[music playing] Speaker 1: Production of Being Well is made possible in part by Sarah Bush Lincoln Health System.

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Ke'an: WE TALKED ABOUT THIS IN PREPARATION FOR THIS PROGRAM, ABOUT PEOPLE ARE CONCERNED ABOUT TAKING SOME SORT OF MINDALTERING DRUG AND THINGS LIKE THAT.

I WANT YOU TO TALK ABOUT WHAT YOU TOLD ME ABOUT THAT.

>>Katie: REALLY QUICK BEFORE WE DO THAT, AS FAR AS PEOPLE COMING INTO MY OFFICE, MY GOAL IN TREATMENT IS TO HAVE PEOPLE ON AS FEW MEDICATIONS POSSIBLE AND ON THE LOWEST EFFECTIVE DOSE AS POSSIBLE.

A LOT OF TIMES PEOPLE THINK PSYCHIATRISTS AND PHYSICIANS IN GENERAL, JUST WANT TO THROW A LOT OF MEDICATION AT PEOPLE.

THAT'S CERTAINLY NOT THE CASE WITH ME.

I OFTEN TELL PARENTS THAT I LIKE TO KEEP PATIENTS ON A MEDICATION IF IT IS EFFECTIVE FOR SIX MONTHS.

SO SIX MONTHS OF BEING DEPRESSIONFREE ON THE MEDICINE, AND THEN TO TRY TO GO OFF IT.

IT TENDS TO WORK BETTER IF IT'S DURING A LOWERSTRESS TIME SUCH AS THE SUMMER THAN FINAL EXAM WEEK, BUT WE KNOW THAT CHILDREN AND ADOLESCENTS' BRAINS ARE CHANGING TO SO FAST.

THEY'RE LEARNING COPING SKILLS EVERY DAY.

I NEVER WANT SOMEONE TO BE ON A MEDICINE THAT DOESN'T NEED IT ANYMORE.

ONCE SOMEONE HAS HAD ONE EPISODE OF MAJOR DEPRESSION, THEY'RE LIKELY TO HAVE SUBSEQUENT EPISODES, BUT IT'S NOT 100%.

IF SOMEONE GOES OFF AFTER SIX MONTHS AND FEEL TERRIBLE AND WANT TO GO BACK ON, THAT'S FINE.

I'M NOT GOING TO FORCE PEOPLE EVERY SIX MONTHS TO GO OFF, BUT I WANT THEM TO KNOW THEY'RE STILL NEEDING IT AND AREN'T JUST BLINDLY TAKING A A MEDICATION.

AS FAR AS THE SSRIs THAT DR. STOLTZ TALKED ABOUT, PEOPLE ARE OFTEN VERY CONCERNED THAT PSYCHOTROPIC MEDICATIONS ARE GOING TO CHANGE PERSONALITY.

IF SOMEONE TAKES A PSYCHOTROPIC MEDICATION AND IT MAKES THEM FEEL LIKE A ZOMBIE, I GET THAT COMMENT A LOT OR CONCERN A LOT, THAT'S NOT AN EFFECTIVE MEDICATION OR DOSE.

I DON'T KNOW MANY PSYCHIATRISTS WHERE CREATING ZOMBIES IS THEIR GOAL IN PRACTICE.

THE ANTIDEPRESSANTS, THERE SOMETIMES IS A SIDE EFFECT OF EMOTIONAL BLUNTING OR FEELING BLAH.

I TELL PEOPLE THAT IF THEY START A MEDICINE AND IT MAKES THEM FEEL WORSE, INSTEAD OF BETTER, THAT IT'S NOT A GOOD MEDICINE.

SO, TO TALK TO ME.

BUT ALSO TO KNOW THAT IT CAN TAKE SEVERAL WEEKS FOR THESE MEDICINES TO KICK IN.

USUALLY BY THE TIME THEY GET TO ME THEY'RE STRUGGLING A LOT AND THEY WANT SOMETHING TO HELP THEIR PAIN QUICKLY.

AND WE DON'T HAVE THAT.

THE SSRIs BASICALLY ALLOW A SUBSTANCE, SEROTONIN, TO STAY BETWEEN TWO NERVE CELLS FOR A LITTLE BIT LONGER BEFORE THE CLEANUP CREW COMES AND TAKES AWAY THAT SEROTONIN.

SO IT'S NOT DOING A HUGE THING TO YOUR BRAIN.

IT'S JUST KIND OF ASSUMING THAT YOUR BRAIN IS SOMEWHAT SLUGGISH WHEN YOU'RE DEPRESSED AND YOU NEED THAT EXTRA TIME TO ALLOW YOUR BRAIN CELLS TO TAKE UP THE SUBSTANCE THEY NEED, AND THAT'S A SUBSTANCE THAT MAKES YOU FEEL HAPPY AND CALM.

>> Ke'An: I WANTED TO ASK, IS DEPRESSION CURABLE, OR IS IT TREATABLE?

>> David: I'LL LET YOU ANSWER THAT.

>> Katie: EXCELLENT.

DEPRESSION IS TYPICALLY A CHRONIC ILLNESS WITH ACUTE EXACERBATION.

SO SOMETHING THAT PEOPLE WILL STRUGGLE WITH THROUGHOUT THEIR LIVES.

