Suicide Prevention Shadle Park HS, April 2, 2015 Dr. Dave Crump, Director SPS Chris Moore, Coordinator, SPS Sabrina Votova, Coordinator, Youth Suicide Prevention Program

Today’s agenda Signs and Symptoms Contagion and Glamorization Communication Community Resources Questions & Answers This is what we’ll cover in the time we have now. © YSPP 2

Myth or Fact? Depression among adolescents is extremely rare, and the symptoms are so dramatic that it is obvious when depression affects a teen. MYTH Depression is actually relatively common among youth. Symptoms may be subtle, confusing, or hard to distinguish from normal adolescent behavior. Ask the question then explain why this is a myth. Direct everyone to the parent depression booklet, particularly the information about watrning signs on pages 6 and 7. © YSPP 3

Normal adolescent behavior Testing rules and limits Touchy if asked too many questions Moody at times Easily embarrassed Amplified emotions and reactions Moving away from family – peer-oriented and motivated by peers' approval One reason it can be hard to determine whether a young person is depressed is that normal adolescence is already a difficult time. Explain these characteristics of normal adolescents and that kids are starting to behave in these ways younger than when we were children. Be sure to explain the idea of the “adolescent roller coaster” and that those amplified feelings may look disproportionate or silly from an adult perspective, but for the young person they are real and need to be addressed as such. © YSPP 4

Signs and Symptoms of Suicide Increased use of alcohol and/or drugs Changing normal routine, such as eating and sleeping patterns Preoccupied with death, dying or violence Feeling trapped and hopeless Engaging in risky and/or self-destructive behavior Giving away personal belongings This is what we’ll cover in the time we have now. © YSPP 5

Signs and Symptoms of Suicide Lack of or difficulty concentrating Feelings of worthlessness or guilt Impulsivity Hyperactivity Talking or joking about suicide Mood swings This is what we’ll cover in the time we have now. © YSPP 6

Signs and Symptoms of Suicide Developing personality changes, such as becoming very shy or outgoing Talking positively about death or romanticizing dying (“If I were dead, people might love me more.”) Saying things like, “I’d be better off dead”, “I wish I could disappear forever”, or “There’s no way out.” Writing stories or poetry about death, dying or suicide This is what we’ll cover in the time we have now. © YSPP 7

Depression Depression is an illness that involves the body, mood, and thoughts It effects the way a person eats, sleeps, thinks, and the way one feels about oneself, others and life It engulfs your day to day life, interfering with one’s ability to work, study, eat and have fun This is what we’ll cover in the time we have now. © YSPP 8

Youth depression: Facts One in every 8 adolescents may have depression. Major depression is more common in higher-risk groups. The majority of children and adolescents with depression do not get help they need. Depression is a treatable illness that is not the person’s fault. Treatment for depression includes counseling, sometimes with medication. www.yspp.org

Signs of youth depression Irritability Persistent anxiety and/or feelings of sadness A drop in school performance Problems with authority Indecision, lack of concentration Poor self-esteem Overreaction to criticism Frequent physical complaints These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression. Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression. Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well. There is a more comprehensive list on pages 6 and 7 of the parent depression booklet. © YSPP 10

Signs of youth depression Helplessness, hopelessness, sadness Loss of interest in activities Appetite or weight change Sleep changes Loss of energy Easily loses temper Anger or hostility Self-loathing Tearful, frequent crying Withdrawal from loved ones These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression. Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression. Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well. There is a more comprehensive list on pages 6 and 7 of the parent depression booklet. © YSPP 11

Signs of youth depression Problems at school Running away Drug and alcohol abuse Fixation on suicide Talking about death Giving away prized/special possessions These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression. Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression. Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well. There is a more comprehensive list on pages 6 and 7 of the parent depression booklet. © YSPP 12

A time for caution When your depressed student begins to feel better. These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression. Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression. Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well. There is a more comprehensive list on pages 6 and 7 of the parent depression booklet. © YSPP 13

It’s more than just a bad day. These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression. Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression. Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well. There is a more comprehensive list on pages 6 and 7 of the parent depression booklet. © YSPP 14

Substance Abuse and Suicide This is second only to depression as a risk factor! Often goes hand in hand with mental disorders More than 3 times more likely to consider, plan or attempt suicide Among substance abusers, 11% had serious thoughts of suicide These are some signs of depression in adolescents. Some of these are signs adults often miss. For example, especially for boys, getting in trouble can be an early sign of depression. Often youth showing this kind of sign are channeled into othyer systems and services instead of being evaluated for depression. Depression can affect school performance. It makes concentration, decision-making and focus difficult for many people. Depressed youth may have lower academic performance, miss early classes because of oversleeping, or overreact to mistakes or low grades. Again, these are not always flagged as possible depression. Another sign we often miss is physical complaints, like headaches, stomach aches, or just not feeling well. There is a more comprehensive list on pages 6 and 7 of the parent depression booklet. © YSPP 15

