become the second leading cause of death in teens ages twelve to nineteen no family friend or loved one should ever have to go through or witness such a tragedy there are ways to prevent suicide though approximately seventy six percent of teenagers turn to a friend in the time of need friends of people that are struggling with suicide and mental health can be incredibly influential to those that are suffering sometimes a friend is all you really need today we are joined by years well yeah we're definitely concerned with the rising suicide rate over the past fifteen or so years it has been edging up slightly every year you know really at the root of most suicides nine the percent of them have been attributed to a mental illness or mental health condition and when i lost my sister christy in two thousand and one she had been long suffering with severe depression for many  years and she abruptly stopped her treatment and that was a very bad decision that she made and unfortunately she died so we know that mental health is a very strong component with this and that's something that we're very much keeping a close eye on and trying to raise awareness and educate people about the mental health factor here even among teenagers so mental health is obviously a factor what are some other factors mental health is not the only explanation it's definitely a factor but most and in fact one out of four people have a mental health condition in the course of their lifetime that's a lot of people but most of them will never have thoughts of suicide much less engage in suicide behavior so there are other things that can happen with a person that might think of it as piling on right is more things that pile on the more risk factors that are present them stronger the likelihood that suicidal behavior or thoughts might start to creep in so those might those different risk factors might include health conditions outside of mental health that some of these dealing with some other type of serious health issue or chronic pain or an injury or something like that concussions we're hearing more about another health risk factor might be things that are going on with that person's family history maybe that individual has suffered from abuse of some point at some point in their life or some type of an assault maybe there are mental health conditions that run in families or even suicides that have occurred within the family so those are some examples and then another area of risk are what we call environmental factors so we hear a lot about bullying and online bull being or just the stresses and pressures of life right for high school students you guys are under a lot of stress to pick what college am i going to go to my going to get into the college that i want to get into so those pressures and relationships stress and then again the more things that pile on the more of the risk so then how can you tell the difference between whether there's just a lot going on or whether you actually a person has  great question cole i think you know if you're if you're caring about a friend if you're concerned about a friend you probably know the baseline for that friend right like what's kind of normal for that person if you start to see that things are changing for that person those can be a strong signal that it is time to have a conversation with them in yourself if you're starting to feel or experience thoughts of hopelessness or despair about the future or is starting to feel like you're not worth anything those are signs to look for in yourself so there's two different things we talking about here are you talking about a person who is concerned about themselves or looking outward at friends or people they know and so if we're looking outward with friends or people then yeah how would someone bring that up to their friend it's very difficult it is difficult it's awkward and cold mention the statistic that we have which is that seventy six percent of teenagers and young adults are more likely to talk to a friend about their mental health and they are about a parent or another trusted adult but those can be very awkward conversations how do you talk to somebody one of the things that we recommend is just ask your job as a friend is not to diagnose some or to try to treat them it's really just to have that conversation and just tell them that you've noticed i've noticed this change in you i'm concerned and do you want to talk about it maybe they don't want to talk about it right away but you've opened the door and keep asking it's ok to keep asking you don't want to nag them to you know but you do want to keep letting them know you care and with winter like you just said that you don't want to keep  how do you know whenever you get to the difference of just making sure they're ok or that you start to bother them with how much like start i think as long as you keep telling them these are the things i'm noticed and noticing and i'm concerned i'm concerned about these things you know are you sure you don't want to talk about it if you are really concerned this can also be awkward definitely tell an adult about what you're seeing with that person don't just keep it to yourself if you continue to be concerned about that person talk to a teacher talk to the guidance counselor if you can even talk to that that's person's parent because you never know if there is more going on there or them what you're you're actually seeing and how would you say these situations to the point where it's awkward because i know my friends upset you don't really want to get involved in their personal life but you still want to know what to make sure that they're ok does how does that create like an awkward situation yeah i mean and maybe some people are more comfortable with having these conversations than others it can become awkward if if you know for sure that that person is having struggles with their mental health if they've maybe talked about that they're feeling depressed or they're feeling anxious or they're not feeling quite like themself it can be easy to just say oh they're just having a rough day or  i don't want to bug them about that i don't want to feel like i'm intruding on that but most people need people to talk to you know that it's very important to have people who have your back and who are supporting you so just i think if you're not feeling awkward about having that conversation that's fantastic if you are feeling awkward about it we have a campaign called seize the awkward you can check it out it's easy awkward dot org embrace the awkward that's what it's all about it's better to have an awkward conversation than to regret it later so whenever i don't want to intrude whenever i'm asking them about it and then i tell it like a parent what if my friend gets like mad at me or our relationship is at the same like how would i deal with that i know that's a tough dilemma tess it's that that could happen and let's be realistic it could happen we've heard many situations where young people have talked to somebody else about a friend that they were concerned about and they were worried about that risk is is that going to alienate that person from me are they go separate from me that is a far better outcome than the outcomes that we're talking about today which is suicide so you could save a life even if you don't save that friendship it's more important to save a life that is so i tested she's worried about her friend doesn't matter what are some ways that you can ask your friend a certain without with trying not to intrude on like  want to do is say i think you are bipolar so