Is Your Child or Teen "Huffing"?

Common Household Products - A Source of Inhalant Abuse

Reports about teens dying after inhaling the chemical difluoroethane from a popular computer-cleaning spray known as Dust-Off called widespread attention to the practice of inhalant abuse. Then, as now, the product Dust-Off itself was not the source of the problem; it is only one example of hundreds of common household products with the potential to be abused by inhalant abusers.

Inhalant abuse (commonly called "huffing") is the intentional inhalation of chemical vapors to attain a mental "high" or euphoric effect. A wide variety of substances, including many common household products, are abused by inhalers (see list below). The 2010 National Survey on Drug Use and Health (NSDUH) revealed that the primary population of inhalant abusers (68%) is under 18 years of age. Although inhalant abuse is declining from its peak in the 1990s, it is still a significant problem. In 2011, 7% of eighth graders reported inhalant use, along with 4.5% of 10th graders and 3.2% of 12th graders.

Inhalants produce an effect that may be similar to alcohol intoxication. Initial symptoms described by abusers who were "huffing" include

• drowsiness,
• lightheadedness,
• loss of inhibition.

Further use can lead to the following:

• Dizziness
• Hallucinations or delusions
• Belligerence
• Apathy
• Impaired judgment

Long-term inhalant abusers can suffer damaging health consequences including

• depression and mood changes,
• weight loss,
• inattentiveness,
• lack of coordination,
• irritability,
• weakness.

More serious consequences can include permanent damage to the brain and other organs or even death. Sudden cardiac death from fatal cardiac arrhythmias has been reported even in teen inhalant abusers. Death from huffing can occur upon the first time of use or after prolonged inhalant abuse. Other causes of death related to huffing include asphyxiation,aspiration, or suffocation.

Chronic inhalant abuse may result in serious and sometimes irreversible damage to the user's heart, liver, kidneys, lungs, and brain. Brain damage may result in personality changes, diminished cognitive functioning, memory impairment, and slurred speech. Further, inhalant users usually begin smoking, using alcohol, and using other drugs at younger ages and display a higher lifetime prevalence of substance-use disorders than those who do not use inhalants.

Substances commonly used by inhalant abusers fall into several categories:

• Volatile solvents, such as those found in paint thinner, gasoline, felt-tip markers, nail polish remover, glue, and other household products.
• Aerosol sprays containing propellants and solvents: Examples include spray paint, deodorant, and hair-care products.
• Gases, most commonly nitrous oxide (laughing gas)
• Nitrites, a group of chemicals that are used in room deodorizers, are more often abused by those seeking sexual enhancement rather than a euphoric state. Nitrites are most commonly abused by adults.

Parents of teens need to be especially vigilant about signs of inhalant abuse (huffing), since the abused substances are simple household items and not readily identifiable as drugs of abuse. Signs of inhalant abuse include chemical smells on clothing or breath, slurred speech, loss of appetite,nausea, a drunk or disoriented appearance, pain or stains on skin or clothing, inattentiveness, and lack of coordination. Chemical-soaked rags or empty spray paint or other solvent containers may be found. Inhalants are substances that are easily purchased and are inexpensive, making them attractive to curious teens.

Medical Author:

Melissa Conrad Stöppler, MD 

Medical Editor:

Charles Patrick Davis, MD, PhD 

DMX Abuse--What Parents Should Know

Cough Syrup Abuse

One of the riskiest teen behaviors is lurking right there in your own medicine cabinet. Taking cough and cold medications continues to be a hot craze for kids, but now younger kids are joining the ranks. Pharmacies and drug stores are now locking these medicines up to fight off kid theft. Drug rehab centers across the country are seeing record numbers of teens and young adults needing treatment for long term abuse and addiction to over the counter (OTC) cough syrups. By far the most popular with teens who abuse cough syrups are ones that include the ingredient dextromethorphan (DXM). The consequences are tragic and can cause addictions as well as deaths. Some of the slang names for DXM include: Dex, DXM, Skittles, Poor Man's PCP, Candy, Red Devils, Robo, Velvet, Vitamin D, Syrup, Tussin, Triple-C, CCC, Robo-tripping, Dexing, Robo-fizzing, and Skittling. What every parent needs to know to keep teens safer. One out of every fourteen kids aged 12 to 17 (more than 2.4 million) admit to using or abusing cough syrup containing DMX, according to the American Medical Association.

