Inside, I was frantic. Outwardly, I tried to remain calm and remember my training. "Have you decided how you're going to kill yourself?"� I asked.

"Yes. I'm going to drive up the canyon and run my car off the road."�

"And when do you plan on doing this?"�

"After we're done talking and I've put my girls to bed."�

Oh "� crap.

Finding yourself in a situation where someone you know or care about may be considering taking their life is frightening. However, knowing what to look for and how to talk to the person can be as valuable as knowing how to perform CPR. They're all life-saving techniques.

The National Suicide Prevention Lifeline (www.suicidepreventionlifeline.org) lists several potential warning signs of suicide, including:

• Threatening to hurt or kill yourself

• Looking for means (hoarding pills, obtaining a weapon, etc.)

• Talking or writing about death, dying, or suicide

• Feeling hopeless

• Feeling angry

• Acting reckless or engaging in risky activities

• Feeling trapped, like there's no way out

• Increased alcohol or drug use

• Withdrawing from friends, family, or society

• Feeling anxious or agitated

• Experiencing sleep problems

• Dramatic changes in mood

• Feeling like life has no purpose or meaning

• Giving away cherished possessions

If someone you know is exhibiting any of these signs, it is important to ask them if they are thinking about suicide. Be calm and matter-of-fact. Remember that saying the word or talking about the subject will NOT plant thoughts of suicide in their head. If you appear confident in the face of a crisis, this can be reassuring for the person with whom you are talking. Let them know you care and you want to help. Express empathy with what they're going through ("It must be scary to feel so alone"�). Tell them that it is actually common to have thoughts of suicide, but that doesn't mean we need to act on those thoughts. Let them do most of the talking if they can. Above all, do not pass judgment on what they are feeling. Comments like, "Why would you want to kill yourself? You have so much to live for!"� and, "You would destroy your family if you did something like that,"� only make the person feel worse.

So what do you do when the person you're talking to says, yes, they are thinking about suicide? That's when you need to ask the all-important HOW-WHEN-WHAT questions:

HOW

do you plan to do it?

WHEN

do you plan to do it?

WHAT

Do you have WHAT you need to do it?

The more concrete their plan, ("I'm going to drive my car off the cliff after my kids are asleep"�) the more serious the situation (although any suggestion of suicide should always be taken seriously). Do not leave the person alone and get them help as soon as possible - whether that means calling their doctor or 911.

I don't know what happened to the woman I talked to on that long ago night. I checked the newspaper every day for several days but never saw any mention of a car accident in the canyon. I hope she got help. Even if the worst happened -and sometimes the worst DOES happen - I know I tried my best. That's really all you can do.

For more information on suicide prevention, go to: 

• Mental Health First Aid (www.mentalhealthfirstaid.org)

• Suicide Prevention Lifeline (www.suicidepreventionlifeline.org or 1-800-273-TALK)

• National Alliance on Mental Illness (www.nami.org)

• American Foundation for Suicide Prevention (www.afsp.org)

The post How to help a suicidal individual appeared first on FamilyToday.

"You have to stay calm,"� the therapist said. "When kids are falling apart, they need their parents to remain steady."�

However, it's hard to remain steady when you see your child in pain. It can be even harder to understand why they would deliberately cause that pain by cutting, burning, biting or engaging in other forms of self-harm.

To help the child who is self-harming, it is important to understand the reason behind the behavior. Self-harm is usually a symptom of something deeper and more complex.

The child who self-harms may do so to

• Express emotional pain they can't express verbally.

• Relieve the build-up of tension caused by anxiety, depression or other psychological or physical trauma.

• "Feel"� something other than the numbness of despair.

• Feel a sense of control over their lives ("I'm going to hurt myself before someone else does"�).

What should you do when you discover that those scratches on your son or daughter's arm were not, in fact, caused by your overly playful cat (an excuse my daughter actually used)?

• Make sure your child receives an evaluation by a mental health professional who can diagnose and treat any underlying psychiatric disorders.

• Validate their feelings. Even if you think they're getting all worked up about nothing, that's not how they feel. Saying, "You must be in a tremendous amount of pain to want to do this to yourself"� lets them know you recognize their distress.

• Ask how you can help. If they say, "I don't know,"� be prepared to suggest some coping strategies. Remember, the part of your child's brain that helps them reason and make good decisions isn't finished developing until they are in their early twenties. Model problem-solving skills by saying, "Let's write down some things you might try when you feel like you want to hurt yourself."� Potential coping strategies include: squeezing an ice cube, snapping the wrist with a rubber band, going for a walk, practicing breathing exercises, writing in a journal, screaming into a pillow, etc.

