Building Resiliency in Teens To Protect Against Teen Anxiety, Depression and Suicide

1. Building Resiliency in TeensTo Protect AgainstTeen Anxiety, Depression and Suicide Melissa Ladrech, LMFT

2. Today’s Topics • Teen Depression, Anxiety and Suicide • TeenScreen Program at Redwood • Talking to Your Teen About Depression, Anxiety and Suicide • Building Resiliency in Teens

3. Teen Anxiety and Depression Symptoms and Signs What are some signs that you are aware of?

4. Symptoms and Signs Emotional changes • Irritability, frustration or feelings of anger, even over small matters • Feelings of sadness, which can include crying spells for no apparent reason • Loss of interest or pleasure in normal activities • Loss of interest in, or conflict with, family and friends 1998-2013 Mayo Foundation for Medical Education and Research (MFMER).

5. Symptoms and Signs Emotional changes • Feelings of worthlessness, guilt, fixation on past failures or exaggerated self-blame or self-criticism • Extreme sensitivity to rejection or failure, and the need for excessive reassurance • Trouble thinking, concentrating, making decisions and remembering things • Ongoing sense that life and the future are grim and bleak • Frequent thoughts of death, dying or suicide 1998-2013 Mayo Foundation for Medical Education and Research (MFMER).

6. Symptoms and Signs Behavioral changes • Tiredness and loss of energy • Insomnia or sleeping too much • Changes in appetite • Increased use of alcohol or drugs • Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still 1998-2013 Mayo Foundation for Medical Education and Research (MFMER).

7. Symptoms and Signs Behavioral changes • Slowed thinking, speaking or body movements • Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse • Stellar or Poor school performance or frequent absences from school • Neglected appearance — such as mismatched clothes and unkempt hair • Disruptive or risky behavior • Self-harm, such as cuttingor burning 1998-2013 Mayo Foundation for Medical Education and Research (MFMER).

8. Suicide Rates for 15-24 year oldsSources: http://www.dhcs.ca.gov/services/MH/Pages/InformationandData.aspx; http://www.suicidology.org/stats-and-tools/suicide-fact-sheets;

9. What is TeenScreen • Developed by Columbia University in 1991, in a response to parents interest in the research being conducted at CU on depression. The TS program was developed to raise awareness of the stresses that teens have to deal with, and promote their mental health and wellness. • This is an evidenced based program utilized in 43 States and over 500 locations

10. What is TeenScreen • Goals of TS: • Identify teens with suicidal ideation, attempt(s) and or behavior in order to prevent teen suicide • Making mental health checkups available to all teens • Identifying areas of emotional or mental difficulties • Assist families in connecting with effective services and support, so that teens can avoid losing critical years of healthy development and growth.

11. What is TeenScreen • TS consists of a 12 min, self-administered computer questionnaire that includes questions about depression, suicidal ideation, suicide attempts, anxiety, substance use, PTSD, eating issues and general health problems (vision, hearing and dental). • The screen assesses the risk factors associated with these issues. • It is NOT a diagnostic tool.

12. TeenScreen • Most teens who participate in TeenScreen are only experiencing typical teenage problems. • Generally 25% of teens are having more difficulties. • From 2-8 teens at each school report that they are having thoughts of suicide.

13. TeenScreen Participation at Redwood High School and TUHSD

14. TeenScreen at Redwood High School is Consistent with National Averages • Of the 25% that are experiencing difficulties: • 10-15% Symptoms of Depression • 10-15% Anxiety • 5-10% Eating Issues

15. How do we protect our teens from anxiety, depression and suicidal thinking?

16. Myth or Fact Confronting a person about suicide will only make them angry and increase the risk of suicide.

17. Fact • Myth: Confronting a person about suicide will only make them angry and increase the risk of suicide. • Fact: Asking someone directly about suicidal intent lowers anxiety, opens up communication and lowers the risk of an impulsive act.

18. Asking about depression, anxiety and suicide • Talk to teens before there is an issue. • Be honest, respectful, empathetic and transparent. • Let teens know that you have noticed some changes, you care about them and you would like to hear about what is going on. • If they don’t want to talk to you about it, help them figure out who they might be able to talk to about it.

19. MY3 App • Is MY3 free?Yes, MY3 is completely free. You can download it from the Android or Apple App Store. • Who created MY3 ?MY3 was created by the California Mental Health Services Authority and Link2Health Solutions, the administrator of the National Suicide Prevention Lifeline. See the ABOUT section for more information.. • Can I download MY3 for a friend?You can download MY3 for yourself or for someone else. If you download it for someone else, please make sure that you consult with them during the setup. MY3 is meant to reflect the needs and connections of the user. • Who is supposed to use this app?MY3 is for individuals who may be having thoughts of suicide, or who have a history of suicidal behavior. It is designed to help these individuals stay safe during when they are experiencing thoughts of suicide. • http://www.my3app.org

20. Asking about thoughts of suicide Less Direct: • Do you ever wish you could go to sleep and never wake up? • Do you ever wish you were not here? • Do you ever wish you were dead? Direct Approach: • You know, when people are as upset as you seem to be, they sometimes wish they were dead. I’m wondering if you’re feeling that way, too? • You sound pretty desperate, I wonder if you’re thinking about suicide? • Are you thinking about ending your life? • Are you thinking about killing yourself?