The ingredient found in most popular nonprescription cold and cough medicines - called Dextromethorphan or DXM - can be safely taken in the recommended dosage. While cough syrups containing dextromethorphan are definitely the most common way to ingest this drug, it is increasingly being abused in tablets and gel capsules. However, when taken in high doses it can produce euphoric highs and hallucinations and can become a dangerous, even deadly mind-altering drug. Many kids are taking as much as 25 to 50 times the recommended dose to get high, which could potentially cause long term side effects, including coma or death. When cough syrups containing DXM are taken in excessive amounts, it becomes the equivalent of a hallucinogenic drug such as LSD, and individual will feel their body begin to slow and feel more at ease while the brain acts at a reduced capacity. The American Medical association recently released a warning to parents stating that when kids take DXM in large amounts it can become a dangerous, even deadly mind-altering drug. Cough syrup abuse is on the rise perhaps because medicines containing DXM are easily accessible in drug stores (or medicine cabinets); since these OTC's are legal, cold-and cough syrup abuse has soared in recent years. Cough syrup abuse has dangerous side effects besides the DXM addiction. Most cough medicines contain acetaminophen. Acetaminophen is the brand name Tylenol. Although Tylenol is considered harmless, in fact large doses are harmful to the liver. A dose of acetaminophen over 4g in a day is considered dangerous, and it can lead to severe liver damage. Because of the acetaminophen, some DXM users extract the DXM from the cough syrup. This removes other substances from the syrup, so pure DXM is swallowed, Acetaminophen is not soluble in water, and so it can be removed using filtering processes.

Much like that of prescription or street drugs, if a person abuses cough syrups containing DXM long enough, they may develop an addiction, and problems may arise in cessation. If the individual stops taking the cough syrup abruptly, he or she can experience withdrawal symptoms, such as restlessness, muscle aches, cold flashes, vomiting, bone aches and insomnia. No matter what the reasons for abusing these over the counter cough syrups containing DXM, an individual can develop dependence and an addiction if the drug is taken too long or in too high of doses. The withdrawal process should be properly monitored at a drug treatment center. It is vitally important that those with an addiction seek the help they need to stop taking the drug and to learn how to function normally without it.

11 Facts About Teens And Alcohol

1. 
   
2. 
   
3. In 2012, nearly three-quarters of students (72 percent) have consumed alcohol (more than just a few sips) by the end of high school, and more than a third (37 percent) have done so by eighth grade.
    
4. According to a study by Columbia University, underage drinkers account for 11.4 percent of all of the alcohol consumed in the U.S.
    
5. The average age teen boys first try alcohol is age 11, for teen girls it’s 13.
    
6. Nearly 10 million young people, ages 12 to 20, reported that they’ve consumed alcohol in the past 30 days.
    
7. Teens who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after the legal age of 21.
    
8. In 2010, there were approximately 189,000 emergency rooms visits by teens under age 21 for injuries and other conditions linked to alcohol.
    
9. Teens who drink heavily are three times more likely to try and hurt themselves (self-harm, attempt suicide etc.) than those who don't.
    
10. 9 out of 10 American teens report that drinking is not worth the consequences it can cause.
     
11. The three leading causes of death for 15 to 24-year-olds are automobile crashes, homicides and suicides – alcohol is a leading factor in all three.
     
12. In 2010, 56 percent of drivers aged 15 to 20 who were killed in motor vehicle crashes after drinking and driving were not wearing a seat belt.
     
13. The rate of current alcohol consumption increases with age, according to the 2011 National Survey on Drug Use and Health, from 2 percent at age 12 to 21 percent at age 16, and 55 percent at age 20.

Create a designated driver program at your school. GO

Sources: CDC, The Century Council, SADD, National Council on Alcoholism & Drug Abuse

Let Cory Monteith's Overdose Death be a Loud Wake-Up Call

Cory Monteith often spoke frankly about his ongoing struggles with addiction, acknowledging it had complicated his high school years and that in many ways he was lucky to be alive. With news that Mr. Monteith died of an overdose involving alcohol and heroin, his passing is cause to reflect on the challenges addiction poses to millions of individuals, their families, and communities worldwide.

