“Adolescents’ angst does not always pass —sometimes they really need help,” clinical psychologist Carol Mahlstedttold a group of parents and students Monday night at Ridgefield HighSchool.
“Suicide shatters some very important assumptions,” she said. “The death of a child is one of life’s most profound sorrows.”
Ms.Mahlstedt and five other mental health experts offered a symposium onsuicide, stress and how parents could help their children cope in theaftermath of a Ridgefield High School senior’s suicide last month.
Severalpeople in the audience commented on the approximately 60 people whocame to listen. “It was interesting and disappointing that the turnoutwas so low — there’s something like 1,800 students in the high school,”said Leslie McGuire, a Ridgefielder who runs a national screeningprogram for at-risk youth called TeenScreen (see other story).
Thepanelists were Dr. Mahlstedt, family doctor Thomas Cigno, clinicalpsychologist Richard Salwen, psychiatrist John Gelines, schoolpsychologist Patrick McAuliffe and Elizabeth Driscoll Jorgensen, who isa certified alcohol and drug counselor.
Grief and copingDr. Mahlstedt encouraged parents to recognize that for teenagers, dealing with death for the first time can be disorienting.
The grief process has five stages, she said:
- a psychological process of intense feelings;
- a physical process which can include changes in sleep, appetite and energy patterns and which can be physically exhausting;
- a behavioral process which might include feelings of anger, sadness and anxiety;
- a social process which can include a wish for increased or decreased contact with others;
- a spiritual process which can include a crisis of faith.
Risk factorsDr.Salwen told parents that there are risk factors for suicide that theyshould watch for with their teenagers. But, he said, sometimes thoserisk factors are normal teenage behavior, so parents have to be careful.
“Oneproblem is that adolescent risk factors — the lists all overlap andthere’s a long list of behaviors that look very much like your teenslook when they’re having a bad day,” he said. “As a parent, you have toask what do I need to be anxious about?”
Risk factors includefeelings of hopelessness and helplessness, emotional illness, aprevious suicide attempt, a recent history of loss, an exposure tosuicide, family conflict, a history of physical, emotional or sexualabuse or neglect, a substance abuse problem, a medical illness, or ahistory of impulsive, aggressive or self-destructive behavior, he said.
“Whena child feels trapped, that they don’t have coping skills, they feelthey can’t turn to their parents, clergy or friends, and they have asense of being hopeless, helpless, trapped,” which puts them at risk,he said. Social isolation, academic difficulties, legal issues, sexualidentity conflicts, and access to lethal means are all risk-enhancers,he said.
Often, but not always, there are warning signs.
“Children who complete suicides have almost invariably made other suicide attempts,” he said.
But he also said that 70% of kids in the high school will have thought at some point about suicide within the last year.
Affluence causes problemsDr.McAuliffe said that speaking personally — and not in his role as schoolpsychologist — he thought parents should be aware that kids who havegrown up in affluent circles have specific risks.
“There are anumber of adjustment disorders in affluent communities,” he said.“There is a higher rate of internalizing problems. There is moredepression and anxiety. There is a higher level of substance usedisorders. Achievement pressures in affluent communities are very highand can lead to stress,” he said. “Isolation from adults is a secondstress cause.”
He said families in which both parents work high-level jobs sometimes have “an erosion of family time.”
“Some stress is good — it helps get things done,” he said. “Too much stress is disabling.”
He urged parents to spend time with their teenagers and to help them set realistic goals.
Dr. Mahlsted had a similar list.
Parentscan help their children by encouraging them to set realistic goals, tomake time for relaxation and play and exercise, and by encouraging themto express their feelings by journaling and talking about their valuesand life purposes, she said.
Elizabeth Driscoll Jorgensen said bythe “magical age” of 15, parents can expect their Ridgefield teens tohave been exposed to alcohol and other drug use.
“The median age forfirst use of marijuana is 11.9 years,” she said. “There is no stigmaabout marijuana in Fairfield County among teens.”
She said parentsneed to talk to their kids openly and often about their expectations.“Set firm and caring limits on teens with regards to your expectationsabout substance use,” she said. “Network with like-minded parents. Askthe questions: Who? Where? What’s the phone number? Call and check thatthere’s parental supervision.”
She said teenagers need eight to 10 hours of sleep, and sleep deprivation can reinforce feelings of depression.
Depressionand substance abuse are inter-related, she said. Marijuana use can feedinto a cycle in which the user feels more depressed by the drug’seffects.
Stress, achievement, expectationsThepanelists urged parents to go easy on their kids. In answer to anaudience member’s question about how to recognize what is pushing achild too hard academically, Ms. Jorgensen said she thought parents whourge an honor roll student to make the high honors were likley pushingtoo hard.
“If your kid is on the honor roll, rejoice,” she said.
Dr.Mahlstedt said teenagers confuse their parents’ desire for them tosucceed with a feeling that they are measured only by theiraccomplishments. “A lot of teenagers walk around with the assumptionsthat they are only loved for what they achieve, not for who they are,”she said.
Dr. Salwen agreed. “If you need to get into Harvard tofeel you are successful in life, you’ve got a problem,” he said. “It’snot about where you go to undergraduate school or how much money youmake.”
Teens need to feel they can talk to their parents and they will be loved, he said.
Ms.Jorgensen agreed. She said she has a practice in her office that hasproven hugely helpful — she has the parents agree to an “amnesty”period with their kids in which the kids can tell them anything withoutfear of punishment. The result is the kids are relieved and the parentsare able to know what’s going on, she said.
“Having open lines of communication is the key to prevention,” Dr. McAuliffe agreed.
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