if you don't want to do that it's better to just say i'm noticing these changes in you i'm concerned do you want to talk i'm here for you i'm worried about you is there anything i can do to help and know your boundaries you know your job is there to be a great support a listening friend a caring friend you're not there to be there therapist that they may want to talk a lot but encourage them to get the help they need right if you are determining that that person is struggling really kind of also encourage them to talk to some professional not just you you can continue to be there for them but you're not there for best so if you're how how vital is it to get past the awkwardness of the first step because if you're asking a friend i t's going to be very awkward but it's also more important to get past that first awkwardness it is and i think you'll be surprised that people you know will open up and they'll be gracious and grateful that you opened that door so yeah getting getting past that first step and opening up that conversation is really important but as i mentioned it is the next step is to encourage them to get the help that they need because this is very treatable the issues that we're talking about here are there is help available treatment is very effective for almost everybody so the next step is really to encourage them to get that help that they need and not to feel ashamed of it and not to feel stigma around them so you assume it's more important for the other person to start leaving the conversation so you open the door to them and then once the doors open they walk through and leave the conversation then why is that well sometimes for a in many cases a person who is struggling is kind of in their own zone so to speak the experiencing a lot of what we call psychological pain and they can become very focused on that pain and as that happens the world kind of starts to close for them and the options in life they don't see them like somebody else might see them because they're so focused on their struggle so you might be a way to help them see that there's more there's more they can do than just focusing on their pain that there are options for them for getting help because they might not be thinking about getting help at that point they might just be thinking about i'm in all this pain it's never going to change you know this is terrible and then they start to go to thoughts about how do i escape the pain and that's when thoughts of suicide can start to creep in so having that awkward conversation you could be the one that kind of helps pull them out of that and start to see that there is a way for them to start to get out of this situation rather than to consider suicide so and i were having a conversation we should more listen instead of like giving them advice correct yeah yeah you're there to listen the only thing i would say add to that is encourage them to get help encourage them to get into treatment and so listen and encourage them to seek help those are the two things that your role as a caring friend with me now what are you looking and listening for whenever you know that you know something's wrong with your friend what are some of the warning signs that they will give you this is great so there are three categories of warning signs that we have the first is a way a person talks and that could be verbal talk or it could be the type of communication they're doing on social media so verbal talk can be anything that ties into hopelessness for their future that they want to die that they see no end to their pain that life isn't worth living nobody cares about me nobody wants me my i'm no good so any of those types of statements that are making them feel just miserable about their future miserable about their existence those are things to look out for on social media you might notice changes in the type of content that they're sharing it could start to go to darker themes they could share content about other people who are dying by suicide they could be making statements about that are very straightforward about how they hate their life or things like that so pay attention to both verbal as well as social media so that's one category behaviorally is the second category we can see a lot of changes in the way a person behaves can you guys think of any off the top  people the behavior that call you just mentioned is really a kind of detachment behavior and so they start to become withdrawn and start to isolate themselves they might stop engaging with their friends stop different functions or activities that they enjoy they may even start to disengage with their schoolwork school performance can decline things like that and then tests you had mentioned impulsive behavior in young people sorry your brains aren't done cooking yet so the frontal lobe which is you know you have an additional risk factor there controls impulsive behavior and risk taking behavior so not only are you guys more likely to take risks and act on your impulses you combine that with thoughts of suicide and you have a pretty deadly combination so looking at impulsive behaviors maybe they're taking more risks with criminal acts social activities relationships things like that definitely be on the lookout for things like that you might also see changes in the way they dress the way they take care of their appearance they might start to not take good care of their appearance they might start to you might notice weight changes on their eating more eating last things like that so those are some examples of behavior and when we come back we'll talk more about suicide prevention  and we're with our episode about suicide and prevention and with the kora and so we've talked about how to help a friend but we haven't talked about ourselves and if we are dealing with suicidal thoughts or thinking about it how yes how should we know if it's like we're having a bad day or if we're just depressed and you need to get help yeah that's a great question and fortunately i can speak from personal experience because not only did i lose my sister to suicide but mental health conditions have affected me as well and i've struggled for a long time with depression and anxiety i can tell you that if your are good rule of thumb is two weeks or more everybody can have a bad couple of days and might even have a really bad week but if your mood if you have are having a down mood or you're feeling anxious or you're feeling even super amped up and just not yourself and the good rule of thumb is two weeks or more because after two weeks if you're still feeling that way most days there probably is something going on that needs to be evaluated you know that hopefully there's nothing serious but we want to make sure that that person gets evaluated so if you're having those feelings and you're just feeling low energy can't get up and get excited about things you used to you're struggling with your life you're struggling with thoughts really negative thoughts then that's a good time to get evaluated and how do you seem to talk to people both if it's about yourself it can be hard a lot of and i'm not going to be honest i mean a lot of people don't want to admit that they're having those types of feelings especially if you're a strong performer writer people have i expectations for you you might be worried about disappointing people the thing to think about with mental health there is a word the word health is in there for a reason and if you were having let's say for example chronic stomach pain for two weeks would you say something probably if you were having migraines for example