Many of us do not include handsome 'Glee' actors in our conception of the addicted individual. Indeed, for some, Mr. Monteith's sunny disposition, talent, and fairytale rise to fame stands in harsh contrast to the seemingly haggard faces and unenviable lives of those that populate street-level drug scenes like that in Vancouver's poverty-stricken Downtown Eastside.

This vast social and economic gulf between Mr. Monteith and those that face not only addiction but homelessness too begs the question if someone like Mr. Monteith - with stature and a wealth of resources at his disposal - was not able to conquer his addiction, why do we still express disdain for those individuals of lesser means with multiple, competing health issues who also "fail" to recover?

Obstacles to addiction treatment vary widely from country to country, city to city, even from neighbourhood to neighbourhood. But two challenges that remain constant across diverse settings are the inadequacy of specialized clinical addiction training and a perpetual and crippling lack of treatment facilities.

These constraints are crucial, because inadequate or inaccessible care means many people will never get the evidence-based care they need, and will instead be left to contend with overwhelming consequences of untreated addiction - among them the loss of family ties, employment, and too often, premature death from overdoses or blood-borne diseases like HIV or Hepatitis C.

Thankfully, B.C.'s provincial government and local health authorities have redoubled their efforts to address this healthcare gap.

Over the next five years, the St. Paul's Hospital Goldcorp Fellowship in Addiction Medicine will provide evidence-based clinical training for 20 addiction medicine doctors to help fight and manage addiction with the most advanced tools available - whether on the streets of the Downtown Eastside or in the suites of the Fairmont Pacific Rim Hotel.

Later this year, a network of researchers will launch a centre for clinical trials focusing specifically on testing cutting-edge addiction treatments, a research enterprise that has the potential to produce game-changing therapies that could influence how we treat addiction the world over.

For this work to be successful, however, we as a society must accept that addiction should be treated as an illness like diabetes or cancer - and not as a moral failing deserving of stigma or prison time. Whether addicts are movie stars or people living on the street, those that face this illness require our compassion. Without it, efforts to connect drug-dependent individuals with evidence-based care will be for naught, police and jail guards will continue to be the ones tasked to handle those with addiction who need help most.

Rather than punishing and shaming people like Mr. Monteith and his less affluent counterparts, we need to ensure that governments and health authorities provide full and ready access to addiction treatment services. As a society, we need to recognize that the spiral of addiction, stigma, and the tragedy of premature deaths can be averted through a compassionate response that prioritizes evidence-based clinical treatment. Once this is done, will we finally be able to heal those among us, at all levels of society, who need our help.

So far, they have only received our scorn.

By Michaela Montaner

Glee star Cory Monteith died from heroin and alcohol overdose, says coroner

By KUNAL DUTTA  , TIM WALKER

Cory Monteith, the Canadian star of the hit musical television series Glee, who was found dead in a Vancouver hotel room, died from a heroin and alcohol overdose, according to a coroner’s report.

The British Columbia Coroner’s Service confirmed the actor’s cause of death after conducting an autopsy and toxicological analysis. A statement said: “There is no evidence at this time to suggest Monteith’s death was anything other than a most tragic accident.”

The 31-year-old was believed to have been alone when he died in his room at the Fairmont Pacific Rim hotel, where he was found on Saturday. The coroner’s office said the investigation into his death was continuing, and that no other details were available. Police in Vancouver had earlier said it was unlikely that the death was the result of substance abuse.

Monteith, who played Glee’s singing quarterback Finn Hudson, had been an integral member of the show’s cast since it began in 2009, and was expected to return in its fifth series this September. The Fox network and the producers of Glee, including 20th Century Fox Television, described the actor as “an exceptional talent and an even more exceptional person”.

Monteith was treated for drug addiction earlier this year. He had previously been in rehab aged 19, and spoke openly about his past struggles with substance abuse. In a 2011 interview, he said he was “lucky to be alive”. His girlfriend and Glee co-star Lea Michele publicly supported the actor when he admitted himself to a rehabilitation centre in March. At the time, she told People magazine: “I love and support Cory and will stand by him through this. I am grateful and proud he made this decision.”

