professional counselor and also a registered nurse she has worked both impatient and outpatient with children and adults with mental health issues each day in our nation there are an average of over thirteen hundred times there are thirteen ends attempts by young people in grades nine through twelve thank you for joining us a point you're welcome so can you just give us a little more on like your background like what your job is and what you do i started out as nurse and ended up working in the impatient psychiatric unit in the hospital and i really like mental health nursing and ended up having a family and then went back to school and got my master's in counseling so i have to state licenses i am a registered nurse but i'm also a licensed professional counselor and i have a private practice in water dam plaza and with the satellite office in burkett's town and the name of my private practice is counseling and trauma services and myself and the people that work under me specialize in post traumatic stress disorder when bad stuff we deal with all kinds of mental health issues but we specialize in when bad stuff happens we can help people to heal and that's exciting so how do you get involved in this in the first place like what was your motivating factor to get into this sort of field well i'm a helper i'm a nurse but i like i like helping people i'm i've been a volunteer for the american red cross for probably twenty three twenty four years now i'm on their mental health disaster team and what medal the mel health disaster team does is if there's a the most common disaster in southwestern pennsylvania are single family fires and if there's a fire anywhere and then red cross goes and helps to provide food shelter and clothing to the victims of the fire well if if there's a somebody killed or if somebody is injured if if children are involved if pets are involved if somebody is just not handling it very well or if one of the volunteers or the staff of the red cross or saw something that bothered them then they call mental health and i go in and talk with them and i've been doing that for a long time and that piece that started my interest in in helping people who have experienced bad stuff i am also a member of the disaster medical assistance team of the u s government which makes me a part time temporary government employee under health and human services and what that means is they have the disaster medical assistance team will go into disaster areas and set up a mobile hospital so this is a hospital in tents and i am mental health support for the team and the victims don't get the ploy very often but when i do it it it's very yeah and you also like different patients yes we see some of us the children i'm not seeing children anymore i'm just focusing on adults but i have other people who do see children and teenagers and and  see people who are retired so the whole gamut of the whole age gamut so why would you say this is become such a big problem with in the past years like what is the new show like how is the wipe and shine on mental health  because mental health is getting more common because people are talking about it back in the early part of the early and in an institution they got restricted to their room and so the mental health is getting more attention because it's coming out in the open then people are saying you know what i have depression and that's not a bad thing that they actually the stats actually say that ten percent of the population of the us population at one time or another has depression and so what you you have from choices you can be an ostrich and put your head in the sand and pretend it doesn't happen and then let it get worse and worse and worse or you can say you know what i am feeling sad maybe i can get some help with this and when you get help for teenagers i think that you want to be independent you want to make healthy choices for yourself but this mary you don't know about very much and this is where you go to people whom you trust and say hey listen i am feeling sad  what are some of the symptoms of depression people may feel ok now i'm going to say teenagers because kids can be different but for a teenager you may not want to be be doing things with your friends though if you liked if you had a hobby like scrapbooking or sports or something like that you may not be interested in doing it anymore by big changes yes  your appetite may eat you your appetite can either you can either stop eating or you can over eat your sleep you're so you can either most of the ninety percent of the people have trouble sleeping and usually the trouble sleeping is in three spears you have difficulty falling asleep interrupted sleep and early morning awakening and ninety percent of the people have problems with falling asleep but ten percent of the people have difficulty with sleeping too much so everybody is sort of unique and special unto themselves there is a feeling of hopelessness and helplessness and ultimately there's a if it gets bad there can be suicidal thinking and there's also a little bit on this on the suicide scale a little bit less if it's called a passive death wish and their depression is such that it's pretty bad but you don't have the energy or you there's religious beliefs or you believe that you have a purpose or and somebody needs you but you're not you don't you're not going to hurt yourself overtly however the way i assess people for that is i asked them if you were in a car a car accident through no fault of your own and accidentally died would that be ok well other than religious reasons because if somebody has a really strong religious belief they say yeah that's great i'm going to be with god and that's wonderful i'm happy for about it but somebody who's depressed is going to say yeah that would be fine i would that would be ok i would like that so that's what i call a passive death wish and that's a red flag and so there's symptoms of of depression