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Podcast: Suicide Prevention & Mental Health in Teens

BIRMINGHAM – No one wants to talk about teen depression or suicide, but the fact is, not talking about it further stigmatizes the very real threat—which in turn keeps kids from reaching out for help.

Dr. Daniel Marullo, a Pediatric Psychologist with Behavioral Health at the Ireland Center at Children’s of Alabama, addresses how to deal with teen mental health. “I think most people don't realize that the top killers of our children are actually behavioral in nature,” states Dr. Marullo. “The top three include accidents, suicide, and homicide.”

Depression in Teens

Depression in children and teens doesn’t always appear on the surface what one would expect—isolated and sad like Eeyore from Winnie the Pooh. As a psychologist, Dr. Marullo and his colleagues go beyond outward appearance, always on the lookout for behavioral changes. Instead of sadness, increased anger may present. Changes in sleeping or eating, too much or too little, are also signs of depression.

Depression Is a Physical Disorder, Not a Cause for Shame

Many misconceptions surround depression, including it being a result of some sort of moral failing—either on a parent’s part or the child’s. “There’s this whole issue of mental health as being completely different than physical health,” explains Dr. Marullo. “But when you really think about it, it's like ‘Wow, you wouldn't blame somebody with cancer for having cancer. Why would you blame somebody who has depression?’”

Teen Suicide: Causes, Symptoms & Warning Signs

When things go wrong in a teen’s life, it can literally feel like the end of the world. They don’t think about the future or what changes may come. Impulsivity is also an issue. In a moment of pain, teens may act out—with no intent of hurting themselves or others—but they become overwhelmed and find themselves in a dire situation.

Changes in behavior, such as classic symptoms of depression, irritability, and anger should be noted. If your happy-go-lucky child is suddenly flying off the handle, it may be a sign of depression or another issue. Sleep disturbances, or changes in appetite, concentration, or relationships are all red flags. Physical symptoms include headaches, stomachaches, or fatigue.

“The main thing to watch for is any persistent change in behavior,” says Dr. Marullo. “Everyone is entitled to a bad day or a rough stretch, and it doesn't mean they're slipping into depression. But, any behavior that’s different, lasts for a while, and raises concern for a parent—I think it's okay to start asking questions.”

Dispelling the Stigma

Suicide is one of those issues where you need to shine a light on it to dispel the stigma. “If a child, a teenager, an adult is having suicidal thoughts, talking about it is not going to put more thoughts into their head. In fact, what you may be doing is making it possible for that person to start dealing with it and getting the help they need.”

Instilling Resilience

Raising children who grow to be happy, healthy adults starts in the womb with proper prenatal care and social support; making sure infants are nurtured, held, and cuddled. “To help our kids be resilient, they need to experience life,” says Dr. Marullo. “That also means they need to fall down and skin their knee. They need to learn how to fail. As parents, grandparents, aunts and uncles, we not only need to teach and model for children how to succeed, but also how to deal when life gets difficult.”

Children thrive with structure, routine, and consistent discipline. A positive role model who makes a child feel like she belongs and has worth is also important.

Treatment Options

In some cases, children may need psychiatric hospitalization so they can be in a safe environment and stabilized as they begin to get suicidal thoughts and depression under control. According to Dr. Marullo, a combination of psychotherapy and medication tends to be the most effective treatment approach. Medication helps improve symptoms, and psychotherapy teaches coping mechanisms.

Resources: Don’t Wait to Seek Help

For Teens
“If you're a teenager who is feeling suicidal, or you have a friend you're concerned about, it's okay to speak up,” assures Dr. Marullo. “Go to a trusted adult, such as a teacher, school counselor, or even your family doctor.”

For Parents
“One, don't freak out,” says Dr. Marullo. “It's okay to talk to your child about what's going on if you have any concerns. If you don't know what to do, there are resources such as suicide hotlines, your child’s pediatrician. If you're concerned your child is imminently thinking of hurting themselves, or even acting out aggressively against other people, call 911. Go to your local emergency department. The main thing is to speak out.”

The National Suicide Prevention Lifeline is 1-800-273-8255, or you can text TALK to 741741.

**To listen to an interview with Dr. Dan Marullo, a Pediatric Psychologist with Behavioral Health at the Ireland Center at Children’s of Alabama, follow this link: