Helping Teens Survive Heartbreak

First love is a wonderful experience, but also a risky one. Most “first” relationships end at some point and with the ending often comes a crushing heartbreak. How can parents help their child through the feelings of tremendous pain, shock and grief that can accompany heartbreak?

Consider the following tips:

Use Emotional Coaching
Listening is one way of providing essential emotional support. Listen for feelings and name them back to the child without trying to cheer up the teenager. For example, “It really hurts.” or “It’s quite a loss.” Be careful not to use the word “but” when listening – as in “Yes it hurts but you’ll soon meet someone even better.”  This too-quick attempt to make the pain go away only tends to prolong the agony.

Share Your Own Experiences
If you’ve had the experience of heartbreak, go ahead and share a little of it. Don’t take front and center – it’s not about you right now. Nonetheless, sharing your feelings can be therapeutic. Your child will feel somewhat better knowing that you suffered a broken heart and lived to tell the tale. He or she can see that you survived and went on to love again (hopefully); this can help ease some of the desperation he or she might be feeling right now.

Refrain from Diminishing the “Ex”
Although the relationship seems to have ended, you never know for sure – the two may get back together at some future date – weeks, months or even years in the future. This is true even if you think it shouldn’t happen. Therefore, don’t say anything that may come back to haunt you. Also remember that your grieving youngster may still have strong positive feelings for the young man or lady. Your insults are not likely to be well-received. Instead of talking about the ex-girlfriend or boyfriend, just support your child through the feelings of pain and loss by listening sympathetically. You don’t have to share all the thoughts that you have!

Suggest “Rescue Remedy”
Grieving heals with a listening ear and time. However, many people find that the Bach Flower preparation called “Rescue Remedy” can also help calm feelings of desperation, hysteria, panic, loss, confusion and overwhelming pain. Rescue Remedy is available online and at health food stores and some pharmacies. It is harmless enough to be used safely by infants and pregnant women and does not interact with other medicines, foods or treatments. However, if you have special health needs or any concerns about it at all, do ask your doctor before suggesting it to your child. Rescue Remedy is available in liquid form as well as candy and chewing gum varieties.

Consider Professional Help
If you are noticing signs of depression, hopelessness, addictive behavior, or loss of interest in friends and school, then consider taking your child to a mental health professional. Teenagers do not always handle heartbreak well; in some cases, it is the trigger for a suicide attempt or an actual suicide. Keep the doors of communication open and if your child tells you that life isn’t worth living anymore, acknowledge the pain and say something like, “I know it can hurt so much that it doesn’t even seem like there’s a future after something like this. But there are professionals who can help people climb out of the dark hole and into the light again and I’d like you to talk with someone like that. There’s no need to try to get through this all on your own.”

Suicidal Feelings

A certain number of people kill themselves each year, most of whom were suffering from severe depression. Fortunately, 90% of people with depression are able to live full lives while managing their episodes of depressed mood. Only about 10% will end their lives (this number depends on where a person lives – countries vary in their availability of effective treatments and support for depression, so there is a wide international variability in suicide rates).  The pervasive sad mood that comes with depression, as well as the increased tendency among the depressed to obsess on negative thoughts, makes them susceptible to the hopelessness and irrationality characteristic of the suicidal person. People do not “choose” suicide; they fall victim to it as part of their illness.

What are the Implications for Parents?
The link between suicidality and depression should serve as alarm bells when helping our children deal with mental health issues. If we have a loved one who is suffering from depression, it is always prudent to watch out for signs of suicidality. A depressed child is at risk for succumbing to suicidal thoughts; it is up to parents to help prevent this. Vigilant parents can be familiar with the warning signs of suicidality and take action. Moreover, they can do everything possible to get their child the right kind of help. In addition, they can work hard to reduce the other stressors in the child’s life – like school work (negotiate accommodations with the school) and conflict in the home. In fact, when the parents work on their own marriage and parenting skills to increase peace in the home, this can help tremendously.