THEY MIGHT GO FOR YEARS WITHOUT NEEDING MEDICATION, FEELING VERY WELL.

AND THEN, YOU KNOW, SOMEONE MAY DIE OR THEY MAY HAVE A BREAKUP, OR THERE MAY BE A TRANSITION IN LIFE, GOING TO COLLEGE FOR EXAMPLE, WHERE THEY STRUGGLE WITH ANOTHER BOUT OF DEPRESSION.

THERE ARE RARE INSTANCES WHERE SOMEONE WILL HAVE ONE EPISODE OF DEPRESSION, IT'S TREATED, AND THEY NEVER EXPERIENCE IT AGAIN.

BUT THAT'S CERTAINLY THE EXCEPTION.

>> Ke'An: OKAY.

ALL RIGHT.

WE WERE WORKING WITH SARAH BUSH LINCOLN TO PUT THIS PROGRAM TOGETHER IN PARTNERSHIP WITH THEM.

THERE WAS AN ARTICLE WITH A LOCAL PRINCIPAL AT MATTOON MIDDLE SCHOOL.

AND HE TALKED ABOUT SOCIAL MEDIA.

AND WE MENTIONED THIS EARLY ON IN THE PROGRAM, HOW SOCIAL MEDIA IS PLAYING A BIG PART IN TEENAGERS' LIVES, AS IT IS IN ANYBODY'S LIVES THESE DAYS.

BUT FOR THE IMMEDIATE GRATIFICATION, AND RELATIONSHIPS, AND THE FRIENDSHIPS, AND THE CONNECTION.

THERE'S ALSO THE OTHER SIDE ALONG WITH SOME OF THE SOCIAL MEDIA WHERE WE'RE SEEING SOME OF THE OUTLETS FOR SOME OF THE SUICIDES THAT ARE HAPPENING THESE DAYS, TOO.

SO LET'S TALK ABOUT SOCIAL MEDIA A LITTLE BIT.

>> Katie: I THINK ONE STATISTIC I SAW RECENTLY, 97% OF ADOLESCENTS AND TEENAGERS USE THE INTERNET, WHICH I GUESS I WAS KIND OF SURPRISED IT WASN'T A HUNDRED.

BUT ONLY 16 REGULARLY TALK TO THEIR PARENTS ABOUT WHAT THEY'RE DOING ON THE INTERNET.

SO IT'S FAIRLY SCARY.

I THINK YOU'RE WANTING TO GIVE YOUR CHILDREN MORE AUTONOMY, TRUST THAT THEY'RE LOOKING AT HEALTHY SITES AND INTERACTING WITH HEALTHY PEOPLE, BUT THAT'S NOT ALWAYS THE CASE.

AND WHAT WE'VE SEEN IS THAT THERE ARE A LOT OF GOOD ONLINE RESOURCES FOR MENTAL HEALTH.

SO DEPRESSION SUPPORT GROUPS, IF YOU LIVE IN AN AREA WHERE THERE AREN'T LOCAL ONES, SUPPORT GROUPS FOR PARENTS WHO HAVE KIDS WITH DEPRESSION WHERE PEOPLE CAN FEEL LIKE THEY'RE NOT ALONE.

AND I THINK THAT'S A VERY BIG POSITIVE.

SOCIALLY IT'S A POSITIVE.

I THINK A A LOT OF PEOPLE COMMUNICATE VIA FACEBOOK AND TEXT MESSAGING, SO IT'S A WAY FOR PEOPLE TO STAY IN TOUCH.

THE FLIP SIDE IS THAT, YOU KNOW, WHEN SOMEONE IS A CYBER BULLY, WHEN SOMEONE IS BULLYING SOMEONE VIA SOME SORT OF ELECTRONIC MEDIA, WHETHER IT'S A TEXT MESSAGE OR A SNAPCHAT, YOU CAN REACH A LOT OF PEOPLE WITH THAT BULLYING IMMEDIATELY, WHETHER IT'S PHOTOS OR COMMENTS.

AND IT CAN BE QUITE DEVASTATING FOR PEOPLE.

THEY FOUND THAT FEMALES ARE A LOT MORE LIKELY TO BE BULLIED, CYBERBULLIED AND ALSO BULLIED IN PERSON.

SO WHEN PEOPLE ARE GETTING BULLIED ONLINE, THEY ARE OFTEN ALSO BEING BULLIED IN THE SCHOOLS.

>> Ke'An: WHAT WOULD YOU LIKE TO SAY ABOUT SOCIAL MEDIA, DR. STOLTZ?

>> David: PARENTS NEED TO PARENT.

AT TIMES YOU MAY NEED TO PUT LIMITS ON IT.

WE MENTIONED EARLIER, THAT SLEEP DEPRIVATION HAS BEEN LINKED TO DEPRESSION.

IT MAY COME TO THE POINT AT 9:00 OR 10:00, YOUR TEENAGER DOES NOT HAVE ACCESS TO THE CELL PHONE.

AND SOME TEENS WOULD BECOME UPSET, HOW AM I SUPPOSED TO TEXT, IF SOMEONE TEXTS ME.

YOU'RE SUPPOSED TO BE SLEEPING THROUGH THE NIGHT.

I'VE HAD A HANDFUL OF TEENS THAT HAVE GOTTEN THEMSELVES OFF OF FACEBOOK BECAUSE OF THE BULLYING.