Myth or Fact? FACT There are gender differences in youth suicide risk. While girls are more likely to attempt suicide than boys are, boys often choose more dangerous methods and are more likely to die from suicide. Read the question and © YSPP 16

Signs of suicidal thinking: The FACTS Feelings Sad, lonely, hopeless, in pain, moody, irritable, increased depression Actions Pushing away friends and family, giving away important possessions, using alcohol/drugs, making unsafe decisions, looking at suicide plans, making art or writing about death, saying goodbye Changes Changes in school performance, appearance or hygiene, personality or attitude Threats Saying they’re going to kill themselves, saying goodbye Situations A recent crisis or trigger situation There are several signs of suicidal thinking that we can be on the lookout for. We’ve broken them down to be easier to remember. FACTS stands for feelings, actions, changes, threats, and situations. As you look at this list, you may notice that most of these are not always or only signs of suicidal thinking. Much in the same way that EMTs and other health care providers try to rule out the worst possible problem before investigating others, though, when we see these signs it’s important to get more information and see if the problem is suicide. Talk through each of these, with examples if possible. You may also want to mention the book Thirteen Reasons Why, which is still somewhat popular with younger teens and sometimes assigned in class – it has some problems but does a good job of showing some of these signs in narrative form. (Read it before recommending it, though.) © YSPP

Myth or Fact? Youth who talk about suicide aren't the ones who are serious about it; they are just trying to get attention. MYTH 80% of youth who attempt suicide have talked about it or shown warning signs. These are other, more serious signs that a youth might be considering suicide:   Talking about suicide, wishing they were dead or wanting to die Talking about suicide plan Read the question and ask for ideas about whether it is a myth or a fact. While some suicide attempts seem sudden or unexplainable, we know that about 80% of people who attempt suicide show some signs ahead of time. It’s a common myth that if someone talks openly about suicide or asks for help, they’re not really suicidal and are Just attention-seeking. This isn’t true. © YSPP 18

How do you support your child or loved one? You must first understand what people (including yourself) may be feeling

Feelings after a tragedy Shock Disbelief Numb Scared Sad Angry Helpless Guilt Relief

Physical stress responses to a tragedy Trembling or shaking Dizziness Pounding heart Rapid breathing Racing thoughts Lump in throat; feeling choked up Stomach tightening or churning

The Unknowing The difficult part is not knowing what the person is feeling and experiencing…

Thinking of You It is natural to feel nervous or even afraid of facing another person's painful feelings. It is important not to let these feelings prevent you from doing what you can to help someone who is struggling. The most important thing to do is simply to be there and listen and show you care.

What is Suicide Contagion and Glamorization?

Contagion Suicide Grief + Over-identification Fixation ___________________ An increase in suicidal behavior among vulnerable people who have been exposed to suicide

Risk Factors for Contagion Suicide A triggering event ~ a suicide + Media coverage AND social media Close friends and “close friends” Vulnerable groups of students

Glamorization News Media Social Media

Glamorization Memorials Yearbooks

What is a Suicide Pact An agreement between two or more people to commit suicide together.

Dynamics of a Suicide Pact Feelings of severe, emotional problems; hopeless and helpless Support each other in living Engage in mutual activities Openly discuss feelings Idea of suicide becomes easier Efforts to support each other fall short Efforts to get help from others fail Lose hope

Ultimate Tragedy These once supportive individuals encourage each other in suicidal behavior.

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.”    -Dr. Leo Buscaglia, Author and Motivational Speaker

Communicating Verbal Communication Non-Verbal Communication

Listen Without judgment Take what they say seriously Do not be afraid to ask the question, “Are you thinking of committing suicide?”

What Not to Say “I KNOW HOW YOU FEEL.” “Don’t feel ________.” (sad, angry, guilty) “It will be better tomorrow.” “Don’t cry.” “At least you’re not hurt.” “She’s in a better place.” “We are all upset.” “He’s out of his pain.” “It could be worse.” “You have to stay strong for your kids.”

Emotions Are Rarely Simple Don't be distressed by differences in the your child responds. It may be different from yours! One person may react very calmly. Another may express strong feelings. One person may have an immediate emotional response. Another may be "numb" at first and respond emotionally later.

NON VERBAL – BODY LANGUAGE Scientists say that body language accounts for 80% of the message we try to tell others and that what we actually say is only 20%.

How do you support your child or loved one? Be understanding Encourage physical activity Encourage social activity Learn more about depression Get in treatment / Stay involved in treatment Consider medication

Consult, consult, consult. Do not be afraid to ask for help Consult, consult, consult! Do not be afraid to ask for help. You are not alone.

Community Resources: Crisis or Help Numbers First Call for Help (FBH) 509-838-4428 National Suicide Prevention Lifeline 1-800-273-8255 The Trevor Project 1-866-488-7386 Crisis Text Line 741-741 Children’s Home Society 509-747-4174

Community Resources: Training QPR Institute ASIST Networks for Life from YSPP

Community Resources: Websites www.smilelifework.org www.nowmattersnow.org www.srhd.org (healthy communities, suicide prevention) www.yspp.org www.suicidepreventionlifeline.org