What are the Warning Signs?
According to the American Academy of Child and Adolescent Psychiatry these signs are:

  • Change in eating and sleeping habits
  • Withdrawal from friends, family, and regular activities
  • Violent behavior or running away
  • Substance abuse
  • Neglect of personal grooming
  • Personality change
  • Difficulty concentrating, persistent boredom
  • Drop in academic performance
  • Marked personality change
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • Loss of interest in previously enjoyable activities
  • Speaking positively about death or romanticizing dying (“If I died, people will appreciate me more.”)
  • Writing about death, dying, or suicide
  • Engaging in reckless or dangerous behavior; being injured frequently in accidents
  • Giving away or discard favorite possessions
  • Saying permanent sounding goodbyes to friends and family
  • Seeking out weapons, pills, or other lethal tools

A child or teen  who is planning to commit suicide may also:

  • Complain of being a bad person or feeling rotten inside
  • Give verbal hints with statements such as: “I won’t be a problem for you much longer.”, “Nothing matters.”, “It’s no use.”, and “I won’t see you again.”
  • Become suddenly cheerful after a period of depression
  • Have signs of psychosis (hallucinations or bizarre thoughts)

The risk of suicide is high among those who have attempted suicide before, know someone who has killed themselves, and are pessimistic about the chances of getting relief from chronic depression. Also, teens who have a family history of mental illness and suicide are more likely to attempt suicide as are teens who have clinical depression or who suffer from active addiction. Teens who’ve already made a suicide attempt have a higher chance of committing suicide successfully. Vulnerable teenagers who suffer a serious loss (like the breakup of a romantic relationship) may try to stop the pain with suicide. A history of physical or sexual abuse, incarceration, alienation from parents and refusal to access mental health services all increase suicidal risk. Males have a higher “success” rate for suicide than females, but females make many more suicide attempts than do males. Also take note if your depressed child suddenly seems unusally happy. Sometimes this switch in attitude happens because a child has decided to end his suffering and he is actually experiencing a state of relief. Remember that depressed mood is a serious and potentially life-threatening condition and should always be professionally treated.

The American Academy of Child and Adolescent Psychiatry recommends taking a child’s suicidal statements seriously. If a child or adolescent says, “I want to kill myself,” or “I’m going to commit suicide,” ask him what he means. Don’t be afraid of saying the word “suicide.” You won’t be giving the teen an idea that he hadn’t thought about. Instead, you’ll help him or her think things through. Ask about depression, anxiety and unhappiness. Don’t just tell the child no to talk that way.  Show interest and concern and get your child to a qualified mental health professional (such as a psychiatrist or clinical psychologist).

Suicidal Behavior in Teens
Teenagers are a vulnerable group. They experience tremendous pressure from all sides: from inside their changing bodies, from their parents, from their schools and from their peers. No one can be perfect in every area and so everyone is doing poorly in something. But teenagers can feel isolated with their failures and setbacks, lacking the perspective that older people have that “we’re all in this together.” Teenagers are intent on fitting in, looking good, being acceptable. If the only group they can fit into is a violent, drug-ridden street gang, then that’ll be the group they might very well join, especially if they have little support elsewhere or few sources of success and strength.

Because the pressure is so intense, many teens do not cope well. Their survival strategies depend to a large extent on their genetic make-up and the strategies they learn at home. Some teenagers have “hardy” genes that help them survive and thrive under stressful conditions. They can laugh their way through almost anything or simply tough it out. Others are genetically vulnerable to bouts of depression. However, the depressed teen is more at risk than depressed adults. Teens are very focused in the present. They have trouble imagining that in a few years life can improve tremendously. Their impulsivity can lead them to put an end to it all right now because they just can’t see any way out.

What You Can Do
Parents can also help buffer teens from stress by keeping the doors of communication open. Make it easy for your kids to talk to you. Keep criticism to a minimum; instead, give praise and positive feedback generously. Have fun with your teenager and try to make your home pleasant, comfortable and safe. Keep conflict down with your spouse. Avoid drama. Take care of yourself and create a healthy model of stress management strategies for your kids to learn from. Create a positive atmosphere. Have a dinner table several times a week and use it to have discussions on politics, human nature, interesting things in the news or whatever—keep talking with your kids. Make your values clear. Bring tradition and ritual into your home.  Accept all feelings without correction or disapproval. Ask for behavioral change gently and respectfully. Never yell at your teenager. Never insult, name call, use sarcasm or any other form of verbal abuse. Instead, be sensitive to your teen’s feelings at all times. Discipline when necessary but only after you’ve warned a child that discipline will occur and only with mild discipline—never affecting the teen’s social life (see Raise Your Kids without Raising Your Voice for safe and effective ways of guiding teenagers).