21. Call the Hotline

22. What is resiliency?

23. What is resiliency? • The ability to recover quickly from change, or misfortune, challenges, problems disappointments, and failures by utilizing skills and strengths to cope and minimize psychological distress. • The ability to adapt well to adversity, trauma, tragedy, threats or even significant sources of stress. • Buoyancy

24. 10 Ways to Build Resilience in Teens • We all can develop resilience, and we can help our teens develop it as well. • It involves behaviors, thoughts and actions that can be learned over time. Following are tips to building resilience. American Psychological Association, www.apa.org

25. #1 Make connections • Teach your teen how to make friends, including the skill of empathy, or feeling another's pain. • Encourage your teen to be a friend in order to get friends. • Build a strong family network to support your teen through his or her inevitable disappointments and hurts.

26. #2 Help your teen by having him or her help others • Teens who may feel helpless can be empowered by helping others. • Engage your teen in age-appropriate volunteer work, or ask for assistance yourself with some task that he or she can master.

27. #3 Maintain a daily routine • Sticking to a routine can be comforting to teens, even if they have difficulty admitting it. • Encourage your teen to develop his or her own routines.

28. #4 Take a break • While it is important to stick to routines, endlessly worrying can be counter-productive. • Teach your teen how to focus on something besides what's worrying him. • Be aware of what your teen is exposed to that can be troubling, whether it be news, the Internet or overheard conversations, and make sure your teen takes a break from those things if they trouble her.

29. #5 Teach your teen self-care • Make yourself a good example, and teach your teen the importance of making time to eat properly, exercise and rest. • Make sure your teen has time to have fun, and make sure that your teen hasn't scheduled every moment of his or her life with no "down time" to relax. • Caring for oneself and even having fun will help your teen stay balanced and better deal with stressful times.

30. #6 Move toward your goals • Teach your teen to set reasonable goals and then to move toward them one step at a time. • Moving toward that goal — even if it's a tiny step — and receiving praise for doing so will focus your teen on what he or she has accomplished rather than on what hasn't been accomplished. • With school work, break down large assignments into small, achievable goals, acknowledge accomplishments on the way to larger goals.

31. #7 Nurture a positive self-view • Help your teen remember ways that he or she has successfully handled hardships in the past and then help him or her understand that these past challenges help him or her build the strength to handle future challenges. • Help your teen learn to trust himself or herself to solve problems and make appropriate decisions. • Encourage positive self-talk. • Teach your teen to see the humor in life, and the ability to laugh at one's self.

32. #8 Keep things in perspective and maintain a hopeful outlook • Even when your teen is facing very painful events, help him or her look at the situation in a broader context and keep a long-term perspective. • Help your teen see that there is a future beyond the current situation and that the future can be good. • An optimistic and positive outlook enables your teen to see the good things in life and keep going even in the hardest times.

33. #9 Look for opportunities for self-discovery • Tough times are often the times when teens learn the most about themselves. • Help teens to realize that we all make mistakes, and mistakes are learning opportunities. • Help your teen take a look at how whatever he or she is facing can teach him or her about his or her inner strength, limitations and ability to refocus on productive and rewarding efforts.

34. #10 Accept that change is part of living • Change often can be scary for everyone. Help your teen see that change is part of life and new goals can replace goals that have become unattainable, unrealistic or irrelevant.

35. Coping Strategies • Talk to someone: Family: parent, sibling, cousin, aunt, uncle; Friend, Co-Worker; Call hotline, Chat online • Chill out: Change your scenery; Walk in the woods; Read a book; Go to the movies; Listen to music; Practice deep breathing; Hang out with a pet; Meditate; Play video game • Take care of yourself: Exercise: jog, sports, dance, yoga, hike; Get a good night’s sleep; Eat a yummy and healthy snack; Balance your wants and shoulds • Express your feelings: Write feelings down; Keep a journal; Yell into a pillow; Turn up the music and sing loudly • Get creative: Write poetry; Paint/Draw a picture; Play; Play an instrument; Craft; Build something; Cook or bake

36. Resources • Suicide Prevention Resource Center, www.sprc.org • American Association of Suicidology http://www.suicidology.org • American Academy of Child and Adolescent Psychiatry, www.aacap.org • American Foundation for Suicide Prevention, www.afsp.org • American Psychiatric Association, www.psych.org • American Psychological Association, www.apa.org • The Balanced Mind Foundation, www.thebalancedmind.org • Mental Health America, www.nmha.org • National Alliance For Mental Illness, www.nami.org • National Council for Suicide Prevention, ncsp.org • Substance Abuse and Mental Health Services Administration, www.samhsa.gov

37. Questions?

38. Thank You ! Please fill out post survey form Contact information: Melissa Ladrech 415.499.1193 x 3004 mladrech@fsamarin.org