>> Ke'An: MMHMM.

>> David: THEY HAVE TURNED IT OFF THEMSELVES WITHOUT THEIR PARENTS' INPUT.

AND AGAIN, PARENTS HAVE TO KNOW WHAT THEIR KIDS ARE READING OR RECEIVING ON THE INTERNET.

>> Ke'an: I THINK IT'S EASY TO GET SO WRAPPED UP IN ALL THE DIFFERENT THINGS THAT PEOPLE ARE DOING AND POSTING, AND FEELING LIKE THEY HAVE THE PERFECT LIFE.

THEY HAVE THIS.

I DON'T HAVE THIS.

I'M FEELING BAD ABOUT MYSELF.

AND I SEE A LOT OF THAT.

AND IN PREPARATION FOR THIS PROGRAM, ONE OF THE PEOPLE I TALKED TO SAID, YOU KNOW, I HAD A DAUGHTER WHO WAS INSTAGRAMING ALL THE TIME.

SHE DIDN'T REALIZE THAT SHE WAS PAYING MORE ATTENTION TO WHAT EVERYBODY ELSE WAS DOING.

THEN WHEN SHE STEPPED AWAY FROM IT, SHE FELT BETTER ABOUT HERSELF.

NOT TO SAY THAT THERE'S ANYTHING WRONG WITH IT, BUT IF THERE'S THINGS THAT ARE BOTHERING YOU ABOUT IT, TAKE A BREAK AND, YOU KNOW, TRY TO FIGURE OUT HEY, MAYBE THAT'S NOT SO HEALTHY FOR ME.

>> David: AND ONE THING THAT OR A COUPLE OF THINGS THAT CAN ALSO HELP OUT WITH MENTAL HEALTH IS SUNSHINE, GETTING OUTSIDE.

AND IF YOU'RE LOCKED INTO A COMPUTER SCREEN OR A CELL PHONE ALL THE TIME, YOU'RE MISSING THAT.

AND THE OTHER THING IS EXERCISE.

AND IT DOES NOT HAVE TO BE AN ORGANIZED SPORT.

WE'RE TALKING OF PEOPLE WALKING, PLAYING, RIDING A BIKE, GOOFING OFF, JUST MOVING THEIR BODIES.

>> Ke'An: DO MEDICATIONS HAVE SIDE EFFECTS FOR TEENS?

>> Katie: YES.

THE MOST THEY HAVE SIDE EFFECTS.

THEY HAVE THE POTENTIAL FOR SIDE EFFECTS FOR ANYONE.

AND THE RISK PROFILE WITH ONE EXCEPTION THAT I'LL GET TO, IS PRETTY SIMILAR WHETHER IT'S A CHILD OR AN ADULT.

THE MOST COMMON SIDE EFFECT FOR THE SSRI MEDICATIONS, WHICH IS THE FIRSTLINE MEDICINE WE USE FOR DEPRESSION AND ANXIETY, THE MOST COMMON SIDE EFFECTS TEND TO BE GASTROINTESTINAL, SO, NAUSEA, DECREASED APPETITE AND SLEEP ISSUES.

SO, EITHER MAKING SOMEONE TIRED OR HAVING DIFFICULTY SLEEPING AT NIGHT.

WHAT YOU'LL SEE IN THE MEDIA A LOT IS THE CONCERN ABOUT ANTIDEPRESSANTS MAKING PEOPLE SUICIDAL.

THE FDA, IN 2004, CAME OUT WITH A BLACK BOX WARNING, THAT BASICALLY SAID, THAT PEOPLE UNDER THE AGE OF 18 WERE AT INCREASED RISK FOR SUICIDAL THOUGHTS OR ATTEMPTS ON THESE MEDICATIONS.

THEY HAD LOOKED AT 1000 PEOPLE, AND FOUND THE RISK FOR THE SUICIDALITY WAS 4% IN PEOPLE WITH THE MEDICATION AND 2% WITHOUT.

WHAT HAPPENED AFTER THAT WAS A NUMBER OF PRIMARY CARE PROVIDERS STOPPED PRESCRIBING THE MEDICATION, KIND OF COLD TURKEY IMMEDIATELY.

AND ALSO STOPPED DIAGNOSING DEPRESSION AT ALL.

AND SO YOU HAD PEOPLE WHO WERE DEPRESSED, WHO WEREN'T ON MEDICINES ANYMORE AND ALSO WEREN'T GIVEN ALTERNATIVES LIKE COUNSELING OR OTHER THINGS THAT MIGHT HELP WITH DEPRESSION MEDICINES THAT DON'T HAVE THE SAME BLACK BOX WARNING, FOR EXAMPLE.

AND SO THE END RESULT WAS THAT YOU HAD A NUMBER OF PEOPLE WHO WERE FEELING SUICIDAL AND NOT GETTING THE TREATMENT THEY NEEDED.

SO I THINK THE TAKE HOME REALLY IS THAT DEPRESSION KILLS A LOT MORE PEOPLE.

AND IN THIS STUDY, THE MEDICATION, THERE WERE NO COMPLETED SUICIDES.

THERE WAS NO ONE THAT KILLED THEMSELVES OR DIED BY SUICIDE IN THE STUDY.