Following this week’s autopsy, Ms Michele issued an official statement through a spokesperson: “Lea is deeply grateful for all the love and support she’s received from family, friends and fans. Since Cory’s passing, Lea has been grieving alongside his family and making appropriate arrangements with them. They are supporting each other as they endure this profound loss together.”

Filmmaker Gia Milani, who recently directed Monteith in the as-yet-unreleased Canadian film All the Wrong Reasons, said this week that the actor “seemed healthy” when she last saw him four weeks ago in Los Angeles. “He looked super fit and he was energetic and excited,” she said.

Meanwhile the Westboro Baptist Church, a fringe US Christian group, has threatened to picket the star’s funeral, after issuing a series of anti-gay tweets directed at his Glee co-stars. The Church, known for disrupting the funerals of US servicemen, has failed to make good on its promises to picket the victims of the Boston bombing.

For Teens: How to Survive Cyberbullying

Surviving Cyberbullying

Leigh was in eighth grade when the mean messages started. The emails, texts, and posts got worse. It was so bad that she eventually changed schools.

Leigh says she has come through the experience more self-aware and compassionate toward others. It was a terrible time, she says, but with some counseling and support from adults and friends, she was able to make sense of what happened to her.

Most people know about cyberbullying. Here are some suggestions on what to do if you, or someone you know, is involved.

What Counts as Cyberbullying?

Cyberbullying is the use of technology to harass, threaten, embarrass, or target another person. Online threats, rude texts, and mean tweets, posts, or messages all count. So does posting personal information or videos designed to hurt or embarrass someone else.

Cyberbullying also includes photos, messages, or pages that don't get taken down, even after the person has been asked to do so. In other words, it's anything that gets posted online and is deliberately intended to hurt.

In some situations, cyberbullying is considered harassment.Intimidation or mean comments that focus on things like a person's gender, religion, sexual orientation, race, or physical differences fall into this category. Whether it's done in person or online, this type of meanness counts as discrimination and is against the law in many states. That means law enforcement could get involved, and bullies may face serious penalties.

Some schools or other organizations might make a distinction between bullying and harassment. That's because of legal differences and definitions. But to the person being harassed or bullied, there's no real difference — it's painful to go through, no matter what you call it.

Online bullying can be particularly damaging and upsetting because it's usually anonymous or hard to trace. People can be tormented on a 24/7 basis — anytime they check their phone or computer. Sometimes, they might not know what's being said behind their backs or where the meanness is coming from.

Online bullying and harassment can be easier to commit than other acts of bullying because the bully doesn't have to confront his or her target in person.

Virtual Acts, Real Consequences

Because of the role technology plays in our lives, there is often no place to hide from bullies. Online bullying can happen at home, school, or anywhere else people go online.

Sometimes, online bullying, like other kinds of bullying, can leave people at risk for serious problems: Stress from being in a constant state of upset or fear can lead to problems with mood, energy level, sleep, and appetite. It also can make someone feel jumpy, anxious, or sad. If someone is already depressed or anxious, cyberbullying can make things much worse.

It's not just the person being bullied who gets hurt. The punishment for cyberbullies can be serious. More and more schools and after-school programs are creating systems to respond to cyberbullying. Schools may kick bullies off sports teams or suspend them from school. Some types of cyberbullying may violate school codes or even break anti-discrimination or sexual harassment laws, so a bully may face serious legal trouble.

Why Do People Do It?

Why would someone be a cyberbully? There are probably as many reasons as there arebullies themselves.

Sometimes, what seems like online harassment may be accidental. The impersonal nature of text messages, posts, and other ways of communicating online means it can be hard to figure out if someone is joking or not.

Most people know when they're being bullied, though, because bullying involves relentless insults or threats. The people doing the bullying know they've crossed a line too. It's not a one-off joke or insult — it's constant harassment and threats.

What to Do

If you're being bullied, harassed, or teased in a hurtful way — or know someone who is — there is no reason to suffer in silence. In fact, you absolutely should report upsetting IMs, emails, texts, etc.

Tell someone. Most experts agree: The first thing to do is tell an adult you trust. This is often easier said than done. People who are cyberbullied may feel embarrassed or reluctant to report a bully. Some may hesitate because they're not 100% sure who is doing the bullying. But bullying can escalate, so speak up until you find someone to help.