If your teen demonstrates any of the symptoms of depression or suicidality, talk to him or her about what you are observing and arrange an appointment with a mental health professional. You can call suicide helplines in your area to get information about how to help your child. You can take your child for a mental health assessment. If your child is uncooperative, seek mental health guidance yourself. Since a suicidal person feels isolated and hopeless, any steps that family members take to address the situation can be powerfully preventative. Remember, too, that many parents have walked this road before you. Access on-line and community support if your child has been threatening suicide.

Helping Your Child Cope with Traumatic Events

All parents want to protect their children from things that can unsettle or harm them. But sadly, there are many things in life that even the most conscientious of parents can’t control. Our children may witness or experience traumatic events despite our best efforts to shield them. When this happens, they may have difficulty bouncing back. Sleep disturbances, sadness, anger, fear, or other symptoms of trauma may plague a traumatized child long after the traumatic event has ended.

What is a Trauma?
Trauma is a psychological reaction to highly stressful events, particularly those that threaten life or safety. When an experience is considered traumatic, it means that the coping resources of the person witnessing or experiencing it are not enough to deal with the impact of the event, and some degree of psychological shock or breakdown occurs. Events that most people consider traumatic include vehicular accidents, crimes, natural disasters and physical or sexual abuse.  Although parents may think that trauma results only from catastrophic events like war or rape, it can actually occur as a result of more normal and common events. For instance, a child can be traumatized by being chased by a dog, by a harsh reprimand from a teacher, from a threatening bully, or from being laughed at while giving an oral report. What makes an event traumatic differs from person to person, as individual coping abilities must be taken into account. Personality factors, psychological profile and past history all play a role in producing a traumatic reaction. A trauma response often includes symptoms like reliving the event over and over again (obsessing about it; experiencing intrusive thoughts), panic attacks, nightmares, numbing and fog responses, avoiding people, places and things that trigger a memory of the event, depressed and/or angry mood and increased nervousness (startle response).

How can Parents Help Children Cope with Trauma?
Parental support is critical when a child is dealing with trauma. Unlike adults, younger children don’t yet have the ability to understand what they are going through. Not only is the original event traumatic, but their trauma symptoms too, can be traumatic. For instance, physical symptoms like tremors and nightmares, mental symptoms like obsessions and hallucinations, and emotional symptoms like fear and anxiety can be overwhelming for a child to be experiencing.

The first line of business is to help children manage their emotions. Encourage them to talk about their feelings. A traumatized child may talk about the same thing over and over again, and this is okay. The content of the sharing is less important than the process of getting things out. If a child finds difficulty in expressing what he is going through verbally, either because of age or because of the trauma, then consider non-verbal ways of venting emotions. Letting it all out can also be done using drawings and pictures, clay sculptures and toys, play-acting, and story-telling.

Second, give your child a rational explanation of the traumatic event, that is appropriate to his or her age. The more information the child has, the less he or she is likely to generalize the event to other situations. For instance, knowing that a car crashed because it skidded on the snow can help a child feel safe in cars with good snow tires and in cars driving on dry roads. Without this information, the child may conclude that all cars are dangerous at all times. (While this is in fact true, the healthy state of mind is one of sufficient denial that a person can comfortably drive and be driven at all times. Phobic and traumatized people, on the other hand, over-exaggerate the likelihood of a catastrophic event occuring again, such that they can’t live in a normal way.)

When a child is suffering rather mild symptoms, parents may find that self-help interventions are sufficient. For instance, learning how to do EFT (emotional freedom technique) with the child may complete calm the youngster’s nervous system. However, parents may prefer to take their child to a child psychologist who practices EFT or EMDR. Both of these techniques are used to rapidly heal the trauma of one-time events. If the child is experiencing many symptoms of trauma, it is essential that parents DO NOT try the self-help approach. Instead, they should take their child to a mental health professional who is specifically trained in the treatment of post-traumatic-stress-disorder (PTSD). PTSD is the name for the cluster of symptoms that occur in reaction to a traumatic event. The “p” in this label for “post traumatic” points to the fact that trauma symptoms can suddenly occur months, years or even decades after the original traumatic event(s). The mind/body seems to wait for the “right time” to release the memory of the event(s).