BUT THERE WERE LOTS OF PEOPLE WITH DEPRESSION WHO KILL THEMSELVES, SO YOU HAVE TO WEIGH THE PROS AND CONS.

WHEN I HAVE A PATIENT COME IN I PROBABLY GET ONE OR TWO A YEAR WHO COME IN WHO SAY THEY FELT MORE SUICIDAL WITH THE MEDICINE.

WE STOP IT IMMEDIATELY.

WE TRY A DIFFERENT MEDICINE AND IT GOES AWAY.

AS LONG AS YOU'RE REALLY OPEN AND COMMUNICATING WITH PATIENTS, IT TENDS TO BE SOMETHING THAT'S RARE AND QUICKLY TREATED.

>>Ke'an: OKAY.

THANK YOU.

WE HAVE ANOTHER QUESTION FROM CHARLESTON.

WHAT QUESTION SHOULD PARENTS NOT ASK A TEEN WHO IS DEPRESSED?

SHOULD THERE BE QUESTIONS THAT YOU DON'T ASK, NEVER ASK?

DR. STOLTZ?

>> David: I WOULD SAY DON'T ASK QUESTIONS WHERE YOU TRY TO BLAME THE TEEN.

WHY ARE YOU DOING THIS?

DON'T YOU KNOW THAT IT'S EMBARRASSING?

YOU SHOULD OR A COMMAND, YOU SHOULD BE ABLE TO GET OVER THIS BY YOURSELF.

BUT IF YOU'RE CONCERNED, YOU CAN ASK.

YOU ACT LIKE YOU'RE FEELING DOWN IN THE DUMPS, YOU'RE ACTING DEPRESSED, WE HAVE CONCERNS ABOUT YOU.

SO I THINK YOU'RE BETTER OFF TO ASK QUESTIONS, EVEN THOUGH IT MAY BE UNCOMFORTABLE FOR YOUR TEEN, AND FIND OUT IF THERE'S REALLY A PROBLEM.

>> Ke'An: SO STAY AWAY FROM THE SHAME OR OR THE GUILT.

>> Katie: I HEAR THIS A LOT.

PEOPLE ARE VERY CONCERNED ABOUT SAYING THE RIGHT THING.

IN THE END ONE OF THE GREATEST PROTECTIVE FACTORS FOR PEOPLE WHEN IT COMES TO DEPRESSION OR SUICIDE IS HAVING AN ADULT THAT CARES, WHETHER THAT'S IDEALLY A FAMILY MEMBER, BUT IN HOMES WHERE THAT'S NOT POSSIBLE, A TEACHER, A COACH, A NEIGHBOR, A LEADER IN THEIR RELIGIOUS COMMUNITY, SOMEONE THAT CARES ABOUT THEM AND EXPRESSES CONCERN.

SO YOU CAN EVEN SAY, GOSH, I DON'T EVEN KNOW REALLY.

I DON'T KNOW WHAT TO ASK.

I'M NOT SURE, YOU KNOW, HOW TO SUPPORT YOU.

BUT I WANT TO SUPPORT YOU, YOU KNOW, WHAT CAN I DO, WHAT DO YOU NEED.

IF THEY DON'T KNOW WHAT THEY NEED, BRAINSTORMING.

MAYBE WE SHOULD GO TO SOMEONE ELSE, A COUNSELOR OR A DOCTOR AND SEE IF THEY CAN HELP US COME UP WITH WHAT WE NEED.

I THINK THE IMPORTANT THING IS TO EXPRESS CONCERN LESS THAN WORRYING ABOUT SAYING THE RIGHT THING.

>> Ke'An: OKAY.

YEAH.

THAT WAS GOING TO BE MY NEXT QUESTION, WHAT SHOULD I DO IF I SUSPECT MY TEEN IS SUICIDAL, TRYING TO TALK AND GET PAST THAT BOUNDARY OF LET'S TALK ABOUT THIS.

WALK ME THROUGH WHAT A PARENT SHOULD DO AFTER OPENING THAT CONVERSATION UP.

THEN WHAT STEPS DO THEY TAKE?

>> Katie: SO A PATIENT OR A CHILD COMES TO THEIR PARENT AND SAYS THAT THEY'RE FEELING SUICIDAL OR THEY ASK AND SAY YES.

IT'S IMPORTANT TO DETERMINE IMMEDIACY.

SO FINDING OUT, YOU KNOW, HOW LONG HAVE YOU BEEN THINKING ABOUT THIS?

ARE YOU PLANNING IT, HAVE YOU COME UP WITH WAYS TO ACT THIS OUT, DO YOU FEEL LIKE YOU'RE ABLE TO STAY SAFE?

IF ANY OF THOSE ANSWERS ARE CONCERNING, TAKE THEM TO A LOCAL EMERGENCY ROOM IMMEDIATELY OR CALL THE HOTLINE.

REMAINING CALM, MAKING SURE THAT YOU'RE STAYING WITH THE CHILD, ACKNOWLEDGING THE STRUGGLE THEY'RE HAVING, GIVING THEM SUPPORT WITHOUT TELLING THEM THEY'LL GET OVER IT OR TRYING TO SOLVE THE ISSUE IN THE IMMEDIACY.