Most parents are so concerned about protecting their kids that sometimes they focus on taking all precautions to stop the bullying. If you're being bullied and worry about losing your Internet or phone privileges, explain your fears to your parents. Let them know how important it is to stay connected, and work with them to figure out a solution that doesn't leave you feeling punished as well. You may have to do some negotiating on safe phone or computer use — the most important thing is to first get the bullying under control.

You can also talk to your school counselor or trusted teacher or other family member. If the bullying feels like it's really getting you down (like if it's affecting your sleep or concentration), counseling can help. If you're not ready for that, you can still benefit from the support of a trusted adult.

Walk away. What you've heard about walking away from a real-life bully works in the virtual world too. Ignoring bullies is the best way to take away their power, but it isn't always easy to do (both in the real world and online).

If you see something upsetting, try to step away from the computer or turn off your phone for a while. Don't respond (or forward the message to someone else). Find something to distract yourself from what's going on. Do something you love that doesn't give you time to think about what's happening, like playing the guitar, going for a run, or immersing yourself in a book or movie. You can also just chat with a parent or sibling or play with a pet.

Taking a break like this allows you to keep things in perspective and focus on the good things in your life. It also gives you time to figure out how you want to handle things.

Resist the urge to retaliate or respond. Walking away or taking a break when you're faced with online bullying gives you some space so you won't be tempted to fire back a response or engage with the bully or bullies. Responding when we're upset can make things worse. (Standing up to a bully can be effective sometimes, but it's more likely to provoke the person and escalate the situation.) Taking a break gives the power back to you!

Although it's not a good idea to respond to a bully, it is a good idea to save evidence of the bullying if you can. It can help you prove your case, if needed. You don't have to keep mean emails, texts, or other communications where you see them all the time — you can forward them to a parent or save them to a flash drive.

Report bullying to your service provider. Sites like Facebook and YouTube take it seriously when people use their sites to post cruel or mean stuff or set up fake accounts. If users report abuse, the site administrator may block the bully from using the site in future. If you're being harassed by someone sending you mean texts or emails, you can complain to phone service or email providers (such as Gmail, Verizon, Comcast, and Yahoo).

Block the bully. Most devices have settings that allow you to electronically block the bully or bullies from sending notes. If you don't know how to do this, ask a friend or adult who does.

Be safe online. Password protect your cell phone and your online sites, and change your passwords often. Be sure to share your passwords only with your parent or guardian. It's also wise to think twice before sharing personal information or photos/videos that you don't want the world to see. Once you've posted a photo or message, it can be difficult or impossible to delete. So remind yourself to be cautious when posting photos or responding to someone's upsetting message.

If a Friend Is a Bully

If you know of a friend who is acting as a cyberbully, take him or her aside and talk about it. Without putting your friend down, stand up for your own principles: Let the bully know it's not OK.

Explain to your friend that bullying can have very serious consequences: for the bully, for the person (or people) being bullied, and even for bystanders like you and your friends. Meanness is like pollution — it can spread to bystanders who may get stressed out or upset about what's going on. Do what you can to build a bully-free environment!

Reviewed by: Michelle New, PhD

Teen Depression: A Guide for Parents

Teenage depression isn’t just bad moods and the occasional melancholy—it’s a serious problem that impacts every aspect of a teen’s life. Teen depression can lead to drug and alcohol abuse, self–loathing and self–mutilation, pregnancy, violence, and even suicide. But as a concerned parent, teacher, or friend, there are many ways you can help. Talking about the problem and offering support can go a long way toward getting your teenager back on track.

Teenage depression isn’t just bad moods and the occasional melancholy—it’s a serious problem that impacts every aspect of a teen’s life. Teen depression can lead to drug and alcohol abuse, self–loathing and self–mutilation, pregnancy, violence, and even suicide. But as a concerned parent, teacher, or friend, there are many ways you can help. Talking about the problem and offering support can go a long way toward getting your teenager back on track.

Understanding teen depression

For Teens

If you’re a teenager struggling with depression or you’d like to learn how to help a depressed friend, see Teen Depression: A Guide for Teenagers.

