The subject of depression and suicide, especially in the case of children and teens, is a tremendous concern. Unfortunately, many cases go missed not necessarily because those surrounding these young people don’t care or pay enough attention to them, but more because they aren’t aware of what to look out for.
I am a suicide survivor. I also grew up with a suicidal mother and witnessed a peer successfully commit suicide, ironically, when I was in the emergency room beside her being treated for the same thing. I was saved, while her family still mourns for her.
These experiences, including the fact that my twelve-year-old daughter has been suffering with depression and suicidal thoughts for the last three years, are what steered me to obtaining my psychology degree, specializing in children with mental/emotional issues, and other special needs.
What triggers a young person to slip into such a dark place? Are there signs, and if so, what are they? How can we help someone going through this turmoil? Does medication really help? These are all questions most of us ask while either in the midst of dealing with this issue, or in retrospect when trying to figure out how a person could have felt low enough about themselves to think dying was the only option.
When I speak about the topic of young people dealing with depression and other mental/emotional struggles, or either helping a teen struggling with wanting to commit suicide or helping families understand how such a thing could happen, I tackle answering the questions above the best I can.
What are the triggers?
Triggers are events, or even other people, that heighten an already depressed individual’s view that life, as they see it, is impossible to cope with. It could be something as small as frustration with not being able to complete a task that others seem to be able to do with ease or a thoughtless, back-handed comment from a peer or something more serious such as an unhappy home life.
We all face similar triggers, also called stressors, but most of us are able to cope with them effectively. Most people face similar hurdles that life presents, but they also learn effective coping tools to get through the negative feelings. Those whose minds are clouded with depressive thoughts aren’t able to see the positive tools to get through such things, causing the depression to deepen after each trigger.
How can I help?
The most difficult part is that unless a person who wants to help is there to witness if/when triggers pop up, knowing how to help can be a challenge. The best way to help in these situations is not to bombard the individual with questions like, “What happened?” or comments such as, “Talk to me.” Most times, the words to describe the feelings that triggers elicit just aren’t there. That’s how to help.
One of young people’s main frustrations is not being able to put words to the deep feelings they experience. That’s the first step toward healing. Owning the feelings, and being able to know what sort of tool to turn to in order to lower the intensity of the reaction to stressors is key.
Yes, there are signs for someone dealing with depression, however, there are some people who are masters at masking their problems. Then when those triggers pile up, bringing the person to the boiling point, the mask tends to fall off.
Some of the main signs of depression are:
- A steady loss of interest in enjoyed activities.
- Pulling away from friends and family.
- A negative view of the world and the people in it.
- An overwhelming sense of not being good enough.
- Beating oneself up verbally, even when good things are happening.
- A sudden fascination with death and dark topics.
Signs that a person suffering from depression is considering suicide can often be so subtle and sudden. It is behavior passed off as “just being a teenager” where intervention is most needed. Contrary to popular belief, kids don’t always verbalize that they will take drastic measures to end their internal suffering. Oftentimes, it’s what they don’t say that gives a clue. In my experience, silence should elicit some investigation.
There are several different types of anti-depressants available, each requiring different dosage levels and strengths, depending on the patient’s individual situation. All of them have the job of tweaking brain chemistry to, hopefully, relieve symptoms and help the patient function more effectively.
One of the oldest form of drugs are called Tricyclic antidepressants (TCAs). This group of antidepressants inhibits specific neurotransmitters (chemicals) in the brain, evening out the imbalance that causes depression and other mood disorders. Some examples include Elavil, Norpramin, Pertofrane, Adapin, Sinequan, Tofranil, Aventyl, Pamelor, Vivactil, and Surmontil.
The next category is Selective Serotonin Reuptake Inhibitors (SSRIs). These are the common ones doctors usually turn to first. Some examples include Zoloft, Prozac, Celexa, Lexapro, Paxil, Luvox and Oleptro.
There are also Serotonin Norepinephrine Reuptake Inhibitors (SNRIs), which are a newer form of antidepressants, which can also be used to treat anxiety disorders. Some kinds are Effexor, Khedezla, Cymbalta, and Fetzima.
Finally, there are Monoamine oxidase inhibitors (MAOIs), which block the activity of an enzyme called monoamine. This enzyme removes dopamine, norepinephrine, epinephrine, and/or serotonin. Therefore, the drug itself helps to stop monoamine from doing its job in order to allow the other chemicals to increase brain functioning and, hopefully, to reduce symptoms of depression.
There are other drugs available but the aforementioned ones appear to be the ones doctors turn to the most. The type of drug used depends on the kind of depression present and, oftentimes, the doctor has to experiment with dosage levels as well as the sort of drug tried until the patient’s specific symptoms appear to level out.
It is important to note that medication alone will not remove depression or suicidal thoughts. In fact, in some cases, they can increase symptoms and thoughts of dying. It is strongly recommended that patients receive both medicinal and psychotherapy or counseling treatments for the most effective results.
Depression is a difficult state of mind to understand and no matter how much education one has under their belt, the best way to help those in dire mental/emotional need is to either have a combination of educational and personal experience or to have been in similar circumstances.
Aside from all the medication and therapy, one thing I have always found most effective is to ensure that the patient has that one person they trust and feel they can turn to no matter how low things may seem. That one person who isn’t prescribing, diagnosing, poking and prodding. Oftentimes, having that one person who believes in the individual and sees him or her as a person underneath all the chaos can be enough to bring them back.
Above all else, especially in the case of young people, understanding is the key. And taking the time to understand leads to acceptance, which to these people, is the greatest gift of all.