What is stress? Eustress Motivates, focuses energy Is short-term Is perceived as within our coping abilities Feels exciting Improves performance Distress Causes anxiety or concern Can be short- or long- term Is perceived as outside of our coping abilities Feels unpleasant Decreases performance Can lead to mental and physical problems
Physiology & Stress STRESS = CORTISOL CORTISOL = DOPAMINE DOPAMINE = ANHEDONIA Anhedonia: pleasure “deafness” No longer able to derive normal pleasure from those things that have been pleasurable in the past.
Your Brain vs. Their Brain Your teen’s prefrontal cortex is still growing until it is 25 years old This part of the brain is responsible for decision making, judgment, impulse control, emotion regulation, frustration tolerance, empathy, and abstract thinking When you are stressed, you can rely on your prefrontal cortex to help you cope but teens don’t always have this available to them!
Why So Much Stress? Higher level of importance is given to things you might see as “trivial” because of lack of life experience. Your reaction is important. What you think is trivial is life shattering to them.
What Kids Do To Self-Medicate Alcohol Drugs Self-Injury Sexual acting out Gambling Video Games Pornography Excessive sleep Eating disorders Criminal activity Other adventurous/risky behaviors
What are you doing to manage YOUR stress? Holmes-Rahe
Concrete ways your child can manage stress Sleep Eat right Avoid caffeine Exercise Music Relaxation techniques (video)video Prayer/spirituality Study smarter, not harder Planning/organization Compartmentalizing 23 ½ Hours (video)video
Planning and Organization
Identifying Mental Health Issues: Depression Feeling sad or empty Irritable mood Anhedonia: lack of interest in things you used to enjoy Significant weight loss or gain Insomnia or hypersomnia Fatigue or loss of energy Feelings of worthlessness Excessive or inappropriate guilt Indecisiveness Recurrent thoughts of death
Identifying Mental Health Issues: Mania Lasts at least 1 week Grandiosity Decreased need for sleep Pressured speech Racing thoughts or ideas Distractibility Goal-directed activity Excessive involvement in pleasurable activities
Identifying Mental Health Issues: Bipolar One or more manic episodes or mixed episodes Type I Type II
Identifying Mental Health Issues: Anxiety Panic attacks Avoidance of places or situations Obsessions or compulsions Re-experiencing of traumatic events and avoidance of stimuli Persistent and excessive anxiety and worry
Other Types of Depression Cyclothymia Dysthymia Bipolar I Bipolar II
Signs and Symptoms Disinterest in favorite extracurricular activities Problems at school and losing interest in school Substance abuse, including alcohol and drug (illegal and legal drugs) use Behavioral problems Withdrawing from family and friends Sleep changes Changes in eating habits Begins to neglect hygiene and other matters of personal appearance Emotional distress brings on physical complaints (aches, fatigues, migraines) Hard time concentrating and paying attention Declining grades in school Loss of interest in schoolwork Risk taking behaviors Complains more frequently of boredom Does not respond as before to praise Changing friend groups Isolating from friends and family
How to Deal Validation I hear you saying you feel really sad. That sounds very painful. Ask open-ended questions Have you ever felt really depressed? How long have you felt that way? Has this happened before? How long did it last? Be in contact with your child’s therapist and psychiatrist Get therapy for yourself Sending only the kid gives them the message: “I am broken, and they want this therapist to fix me.” It is hard to watch your kids struggle!
The “S” Word Untreated depression is the number one cause for suicide In the U.S. alone, suicide kills more than 32,000 people a year. That is the equivalent of a death by suicide every 16 minutes. In 2005 (data released in 2008), suicide was the third-leading cause of death among year olds nationwide. Every day, 12 youths in America die by suicide – that is one person under age 25 every two hours. In a typical high school classroom, it is likely that three students (1 boy, 2 girls) have made a suicide attempt within the past year. SAMHSA, Well Aware
How to talk about it ASK THIS Are you feeling suicidal? Are you thinking about suicide? Do you want to kill yourself? NOT THIS You aren’t going to kill yourself are you? Are you thinking about hurting yourself?
Relationship between stress, suicide, and substance abuse Men and women who smoked marijuana before age 17 are 3.5 times as likely to attempt suicide as those who started later. (NIDA) Alcohol and drug abuse are second only to depression and other mood disorders when it comes to risk factors for suicide. (SAMHSA)
How to Help Show empathy Stay cool, calm, and collected Don’t judge Don’t ignore LISTEN!
Websites Maggie’s True Story Maggie’s True Story
Outside Help Cognitive Behavior Therapy Dialectical Behavior Therapy Talk Therapy Psychiatrists Substance Abuse Treatment Support Groups
To medicate or not to medicate… That is the question! Selective Serotonin Reuptake Inhibitors (SSRIs) May take 4-6 weeks to become fully effective There is not a “silver bullet” for everyone Interaction with alcohol and other substances Research on long-term outcomes reports the best outcomes for depression and anxiety with the combination of psychiatric medication and therapy
Resources in Houston NAMI www. nami metropolitan houston.org/ Interface- Samaritan Counseling www. interface - samaritan.org/ Nick Finnegan Counseling Center www. finnegan counseling.org/ Depression and Bipolar Support Alliance Depression and Bipolar Support Alliance Houston HPD Crisis Intervention Team