we yes so the same is true here if you have any type of something that's making you feel physically not right and it's affecting your thoughts then you it's ok to talk to people and say i'm just not feeling healthy i'm not feeling myself and that active talking to people about that can be life saving for you in the long run because these illnesses these mental illnesses like depression anxiety they can get worse over time if not treated and then that worsening can lead to thoughts of suicide so it's always better to speak up if you're feeling those things and why you think you may not want to admit that you have these these suicidal thoughts or depression yeah i mean i think a lot again you're embarrassed right people will think less of me people will think i'm weak you know we hear men all the time or males talk about how they just feel like they are supposed to be tough all the time and  tough through things like people feeling sorry for you they're like yeah i think i'd be not one but yeah yeah so there's a very strong stigma still out there around mental health but i think it's changing we're hearing about a lot of how ended up that was so tragic and of causing this depression and suicidal thoughts which is i mean i guess it they're just trying to help yeah i mean we're hearing from selena gomez the recent basketball player who talked about  his panic attacks and the rock i think just came out with some of his thoughts rick springfield who you guys probably have no idea who that is that was when i was hearing but i think the more that people coming out with their stories more people will start to feel comfortable that wow there is these really successful people out there who have also struggled with this it's it's it's not a badge of dishonor to have a mental health condition and in fact if anything it can actually help you learn to live a better healthier life and i feel like it's like one of the main mottoes which is probably on the troops things that you're not alone going through this absolutely i'm going to is just i know a lot of people definitely think that i'm the only one going through this but you mart and you need to get the help that you need because it could end up ruining someone or your life yeah that's right and these are very treatable conditions as i had mentioned before so there is no reason to say stay stuck in that state you know so that was a bit of a tongue twister but there's no reason you know to live like that when there are treatment options available so what are so what are those treatment options so there are still many and every person is a snowflake so everybody is different and responds to treatments in different ways and so there is a whole range of different things typically a front line first thing that's that's tried with especially a young person a teenager is psychotherapy talk therapy can provide relief for many students and young people even before medications are tried that might be all that's needed to help you get through that tough time but there are so many treatment options available that's best discussed with your mental health provider so what are some of the other options  doctor going to a friend or is there anything else they are getting like medication yeah yeah well i mean you know as i mentioned talk therapy can be huge and there's different types of talk therapy and again  a person is evaluated based on what their diagnosis is and then a course of treatment is prescribe so treatment for depression treatment for anxiety treatment for bipolar disorder or you know these can different types of treatments applied to different conditions just like you would treat you know a broken arm differently than you would treat all bladder so you know so these are that is there's so many of a little boy i couldn't possibly list them all but there's just know that there are great options available so i think i just like have a question it's kind of weird but so on the hotline that like you have for suicide do is it just like people to talk to you or it what is it exactly i think that's a really good question tess because a lot of people are like well if i call this number what's going to have you know whether i was who i exact so the national suicide prevention lifeline number which is one eight hundred two seven yourself if you are the one who's struggling but you can also call it if you're worried about a friend or family member and what will happen is they will quickly assess what's going on with you they have ways of assessing that very quickly they will then connect you with a crisis center in your county wherever you're at so you only need to remember that one phone number so does no matter where you are in the country you can call that one number and they will connect you with your county's cri center and they will then give you advice and next steps on what to do next right bellville let you know whether or not you should go to an emergency room or just check in with your doctor the next day you know they may give you some advice and and there's the phone number but there's also a texting number the crisis text line is seven four one seven four one so you young folks i know like the temper for to taxed but if you text pretty much anything to that number  you can the same thing happens it's a real person it's a real person texting you back at not a bot fillies have a friend yes there's always options absolutely ok wait so you said they can help you with a friend and  how does that work so if you're worried about somebody actually we just had this experience last month with some folks that are involved with our chapter if you're worried about somebody but they're refusing to get help or they're resistant to it and you're really concerned and you don't know what to do you can call on their behalf and say i have somebody here who's in crisis what can i do and they will actually walk you through the different options that are available to you and i give you that help and support many young people or just people in general who've never been through that before and dealing with somebody who is in crisis that's a really good plan is to just call them and they will let you know what to do and the options and the very like depending on what your symptoms or yeah although assess the severity of the situation and then they'll give you advice based on that and then they'll never like if you call that a friend never contact and get to as we focused on friends getting each other help for a while what about parents how is that one way that they could get their kid help parents have so many options and i think you know obviously they're p d pediatrician is the first thing that they should take their their child to get an assessment and an evaluation a professional needs to be evaluating that person because they know the model and the questionnaire for determining if there is something here and that pediatrician might refer them to a specialist to do a further evaluation if there is a suspicion that there is a mental health condition so you know and then the guidance counselor at the school can often offer support as well so the parent should just definitely not wait because the sooner they can get the child treatment if the child needs that help the better you know it's certainly better to address it earlier on that wait until things are in crisis well thank you for sharing all information with us and being here today to talk about this very tragic topic but unfortunately many people suffer from no one should ever have to go through this alone so please be a friend and set of a stranger to