There are as many misconceptions about teen depression as there are about teenagers in general. Yes, the teen years are tough, but most teens balance the requisite angst with good friendships, success in school or outside activities, and the development of a strong sense of self.

Occasional bad moods or acting out is to be expected, but depression is something different. Depression can destroy the very essence of a teenager’s personality, causing an overwhelming sense of sadness, despair, or anger.

Whether the incidences of teen depression are actually increasing, or we’re just becoming more aware of them, the fact remains that depression strikes teenagers far more often than most people think. And although depression is highly treatable, experts say only one in five depressed teens receive help. Unlike adults, who have the ability to seek assistance on their own, teenagers usually must rely on parents, teachers, or other caregivers to recognize their suffering and get them the treatment they need. So if you have an adolescent in your life, it’s important to learn what teen depression looks like and what to do if you spot the warning signs.

Signs and symptoms of teen depression

Teenagers face a host of pressures, from the changes of puberty to questions about who they are and where they fit in. The natural transition from child to adult can also bring parental conflict as teens start to assert their independence. With all this drama, it isn’t always easy to differentiate between depression and normal teenage moodiness. Making things even more complicated, teens with depression do not necessarily appear sad, nor do they always withdraw from others. For some depressed teens, symptoms of irritability, aggression, and rage are more prominent.

Signs and symptoms of depression in teens

Sadness or hopelessness Irritability, anger, or hostility Tearfulness or frequent crying Withdrawal from friends and family Loss of interest in activities Changes in eating and sleeping habits

Restlessness and agitation Feelings of worthlessness and guilt Lack of enthusiasm and motivation Fatigue or lack of energy Difficulty concentrating Thoughts of death or suicide

If you’re unsure if an adolescent in your life is depressed or just “being a teenager,” consider how long the symptoms have been present, how severe they are, and how different the teen is acting from his or her usual self. While some “growing pains” are to be expected as teenagers grapple with the challenges of growing up, dramatic, long-lasting changes in personality, mood, or behavior are red flags of a deeper problem.

The difference between teenage and adult depression

Depression in teens can look very different from depression in adults. The following symptoms of depression are more common in teenagers than in their adult counterparts:

• Irritable or angry mood – As noted above, irritability, rather than sadness, is often the predominant mood in depressed teens. A depressed teenager may be grumpy, hostile, easily frustrated, or prone to angry outbursts.
• Unexplained aches and pains – Depressed teens frequently complain about physical ailments such as headaches or stomachaches. If a thorough physical exam does not reveal a medical cause, these aches and pains may indicate depression.
• Extreme sensitivity to criticism – Depressed teens are plagued by feelings of worthlessness, making them extremely vulnerable to criticism, rejection, and failure. This is a particular problem for “over-achievers.”
• Withdrawing from some, but not all people – While adults tend to isolate themselves when depressed, teenagers usually keep up at least some friendships. However, teens with depression may socialize less than before, pull away from their parents, or start hanging out with a different crowd.

Effects of teen depression

The negative effects of teenage depression go far beyond a melancholy mood. Many rebellious and unhealthy behaviors or attitudes in teenagers are actually indications of depression. The following are some the ways in which teens “act out” or “act in” in an attempt to cope with their emotional pain:

• Problems at school. Depression can cause low energy and concentration difficulties. At school, this may lead to poor attendance, a drop in grades, or frustration with schoolwork in a formerly good student.
• Running away. Many depressed teens run away from home or talk about running away. Such attempts are usually a cry for help.
• Drug and alcohol abuse. Teens may use alcohol or drugs in an attempt to “self-medicate” their depression. Unfortunately, substance abuse only makes things worse.
• Low self-esteem. Depression can trigger and intensify feelings of ugliness, shame, failure, and unworthiness.
• Internet addiction. Teens may go online to escape their problems, but excessive computer use only increases their isolation, making them more depressed.
• Reckless behavior. Depressed teens may engage in dangerous or high-risk behaviors, such as reckless driving, out-of-control drinking, and unsafe sex.
• Violence. Some depressed teens—usually boys who are the victims of bullying—become violent. As in the case of the Columbine and Newtown school massacres, self-hatred and a wish to die can erupt into violence and homicidal rage.

Teen depression is also associated with a number of other mental health problems, including eating disorders and self-injury.