• Be open about their self-harm. If you think they have been hurting themselves, ASK. But do so calmly.

Finally, don't be afraid to bring up the "S"� word: suicide

It is natural to assume if your child is hurting themselves they are at risk of attempting suicide. It is also reassuring to know the majority of children who self-harm do NOT kill themselves. Whether you approach the subject indirectly ("Sometimes when kids are really upset, they just want to end it all. Do you ever feel that way?"�) or directly ("Hurting yourself is pretty drastic. Are you thinking of killing yourself?"�), you need to know if this is something your child is thinking about. If they say yes, listen to them without judging, and then contact their mental health care provider or the crisis line in your area.

There are few things that can make a parent feel more frightened or helpless than seeing your child with razor cuts running up and down their arms.Just know your child is feeling even more frightened and helpless and is depending on you to know what to do. So take a deep breath, tell them that you will get through this together, and be the person they need you to be.

For more information on children and mental illness, visit the National Alliance on Mental Illness at www.nami.org.

The post Helping the child who self-harms appeared first on FamilyToday.

I remember very clearly the moment my husband and I first knew we had a teenager on our hands. We were returning from a family picnic with our three children, the oldest of whom had just started junior high school the week before. Since we had a habit of family scripture study, we had brought our scriptures to read on the way home. I read one chapter and started to close the book. That's when our middle child (too saintly for her own good) piped up with, "Oh, can you read ANOTHER one?"�

Our oldest promptly muttered a complaint under her breath, to which her dad responded by saying, "Well, that's not a very good attitude to have!"

That was all it took. Our daughter refused to speak to her dad for the next six months. Not only would she not speak to him, but she would leave the room when he entered. Or she'd hide under a blanket. Or cover her face with a pillow. Her previously perfect grades started dropping. She began dressing in black and staying in her room. And she was angry all the time.

Finally we realized our bright, bubbly daughter wasn't just experiencing the normal ups-and-downs of adolescence. Something much more serious was happening.

When the therapist diagnosed our daughter with clinical depression, our first thought was, "What does she have to be depressed about?" (Forgive us. We were new at this.) That was followed by, "She isn't acting depressed. She's just acting mad." (We were very new at this.)

Now, several years later, we know you don't have to "have something to be depressed about" to be depressed. Depression is a brain disorder that can be influenced by genetic and environmental factors. Approximately one out of five youth will have one or more episodes of major depression by the time they reach adulthood.

We also know depression in adolescents can look different than depression in adults, with the most noticeable change being an increase in irritability, anger, or hostility. Of course, those three traits are also part of normal adolescent behavior, so how can you tell the difference?

In addition to anger or irritability, signs of depression in teens can include:

• Frequent sadness, tearfulness, crying

• Hopelessness

• Decreased interest in activities; or inability to enjoy previously favorite activities

• Persistent boredom; low energy

• Social isolation, poor communication

• Low self-esteem and guilt

• Extreme sensitivity to rejection or failure

• Difficulty with relationships

• Frequent complaints of physical illnesses such as headaches and stomachaches

• Frequent absences from school or poor performance in school

• Poor concentration

• A major change in eating or sleeping patterns

• Talk of or efforts to run away from home

• Thoughts or expressions of suicide or self-destructive behavior [1]

If your child is experiencing any of these symptoms for more than two weeks, or if these symptoms are interfering with your child's ability to function, you need to seek professional help. A therapist, psychologist, APRN (registered nurse with additional psychiatric training), or child and adolescent psychiatrist [2] will be able to diagnose and treat your child. Be aware, though, if your child needs antidepressants or other psychotropic medications, these can ONLY be prescribed by an APRN, psychiatrist, or in some cases, your child's physician.

Finally, don't be surprised if your child is resistant to the idea of getting help for their illness. (Our daughter swore we'd drag her kicking and screaming to see a counselor. We finally said, "OK, if that's what it takes.") Teens are very wary about being seen as different or "weird," and there is still a lot of stigma attached to having a mental illness. But depression, left untreated, can kill. So be sensitive, but be firm - and get your child the help he or she needs.

For more information on children and mental illness, visit the National Alliance on Mental Illness at www.nami.org

[1] "Facts for Families," American Academy of Child & Adolescent Psychiatry, http://www.aacap.org

[2] If you are not able to find a child and adolescent psychiatrist in your area or if the psychiatrist has a long waiting list, ask for recommendations of APRNs who specialize in treating teens. You can often get in to see an APRN much faster than a psychiatrist.

The post Typical teen angst, or something more serious? appeared first on FamilyToday.