and i want to really really stress this it is absolutely and i don't say a lot of absolutes but i'm going to tell you this is an absolute it is never never never normal to be thinking about suicide never so how can someone get to the point that they are thinking of suicide ok there's various causes there can be sometimes there's this called a genetic predisposition for depression and if people have depression in their family there's a greater chance that they can be depressed so it can be like passed down yeah and it's not through anything is just genes and so they just they just tend to get sad so if you look at the family history if there is a family history of depression if there's a family history of suicide if somebody in their family has killed themselves that's a major red flag for that person if  if if there's if there feel there's a common thing about feelings suicidal and that feeling hopeless and not being feeling like you're understood home more by other friends you should do that with all now some bullying can be physical threats but the majority of it is not and so what do you do if somebody gives you that sarcastic so what you're talking about is a difference in power and control and the person who is is being bullied loses their power and they lose their control one of the things in counseling i do through work on th skills and and we talk about who is the bully because usually the bully doesn't have a very good self image and they're trying to build themselves up by beating up on other people of verbal if that makes any sense yeah so yeah but bullying can really make people feel helpless and hopeless and so that it can be a cause for suicide and the other questions on the so would you say  it's one of the leading causes of it it's a big one it's a big what then high school students of the year yeah now let me tell you the second biggest and i just attended a conference on this yesterday and when they look at teenage suicides thirty percent of the people of the teenagers who kill themselves are having gender identity issues that's pretty high really yeah yeah and so i think that just being aware of that and again we're talking about feeling safe in the environment and people who have gender identity issues aren't you know  my lesbian and my do i want to be trans m r i even though i am a female do i feel like i'm a male you know i mean there's all these questions and feeling like you're just not fitting and so that can be really really really stressful you know and we're actually going to take a break now and while we're back after a short break to continue our discussion my grandfather served in world war two spending time with him with the best memories of my life i became a physician in v a because of my grandfather so i can help others like him i can't imagine working with better doctors or more dedicated staff fulfilling my life's mission with the help of my team and thanks to these veterans i'm proud to be a doctor in v a i'm proud to honor my grandfather every day search v a careers to find out  more welcome back to the edge continue our conversation with pauline who is a licensed professional counselor so continuing with the gender identity role why do you think that so many people like like you said before thirty percent thirty percent of people that are struggling with gender identity issues have been committing suicide a lot recently a lot of them were bullied and also that feeling of not of not having anyone who really understands i think that people are coming out at an earlier age and think about when you were a teenager when you're a teenager you want to be like your for hand you want to fit in you want to wear the similar similar brand clothes and just be with your friends and and when you have gender for the for the guy i think gals that are just questioning who they are or they might not know who they are and have just been cloaking it under normality they just don't feel like they fit in yeah they're not accepted within the school yeah and there's discrimination yeah yeah and so what are some things that they can do and who can they turn to during this time if they are being boy well i think this is not only for the kids that are having gender identity issues but this is for all teenagers who are feeling depressed ok because the depression is there whether the cause is gender identity issue whether that causes genetic predisposition that oh there's also if you have like abuse in no physical abuse emotional abuse sexual abuse a recent like past tragedy it was recently they can be recent or it can be way early and i can tell you a little bit about that later if you want but regardless of the cause you've got depression and when you when it's a safety issue when you're really thinking about hurting yourself red flag red flag red flag we don't want that to do that so this is what i recommend for people for teenagers to find adults who they trust or even friends are very ok i yes but ok i've had so many teenagers who said well i was thinking about hurting myself so i told my friend does their friend know what to do but it helps i mean i'm not telling you not to do that but your friend is not going to be able to stop you from hurting yourself from probably not because what you're going to say is tess i have something or i'm going to tell you tess i have something to tell you promise you won't tell anybody and then what do you do if you're stuck because the friend is between a rock and a hard place because you told them all i'm thinking about hurting myself but you're obligated to secrecy that's that's why i say i mean you can tell your friends but you need to tell somebody who can as this somebody in this case somebody who's a little older and  has the knowledge of how to help or if they don't know they can find out so you or you would tell if your parents or do parents of teenagers normally come to you about their kids to get to see  they do they do now a lot of times