on the same journey is important because it can be very thing for not just the team but the parents and the whole family all right we're to talk and now we come into how to to help parents who may have some some questions or be a little hesitant now we're going to talk about what to do in the teen adolescence which is probably more common it's very common for teens to maybe distrust the mental health system of the health care system to to not want to carry that stigma are they feel a segment i want to carry a label you know kind of feeling like i'm independent you can't tell me what to do all of these things can be really comm or yeah you need you deserve to go to someone who can help you and give you tools to get through this when and less painful way totally time is not going to make it go away the one of you are strong you know i can handle it on my own it's like you are a strong person but what you have is a medical condition that needs attention not time totally i'm not crazy i think that's something you might hear a lot i'm not perfect but would you say that actually you're right you're not crazy you have a medical condition you have depression that's treatable i'm going to get you into treatment you're totally right you're not i don't want to be locked up in a hospital i think is a common fear for teens as well  you won't be right most people with depression don't need to be in a hospital and you know locked psychiatric facilities are kind of a thing of the past too so i think you know what if you watch old movies like that kind of stuff doesn't happen anymore but y most teens do not need to be hospitalized and i think that's why you know getting teens identifying depression early and getting them into treatment can avoid any kind of hospitalization for sure i don't want to take medications again similar to what you to the parents you might not have to yeah we don't know we don't know if you're going to need to take medications and if you do they're safe and will help you feel better and it will be in conjunction with talk therapy as well  but this i understand that you're uncomfortable but it's my job as a parent or a trusted adult to keep you safe and healthy and we're going to get through this together and so to kind of journey with them and align with them can be really helpful and go a long way  i think i mean specifically about punching a wall i think in general like you can back on this show but i think in general it is a release it tends to be a release of anger or of really intense emotional feelings so it's the the goal is not to cause harm to yourself but it's more your your emotions are so intense in that moment that you need that release and you can't think of another way to do it like a healthier way like going for a run or shouting into a  pillow so again the goal is to get rid of those really intense feelings that are overwhelming and feel terrible emotionally and so for things like cutting burning or punching a wall i mean the end result is physical pain but it's an escape from the motional and i think that does carry over to something like punching a wall self injury for those who that i've talked to who felt and they say it it is a coping strategy it's not a healthy coping strategy but it is a coping strategy it's something that they're doing to cope with the emotions that they're feeling and so part of what they would do in therapy is find healthier safer coping strategies to replace those unhealthy coping strategies so you know to say we'll stop doing that it's like well they don't have another option they can't think of another option like they feel so terrible emotionally on the inside that they can't think of another way to make those feelings go away and so hopefully with some mental health treatment especially someone who maybe specializes in self injury if that's like the predominant concern they would help them practice and develop other coping strategies so that that need to self injury isn't there anymore because they have better ways to deal with their emotions others i think you know that they could but that wouldn't necessarily be related to their depression and suicide ality typically when someone's feeling is feeling so depressed or so suicidal it's about you know just wanting those again those feelings to stop and not being able not having the capacity to think of another option so i think in terms of someone who might be thinking of killing other people they could be experiencing depression but there likely another component there maybe they had been really severely bullied there or there is another reason for it like there must be something about the person that they're thinking of killing or the people they're thinking of killing that would be beyond just depression so  work i mean i will say very clearly like i'm not afraid if i don't like a medical degree and so i definitely think the best person to talk to would be the child their teens medical providers or their primary  provider or a psychiatry is for sure because again i don't have a medical background so i can't prescribe medication but i you know i would say that it is possible it's usually not like it's not safe usually to do it cold turkey to just stop  i definitely think dosages can change and should change if a teen is on medication they should be very closely monitored regularly by their psychiatry so the person prescribe them the medication to monitor those changes in mood and changes in feelings and behaviors so that if the teen is showing a lot of improvement maybe their medication dosage backed off a little bit and continuing can continue to to back off so it's not like black and white kind of thing it can be a really you know i used to have to take a much higher dosage and now i'm down to a low dose and maybe eventually one day i'll be off but i think it's really important that again the prescribe ing doctor or psychiatry s and whatever other mental health professional that teen is seeing are in close collaboration with each other for sure i think that's really important as well so if you know a teen is seeing a counsellor and they're also senior psychiatrists the parents can sign a release of information so that the psychiatrist and a counsellor can talk to each other and that can be really helpful to say the counselor might say hey this teen is showing a lot of improvement they've developed a lot of coping strategies to be able to deal with their emotions in a healthy way you know what do you think about backing off a little bit on the dosage and to have those mental health providers talk to each other so again that's like the extent of my knowledge i definitely again would just recommend having a close collaboration between all of the people involved in the teen's life so psychiatrist dr you know mental health professional and maybe the school counselor all of these people who can give the prescribing like the psychiatry s who's prescribing the medication hearing real stories from real people helps because it puts you know again makes it normalizes and makes it easy to kind of put a face to what we're talking about but thank you i'm just wondering if the the know it that's the point i think that kind of speaks to the prolonging change kind of deal you know there are it's normal to feel depressed feelings at certain points in our lives and it's expected and it doesn't mean that there's necessarily a mental health disorder underlying that so if someone you know didn't get into the college of their dreams they might have feel real feelings of depression that really like hit all the key signs and i would call that situational because it's about you know it's about one thing i think when those feelings remain and start to impact all areas of a teen's life that's when it might you know kind of flip over into a more like diagnos major depressive disorder you also have like seasonal affective disorder and that's a real diagnosable thing as well but that's again situational it's tied to the seasons so somebody might be feeling feelings of depression related to a specific event but if those feelings stay and start to interfere with the teen's life in all aspects that's when it might be something more th