YOU'RE JUST NEEDING TO KEEP THEM SAFE AND ACKNOWLEDGING THAT THEY'RE REALLY STRUGGLING AND THAT YOU WANT THEM TO GET THROUGH IT AND BE ALIVE.

>> Ke'An: OKAY.

WOULD YOU LIKE TO REPLY TO THAT QUESTION?

>> David: I WOULD AGREE WITH EVERYTHING SHE SAID.

>> Ke'An: OKAY.

>> David: I THINK THE BIG THING IS DO NOT BLAME THE INDIVIDUAL.

AND IF YOU ARE REALLY, REALLY CONCERNED, TAKE THEM TO THE EMERGENCY ROOM.

>> Ke'An: IMMEDIATE ACTION.

>> David: IMMEDIATE.

>> Ke'An: OKAY.

WE HAVE ANOTHER QUESTION FROM MAHOMET.

ARE KIDS WHO ARE BULLIED MENTALLY HEALTHY?

>> David: IT DEPENDS ON THE CHILD.

IF YOU HAVE A CHILD THAT HAS A PREDILECTION FOR ANXIETY OR DEPRESSION, IT WILL MOST LIKELY WORSEN THEIR MENTAL HEALTH.

AND WE MENTIONED SOME OF THE KIDS WHO ARE RESILIENT.

I KNOW THAT I HAVE HAD PATIENTS THAT IF THEY WERE BULLIED, THEY WOULD STAND UP, DEFEND THEMSELVES, AND COUNTER ATTACK MAYBE AT TIMES TOO AGGRESSIVELY.

BUT, WHEN YOU HAVE PEOPLE THAT DO HAVE DEPRESSION, IT OFTEN MAKES THINGS WORSE.

>> Ke'An: MMHMM.

>> Katie: WHEN WE TALK ABOUT RISK FACTORS FOR DEPRESSION OR SUICIDE, BASICALLY YOU'RE LOOKING AT PEOPLE WITH THOSE THINGS GOING ON, AND STATING WHAT'S MORE COMMON IN THEM THAN PEOPLE WHO DON'T HAVE DEPRESSION OR SUICIDAL THOUGHTS.

AND BULLYING DEFINITELY INCREASES THE RISK FOR DEVELOPING DEPRESSION OR HAVING SUICIDAL THOUGHTS.

BUT IT ISN'T EXCLUSIVE.

A LOT DEPENDS ON THE SUPPORT THAT THAT PERSON HAS AS WELL AS THE ABILITY TO STAND UP HAVING OTHER SOCIAL SUPPORTS THAT WILL HELP THEM TO FEEL GOOD ABOUT THEMSELVES.

>> Ke'An: OKAY.

NOW WE'VE TALKED A LOT THIS EVENING ABOUT WHAT CAN PARENTS DO.

WE'VE MENTIONED TEACHERS, COUNSELORS, COACHES.

WHAT IF YOU'RE A FRIEND?

WHAT SHOULD ANOTHER TEENAGE CHILD DO IF THEY HAVE A FRIEND WHO IS TALKING TO THEM ABOUT DIFFERENT THINGS THAT THEY'RE LEAPING LEANING TOWARDS SUICIDE.

IF THERE ARE TEENAGERS WATCHING TONIGHT, WHAT CAN THEY DO TO HELP?

>> Katie: THERE ARE A LOT OF SCHOOL PROGRAMS THAT ARE OUT THERE THAT HAVE SHOWN GOOD SUCCESS RATES AS FAR AS DECREASING SUICIDE.

AND THE MAIN COMPONENTS TO THEM ARE TYPICALLY HELPING PEOPLE TO RECOGNIZE THAT THEY HAVE DEPRESSION IN THEMSELVES AND TEACHING TEENS OR ADOLESCENTS HOW TO INTERACT WITH FRIENDS WHO MIGHT BE EXPERIENCING THAT.

FOR PEOPLE THAT DON'T HAVE THAT IN THEIR SCHOOLS, I THINK THE IMPORTANT THING IS TO MAKE SURE THAT THE PERSON'S SAFE, IF THE PERSON IS TALKING ABOUT, YOU KNOW, WANTING TO END THEIR LIFE, HAVING WAYS THAT THEY'RE GOING TO DO IT, COMING UP WITH A DATE, THINGS LIKE THAT.

YOU NEED TO NOT LEAVE THEM ALONE AND GET AN ADULT INVOLVED.

DON'T BE THE HERO, YOU KNOW.

THIS IS LIFE OR DEATH AND I WOULD MUCH RATHER HAVE YOU GET THEM ADULT HELP OR HELP VIA AN EMERGENCY ROOM THAN TO FIND OUT THEY DIED BECAUSE YOU WERE TRYING TO KEEP THEIR SECRET SAFE.

>> Ke'An: OKAY.

DR. STOLTZ?

>> David: AND I WOULD JUST HAVE TO EXPOUND ON THAT A LITTLE BIT.

THE TEEN WHO'S TRYING TO BE A HELPER SHOULD NOT TAKE ALL OF THE BURDEN UPON THEMSELVES.

YOU'RE JUST HOW SHOULD I SAY THIS, YOU'RE A TEENAGER.

THAT SHOULD NOT BE YOUR WHOLE RESPONSIBILITY IN CARING FOR YOUR FRIEND.