Suicide warning signs in teenagers

Teenagers and Suicide

If you suspect that a teenager you know is suicidal, take immediate action! For 24-hour suicide prevention and support in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK.

To find a suicide helpline outside the U.S., visitBefrienders Worldwide.

To learn more about suicide risk factors, warning signs, and what to do in a crisis, read Suicide Prevention.

Seriously depressed teens often think about, speak of, or make "attention-getting" attempts at suicide. But an alarming and increasing number of teenage suicide attempts are successful, so suicidal thoughts or behaviors should always be taken very seriously.

For the overwhelming majority of suicidal teens, depression or another psychological disorder plays a primary role. In depressed teens who also abuse alcohol or drugs, the risk of suicide is even greater. Because of the very real danger of suicide, teenagers who are depressed should be watched closely for any signs of suicidal thoughts or behavior.

Suicide warning signs in depressed teens

• Talking or joking about committing suicide
• Saying things like, “I’d be better off dead,” “I wish I could disappear forever,” or “There’s no way out.”
• Speaking positively about death or romanticizing dying (“If I died, people might love me more”)
• Writing stories and poems about death, dying, or suicide
• Engaging in reckless behavior or having a lot of accidents resulting in injury
• Giving away prized possessions
• Saying goodbye to friends and family as if for the last time
• Seeking out weapons, pills, or other ways to kill themselves

Encouraging a depressed teen to open up

Whether or not that problem turns out to be depression, it still needs to be addressed—the sooner the better. In a loving and non-judgmental way, share your concerns with your teenager. Let him or her know what specific signs of depression you’ve noticed and why they worry you. Then encourage your child to share what he or she is going through.If you suspect that a teenager in your life is suffering from depression, speak up right away. Even if you’re unsure that depression is the issue, the troublesome behaviors and emotions you’re seeing in your teenager are signs of a problem.

Your teen may be reluctant to open up; he or she may be ashamed, afraid of being misunderstood. Alternatively, depressed teens may simply have a hard time expressing what they’re feeling.

If your teen claims nothing is wrong but has no explanation for what is causing the depressed behavior, you should trust your instincts. Remember that denial is a strong emotion. Furthermore, teenagers may not believe that what they’re experiencing is the result of depression.

Tips for Talking to a Depressed Teen
Offer support	Let depressed teenagers know that you’re there for them, fully and unconditionally. Hold back from asking a lot of questions (teenagers don’t like to feel patronized or crowded), but make it clear that you’re ready and willing to provide whatever support they need.
Be gentle but persistent	Don’t give up if your adolescent shuts you out at first. Talking about depression can be very tough for teens. Be respectful of your child’s comfort level while still emphasizing your concern and willingness to listen.
Listen without lecturing	Resist any urge to criticize or pass judgment once your teenager begins to talk. The important thing is that your child is communicating. Avoid offering unsolicited advice or ultimatums as well.
Validate feelings	Don’t try to talk your teen out of his or her depression, even if his or her feelings or concerns appear silly or irrational to you. Simply acknowledge the pain and sadness he or she is feeling. If you don’t, he or she will feel like you don't take his or her emotions seriously.

Getting treatment for teen depression

Depression is very damaging when left untreated, so don’t wait and hope that the symptoms will go away. If you see depression’s warning signs, seek professional help.

Make an immediate appointment for your teen to see the family physician for a depression screening. Be prepared to give your doctor specific information about your teen’s depression symptoms, including how long they’ve been present, how much they’re affecting your child’s daily life, and any patterns you’ve noticed. The doctor should also be told about any close relatives who have ever been diagnosed with depression or other mental health disorders. As part of the depression screening, the doctor will give your teenager a complete physical exam and take blood samples to check for medical causes of your child’s symptoms.

Seek out a depression specialist

If there are no health problems that are causing your teenager’s depression, ask your doctor to refer you to a psychologist or psychiatrist who specializes in children and adolescents. Depression in teens can be tricky, particularly when it comes to treatment options such as medication. A mental health professional with advanced training and a strong background treating adolescents is the best bet for your teenager’s best care.