the majority of parents do a wonderful job but some parents through no fault of their own blow it ok i'm not telling you anything happens you find another person there about your family is there anybody in your family who you trust think about school think about your favorite teacher the guidance counselor the princip i'm going to tell you that people don't become teachers if they don't like kids you know so they are none of your teachers want to see any of you hurt yourself  so they will are going to be good resources and they've had training i know that the guidance counselor they can usually call crisis counselors in to the high school if you need to they have  i don't want this standard operating procedure of what to do if somebody is having suicidal thinking the school has their act together use them yeah use the resources here  also there's coaches there is sponsors there is my best friend's mom has her act together did she want to don't keep it to yourself yes tell someone that you trust but you have to trust them and it doesn't work for them then you find somebody else to trust and there's also the the crisis number for washington county i gave it to you yes i will answer the phone twenty four hours a day seven days a week and they they are really good on stuff like this was their way to say i would call them what would happen well they would talk to you they would want to know your name your phone number and and where you are right now ok and then they're listen if they think that it's necessary they can send a person out to where you are and talk with you now if they think that you're in imminent danger they will call nine one one if and and also if if you think you can't control it and you're going to hurt yourself call nine one one the police will come guess what the police will not bring you to jail they will bring you to the hospital they will make sure that you go to the hospital where you can get help because safety is number one priority and we as adults all want teenagers and that work good question well first of all the state of pennsylvania says that any teenager fourteen or older does not need parents permission to get counseling ok now parents will find fourteen of age or older does not need parents permission to get counseling now ideally it's better you include parents yeah and usually the first time for the initial intake we have the the teenager and the and the family member so that is it doesn't continue like that afterwards if i  any information from that teenager to the family member i have to have a a written release from version from the student from the teenager because or what you tell me is confidential now let me define confidentiality confidentiality means that everything that said in my office is secret but there are a couple extends to exceptions number one if i if somebody tells me if i am seeing you call and you say well you know i've been thinking about hurting myself i go will not keep that secret because your safety is in jeopardy and that's right you already so suicidal thinking or thought of thinking for that matter because i've had to not with teenagers but with adults i'm just so mad at that person i'm going to kill them then i will not keep that secret because that's a safety issue and the second thing is if i hear about children being hurt and this is children up through age eighteen so i'm saying children by the kids and teens yes that if i hear of them i am a mandated reporter according to the state of pennsylvania teachers yes teachers ministers they really expanded the list anybody who works with with people under the age of eighteen are mandated reporters so i have to childline it which i have done before so other than most two things everything that that that a teenager would tell me and in session would be secret now i can say well your mom is calling me and she wants to know me what's going on do you want me to say anything or do you want what do you want me to tell you because if without your permission i can't say anything to that idea is that you have you a flavor for one on with that and a session with  him it does a court i've got one person right now who i'm seeing twice a week because we've got the suicidal thinking down to a passive death wish most most of the time but there is still some philosophical thinking there so if there are safety issues i'm going to see them two or three i had one person who was an incest victim and i saw her three times well it's not that bad let me see i was able to go horseback riding when i haven't been riding yet for a couple of months when you see the quality of their life improving then that means that depression is going down when they say i'm not having thoughts of hurting myself anymore when i don't have a pass or guess wish when when all i'm being more active my grades are going up because that's another something you know you're don't have the concentration you don't have the ability to think you're no you're just not focus you know so when you see improvement in the in the  their daily lives then that means you back on and then we'll have but when i see somebody usually it's once a week until unless i think that they need extra help and then as they improve i want to back it off let's go to every other week  and then we can either stop or if you're not comfortable i've got one person who's coming to see me once every two months because you just don't want to let go i just wanted to touch base a little bit so but you are not alone you have teachers counselors friends family to help you through this time no one should after no one should ever have to go through this tragedy if your loved one has suicidal thoughts please tell a family member or friend or call the number one eight hundred two seven three eight two two five together we can help put a stop to this so we can help put a stop to suicide one life at a time and that's all for today's 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