SO AGAIN, CONTACT A PRINCIPAL, GUIDANCE COUNSELOR, THE OTHER CHILD'S PARENTS.

LET SOMEONE KNOW WHAT'S GOING ON.

>> Ke'an: SO, WHAT CAN YOU TELL VIEWERS WHO ARE WATCHING TONIGHT WHO MAY HAVE HAD SOMEBODY COMMIT SUICIDE THAT WAS CLOSE AND DEAR TO THEM, AND THEY DIDN'T RECOGNIZE THE SIGNS OR SYMPTOMS?

WHAT CAN YOU TELL THEM TO HELP THEM?

>> David: ONE THING, JUST SAY THAT YOU'RE SORRY AND IT'S NOT THEIR FAULT.

IT'S A PERSONAL LOSS.

AND THEY ARE GOING TO GRIEVE.

AND AGAIN, YOU NEED TO MAKE SURE THAT THERE'S NO BLAME.

>> Ke'An: OKAY.

>> Katie: I THINK FOR PEOPLE WHO HAVE LOST SOMEONE THROUGH SUICIDE, THERE'S A BIG ISOLATION THAT OCCURS.

PEOPLE DON'T KNOW WHAT TO SAY.

THEY TEND TO KIND OF TRY TO NOT TRY TO, BUT UNINTENTIONALLY ALIENATE THOSE PEOPLE.

THERE IS DEFINITELY STIGMA AGAINST SUICIDE.

YOU SEE VERY FEW OBITUARIES THAT MENTION SUICIDE IN THEM.

I THINK JUST, YOU KNOW, BEING SUPPORTIVE TO THAT FAMILY, ASKING IF THEY NEED ANYTHING.

FOR PARENTS OR FOR INDIVIDUALS THAT ARE FEELING GUILTY THAT SOMEONE KILLED THEMSELF AND FEELING LIKE THEY SHOULD'VE SEEN THE SYMPTOMS OR SHOULD'VE INTERVENED, A LOT OF THESE RISK FACTORS AND WARNING SIGNS AREN'T TAUGHT.

SO IF YOU DON'T KNOW THEM, YOU'RE NOT NECESSARILY GOING TO RECOGNIZE IT.

SOMETIMES I THINK THE PEOPLE CLOSEST TO THE SITUATION ARE THE LEAST LIKELY TO RECOGNIZE IT BECAUSE IT'S SOMETHING THEY'RE DEALING WITH EVERY DAY.

IF IT'S MAYBE A SMALL CHANGE THAT'S OCCURRING OVER TIME, YOU KNOW, IN THE END WE ALL WANT TO HELP SOMEONE WHO'S SUICIDAL NOT EXPERIENCE THE PAIN THEY'RE FEELING.

THAT'S THE PRIMARY MOTIVATION FOR KILLING THEMSELVES IS WANTING TO BE OUT OF THE PAIN THEY'RE EXPERIENCING.

BUT IN THE END THEY'RE THE ONES THAT TAKE THAT FINAL STEP.

SO AS MUCH AS WE TRY, IN THE END SOMETIMES, YOU KNOW, WE CAN'T STOP EVERYONE.

SO TRYING TO HELP THE PEOPLE WE CAN, BUT ACKNOWLEDGING THAT, YOU KNOW, YOU CAN'T BE THERE 24/7 FOR SOMEONE.

>> Ke'An: LET'S GO OVER SOME OF THE WARNING SIGNS AND SYMPTOMS THAT COULD LEAD UP TO THIS.

IF PEOPLE ARE JUST TUNING IN, MISSED THE FIRST PART OF THE PROGRAM, LET'S TALK ABOUT SOME OF THE WARNING SIGNS OF DEPRESSION TO PAY ATTENTION TO, AND THEN ALSO LEADING INTO SUICIDE ATTEMPTS OR THINKING ABOUT SUICIDE WHEN IT COMES TO TEENAGERS.

LET'S TALK ABOUT THAT AGAIN TO REITERATE.

>> David: WHEN YOU GO THROUGH THE DIAGNOSTIC CRITERIA, AND I'M PARAPHRASING THIS, FEELING OF SADNESS, FEELING HOPELESS AND EMPTY, YOU'RE FEELING DEPRESSED AND DOWN.

THEN YOU HAVE THE UNDERLYING IRRITABILITY.

I THINK THIS IS FREQUENTLY SEEN IN TEENS WITH DEPRESSION, IRRITABLE, ANNOYED MOOD, FRUSTRATION OR FEELINGS OF ANGER.

THEN THERE'S A LOSS OF INTEREST IN THINGS.

YOU STOP HAVING FUN.

YOU STOP HAVING PLEASURE IN NORMAL ACTIVITIES.

YOU STOP HAVING PLEASURE IN SPORTS.

THEN YOU TAKE A BEATING ON SELFESTEEM.

A LITTLE SELFESTEEM, FEELING OF WORTHLESS NECESSARY.

YOU START TO FIXATE ON YOUR MISTAKES, BLOWING THEM OUT OF PROPORTION.

>>Katie: WHEN YOU'RE TALKING ABOUT RISK FACTORS, REGARDLESS OF WHETHER SOMEONE'S DEPRESSED OR NOT, RISK FACTORS FOR SUICIDE.