When choosing a specialist, always get your child’s input. Teenagers are dependent on parents for making many of their health decisions, so listen to what they’re telling you. No one therapist is a miracle worker, and no one treatment works for everyone. If your child feels uncomfortable or is just not ’connecting’ with the psychologist or psychiatrist, ask for a referral to another provider that may be better suited to your teenager.

Don’t rely on medication alone

Expect a discussion with the specialist you’ve chosen about treatment possibilities for your son or daughter. There are a number of treatment options for depression in teenagers, including one-on-one talk therapy, group or family therapy, and medication.

Talk therapy is often a good initial treatment for mild to moderate cases of depression. Over the course of therapy, your teen’s depression may resolve. If it doesn’t, medication may be warranted. However, antidepressants should only be used as part of a broader treatment plan.

Unfortunately, some parents feel pushed into choosing antidepressant medication over other treatments that may be cost-prohibitive or time-intensive. However, unless your child is considered to be high risk for suicide (in which case medication and/or constant observation may be necessary), you have time to carefully weigh your options before committing to any one treatment.

Supporting a teen through depression treatment

As the depressed teenager in your life goes through treatment, the most important thing you can do is to let him or her know that you’re there to listen and offer support. Now more than ever, your teenager needs to know that he or she is valued, accepted, and cared for.

• Be understanding. Living with a depressed teenager can be difficult and draining. At times, you may experience exhaustion, rejection, despair, aggravation, or any other number of negative emotions. During this trying time, it’s important to remember that your child is not being difficult on purpose. Your teen is suffering, so do your best to be patient and understanding.
• Encourage physical activity. Encourage your teenager to stay active. Exercise can go a long way toward relieving the symptoms of depression, so find ways to incorporate it into your teenager’s day. Something as simple as walking the dog or going on a bike ride can be beneficial.
• Encourage social activity. Isolation only makes depression worse, so encourage your teenager to see friends and praise efforts to socialize. Offer to take your teen out with friends or suggest social activities that might be of interest, such as sports, after-school clubs, or an art class.
• Stay involved in treatment. Make sure your teenager is following all treatment instructions and going to therapy. It’s especially important that your child takes any prescribed medication as instructed. Track changes in your teen’s condition, and call the doctor if depression symptoms seem to be getting worse.
• Learn about depression. Just like you would if your child had a disease you knew very little about, read up on depression so that you can be your own “expert.” The more you know, the better equipped you’ll be to help your depressed teen. Encourage your teenager to learn more about depression as well. Reading up on his or her condition can help a depressed teen realize that he or she is not alone, giving your child a better understanding of what he or she is going through.

The road to your depressed teenager’s recovery may be bumpy, so be patient. Rejoice in small victories and prepare for the occasional setback. Most importantly, don’t judge yourself or compare your family to others. As long as you’re doing your best to get your teen the necessary help, you’re doing your job.

Taking care of the whole family when one child is depressed

As a parent dealing with teen depression, you may find yourself focusing all your energy and attention on your depressed child. Meanwhile, you may be neglecting your own needs and the needs of other family members. While helping your depressed child should be a top priority, it’s important to keep your whole family strong and healthy during this difficult time.

• Take care of yourself – In order to help a depressed teen, you need to stay healthy and positive yourself, so don’t ignore your own needs. The stress of the situation can affect your own moods and emotions, so cultivate your well–being by eating right, getting enough sleep, and making time for things you enjoy.
• Reach out for support – Get the emotional support you need. Reach out to friends, join a support group, or see a therapist of your own. It’s okay to feel overwhelmed, frustrated, helpless, or angry. The important thing is to talk about how your teen’s depression is affecting you, rather than bottling up your emotions.
• Be open with the family – Don’t tiptoe around the issue of teen depression in an attempt to “protect” the other children. Kids know when something is wrong. When left in the dark, their imaginations will often jump to far worse conclusions. Be open about what is going on and invite your children to ask questions and share their feelings.
• Remember the siblings – Depression in one child can cause stress or anxiety in other family members, so make sure “healthy” children are not ignored. Siblings may need special individual attention or professional help of their own to handle their feelings about the situation.
• Avoid the blame game – It can be easy to blame yourself or another family member for your teen’s depression, but it only adds to an already stressful situation. Furthermore, depression is normally caused by a number of factors, so it’s unlikely—except in the case of abuse or neglect—that any loved one is “responsible.”