SO THESE ARE FACTORS THAT ARE MORE LIKELY TO BE PRESENT IN SOMEONE WHO HAS DIED BY SUICIDE THAN SOMEONE WHO HAS NOT.

MOST IMPORTANT ONE IS MENTAL ILLNESS AND SUBSTANCE ABUSE.

90% OF PEOPLE WHO KILL THEMSELVES VIA SUICIDE HAVE A HISTORY OF ONE OF THOSE.

HOME ENVIRONMENT, HAVING A LOT OF CONFLICT IN THE HOME, NOT FEELING LIKE THEY HAVE A LOT OF SUPPORT FROM PARENTS.

THE COMMUNITY.

SO PEOPLE WHO ARE EXPOSED TO A LOT OF COMMUNITY VIOLENCE DON'T NECESSARILY HAVE A LOT OF ADULT MENTORS, ROLE MODELING BEHAVIOR FOR THEM.

THAT CAN BE A RISK FACTOR.

IN THE SCHOOLS, PEOPLE WITH LEARNING DISORDERS WHO ARE STRUGGLING ACADEMICALLY AND MAY BE MORE LIKELY TO BE BULLIED, AS WELL AS THE STRAIGHT A STUDENT WHO'S A PERFECTIONIST WHO MAY NOT BE ABLE TO HANDLE A POOR GRADE WELL, FOR EXAMPLE.

GETTING BULLIED, FEELING LIKE TEACHERS AREN'T SUPPORTIVE OR THEY CAN'T TALK TO THEM.

THOSE CAN ALL PLAY A ROLE.

ONCE SOMEONE HAS HAD A SUICIDE ATTEMPT, THEY ARE ENORMOUSLY MORE LIKELY TO HAVE ANOTHER ATTEMPT, EIGHT TIMES MORE LIKELY IN THE YEAR FOLLOWING THAT SUICIDE ATTEMPT TO HAVE ANOTHER ONE.

AND THEY ARE ALSO SIGNIFICANTLY MORE LIKELY TO HAVE AN ATTEMPT WITHIN THE FIRST TWO WEEKS AFTER A PSYCHIATRIC HOSPITALIZATION.

IT'S IMPORTANT TO KNOW IF SOMEONE HAS ATTEMPTED SUICIDE, YOU'RE NOT NECESSARILY OUT OF THE WOODS.

YOU NEED TO KEEP THE DIALOGUE OPEN WITH THEM TO MAKE SURE THEY'RE GETTING THE SUPPORT THEY NEED.

>> Ke'An: OKAY.

SHOULD PARENTS PAY ATTENTION TO THEIR TEEN'S CIRCLE OF FRIENDS THAT THEY'RE AROUND?

>> David: DEFINITELY.

I'M A FATHER NOW WITH THREE GROWN KIDS.

MY WIFE WAS THE BETTER PARENT.

SHE KEPT TRACK OF OUR KIDS, THEIR CIRCLE OF FRIENDS, AND WHAT THEY WERE DOING.

THAT'S JUST PART OF BEING A GOOD PARENT.

YOU HAVE TO KNOW WHAT YOUR CHILD IS DOING, OR IF THEY'RE ENGAGING IN ANY RISKY BEHAVIORS.

>>Katie: I DO.

I THINK IT'S ALSO IMPORTANT TO NOTICE OR KNOW 40% OF PEOPLE WHO ATTEMPT SUICIDE HAVE AN IMMEDIATE STRESSOR SITUATIONALLY.

A LOT OF THAT HAPPENS WITH FRIENDS, A BREAKUP, A DEATH, A BULLYING SITUATION, SEXUAL ABUSE.

AND SO, YOU KNOW, HAVING AN OPEN DIALOGUE WITH KIDS ABOUT WHO THEIR FRIENDS ARE, WHAT THEY'RE DOING WITH THEM, MAKING SURE THEY KNOW THEY CAN COME TO THEM EVEN IF IT'S ABOUT SOMETHING THEY KNOW THEIR PARENTS DON'T SUPPORT CAN HELP.

>> Ke'An: WHAT ABOUT PARENTS WHO KNOW THAT ONE OF THEIR CHILD'S FRIENDS IS STRUGGLING WITH THESE TYPE OF ISSUES, THAT THEY'RE DEPRESSED, THEY'VE EITHER HAD SUICIDE ATTEMPTS OR SOMETHING LIKE THAT?

SHOULD THE PARENTS THINK, I REALLY DON'T WANT MY CHILD FRIENDS WITH THIS OTHER TEENAGER?

I THINK THAT WOULD BE SOMETHING LIKE I HOPE MY TEENAGER DOESN'T START THINKING LIKE THIS, EITHER.

WHAT WOULD YOU TELL PARENTS IN A SITUATION LIKE THAT?

THE ONE STRUGGLING DOESN'T NEED TO BE ALONE, EITHER.

>> Katie: THERE'S A LOT OF CONCERN ABOUT SUICIDE BEING CONTAGIOUS.

THERE ARE SMALL POCKETS WHERE YOU SEE A NUMBER OF YOUNG ADULTS THAT COMMIT SUICIDE IN A SMALL GEOGRAPHIC AREA IN A SHORT AMOUNT OF TIME.

THAT'S TYPICALLY AROUND 2% OF SUICIDES.

IT'S NOT VERY COMMON, BUT IT DEFINITELY IS PREVENTABLE.

THAT'S NOT YOUR TYPICAL EXPERIENCE.

IF A FRIEND IS DEPRESSED OR SUICIDAL, I THINK AS LONG AS YOUR CHILD IS SETTING HEALTHY BOUNDARIES WHERE THEY'RE NOT THE ONLY PERSON THAT THIS INDIVIDUAL IS TALKING TO, OR THEY DON'T FEEL LIKE THEY'RE TAKING ON ALL OF THEIR PROBLEMS WITHOUT ANY SUPPORT FROM ADULTS OR OTHER MENTAL HEALTH PROVIDERS, I THINK IT'S GOOD TO BE A SUPPORTIVE FRIEND, JUST WITH LIMITATIONS.

>> Ke'An: OKAY.

DO YOU HAVE ANYTHING TO ADD?

>> David: NO.

IT JUST REALLY DEPENDS WHAT THE OTHER CHILD IS GOING THROUGH AND THE TYPE OF BEHAVIOR THEY'RE BEING INVOLVED IN.

IF THEY'RE HEAVILY INVOLVED IN DRUG ABUSE, SEXUAL PROMISCUITY, FAST, LEAD-FOOTED DRIVING, YOU MAY NOT WANT YOUR CHILD AROUND THAT BECAUSE OF THE RISK TO YOUR OPEN OWN CHILD.

BUT AS FAR AS THEY CAN BE, THEY CAN BE SUPPORTIVE TO A CERTAIN EXTENT.

>> Ke'An: SO THERE IS HELP OUT THERE, YOU JUST NEED TO TALK ABOUT IT.

YOU NEED TO SEEK IT OUT.

DON'T KEEP IT A SECRET.

THE MOST IMPORTANT THING TO REMEMBER, I THINK FROM WHAT WE'VE TALKED ABOUT TONIGHT IS THAT SUICIDE IS PREVENTABLE AND PEOPLE JUST NEED TO ACT ON IT.

SO WOULD YOU LIKE TO HAVE ANY LAST MINUTE COMMENTS ON WHAT WE'VE TALKED ABOUT TONIGHT?

HAVE WE MISSED ANYTHING THAT WE NEED TO GET OUT TO OUR VIEWERS?

>> David: I THINK FOR PARENTS, DON'T BE AFRAID TO SET LIMITS.

MAKE SURE THAT YOUR CHILD IS GETTING ENOUGH SLEEP.

MAKE SURE THAT THEY ARE HAVING SOME DOWNTIME AND THEY ARE NOT IN TOO MANY CLUBS OR TOO MANY ACTIVITIES.

MAKE SURE THAT YOU KEEP LINES OF COMMUNICATION OPEN.

>> Katie: YOU KNOW, DEPRESSION IS A LOT MORE COMMON THAN ANYONE ACKNOWLEDGES.

IT'S A HEALTH ISSUE JUST LIKE ASTHMA AND HEADACHES AND DIABETES.

I THINK IT'S IMPORTANT TO GET THROUGH THE STIGMA OF IT AND TO RECOGNIZE THAT IT'S SOMETHING THAT IS VERY TREATABLE, THAT SUICIDAL IDEATION, YOUR JOB IS NOT TO FIGURE OUT WHETHER THE PERSON MEANS IT OR NOT.

YOUR JOB IS TO HELP THEM TO GET HELP.

THERE IS A LOT OF HELP OUT THERE.

I ENCOURAGE FAMILIES WHO ARE CONCERNED TO CONTACT LOCAL MENTAL HEALTH CENTERS TO GET ADDITIONAL RESOURCES, FOR ANYONE TO CALL THE HOTLINE IF THEY'RE FEELING CONCERNED THAT SOMEONE MIGHT NOT BE SAFE.

MENTAL HEALTH ISSUES ARE DEFINITELY TREATABLE.

THERE ARE LOTS OF PEOPLE, PHYSICIANS, AS DR. STOLTZ MENTIONED, LAWYERS, CHILDREN, ADULTS WHO LEAD VERY HAPPY AND FULFILLING LIVES DESPITE HAVING DEPRESSION.

>> Ke'An: OKAY.

WELL, THANK YOU BOTH FOR BEING ON THE PROGRAM THIS EVENING.

WE'VE HAD DR. KATIE HECKSEL WITH SARAH BUSH LINCOLN, SHE'S A CHILD PSYCHIATRIST, AS WELL AS DR. DAVID STOLTZ, A PEDIATRICIAN WITH SARAH BUSH LINCOLN AS WELL.

Speaker 1: Production of Being Well is made possible in part by HSHS St. Anthony's Memorial Hospital, delivering compassionate care close to home, from advanced surgical techniques and testing to convenient care for your family.

We promise to make a healthy difference each and every day.

St. Anthony's.

Together we are better.

Sarah Bush Lincoln Health System.

Supporting healthy lifestyles, eating a heart healthy diet, staying active, managing stress, and regular checkups are ways of reducing your health risks.

Proper health is important to all at Sarah Bush Lincoln Health System.

Information available at sarahbush.org.

(singing) Our patient care and investments in medical technology show our ongoing commitment to the communities of East Central Illinois.

Paris Community Hospital Family Medical Center.

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