Technqiues like EFT and EMDR can also be used as part of a longer therapy addressing more chronic forms of trauma (such as being subjected to chronic bullying, physical abuse or incest). These and other interventions are specifically designed to heal both the memories and the bodily reactions and return the child to his normal state. In addition, the Bach Flower Remedy called “Rescue Remedy” can help reduce temporary and chronic symptoms of trauma and is especially effective for home-management of symptoms inbetween psychotherapy sessions.

The good news is that children respond well to treatment of trauma. They can experience a complete healing of their symptoms and a return to “normalcy.” In fact, children are often even happier, calmer and more mature after trauma therapy than they were before the traumatic event(s) occurred.

Refuses to Go to a Mental Health Professional

In an ideal world, consulting a mental health professional would be as easy as consulting a medical doctor – and as stigma-free. Unfortunately, many people still feel an element of shame, embarrassment or other type of awkwardness about going to a psychological professional. Some people still think that mental health professionals only deal with people who are “crazy” and understandably don’t want to be an identified member of such a population. In fact, in the “olden days” mental illness was poorly understood and derogatory terms such as “crazy” were used to describe people who we know know were suffering from various biological disorders such as schizophrenia, manic-depressive disorder or delusional disorders. Psychiatrists and clinical psychologists can now help mentally ill people feel and function better than ever before. Moreover, modern mental health professionals assist not only those who are suffering from true mental illness, but also those who are completely mentally healthy. They help almost everyone to function in less stressful, more productive and happier ways, helping  them achieve their full potential in every area. People who access mental health services in order to feel and achieve their best, tend to be more emotionally sophisticated, open-minded and growth-oriented than those who do not. In other words, it is often the most mentally healthy people who consult mental health pofessionals today.

Although YOU may know all this, your child may not. In fact, your child may have the old misconception that going to a mental health professional means that there is something wrong with you. As a result, he or she may not want to see a mental health professional, even though you know that this is exactly what is needed.

If your child refuses to go to a mental health professional, consider the following tips:

Explain to your Child what Mental Health is and what Mental Health Professionals Do
As previously mentioned, there are many misconceptions that float around regarding the mental health profession — and even young children could have heard of them through playmates and peers. It’s important then that you explain carefully that mental health is just one aspect of our health. Emphasize that healthy people access mental health services in order to learn new skills, improve relationships, reduce stress and emotional discomfort, feel better physically, and achieve more in school or life. Be specific too – talk about the various tasks that mental health professionals perform such as psycho-educational assessments, mental health assessments, family counseling (to reduce conflict or help cope with stress), remove and/or manage fear, anger or sadness, and much more.

Your child may not recognize or agree that he or she has an issue that requires intervention. As a parent, you are in charge of your child’s well-being. If your child had an infection, you would insist on medical attention. Similarly, if your child needs help for an emotional problem, it is up to you to arrange it. If the child in question is a teenager, you might have to deal with resistance – be prepared. First try to motivate the youngster with reason – explain the possible benefits of assessment and treatment. If the child still refuses to cooperate, let him or her know that, privileges will be removed. For example, “No you don’t have to go to see Dr. Haber, but if you decide not to come, you will  not have the use of my car until you change your mind.” Think of whatever consequences might help motivate your adolescent to cooperate.

Tell children what to expect at their first session. If there will be art or music or toys, let your child know that the session should be very enjoyable, even while the therapist is learning about the child’s issues and learning how to be help. If it will be a talking therapy, tell the child how the therapist might open the conversation, what sort of questions might be asked and how the child might approach the conversation. Tell the child how to handle tricky situations like not wanting to talk or open up too much or feeling not understood or being fearful. In other words, prepare for everything!

Gently but Clearly Explain Why you are Referring Them to a Mental Health Practitioner
Tell your child why you have scheduled a mental health consultation. Explain that the consultation is meant to help the child and is not some sort of negative consequence! Kids who are caught breaking the law, or even family rules, are often scheduled for counseling in order to find out the reason for the misbehavior. Children who do not do well in school are referred to educational psychologists for assessment of learning disorders or other causes. Depressed or anxious teens may be sent to psychiatrists or psychologists for treatment. If you are having relationship difficulties with your youngster, make sure to participate in the counseling process in some way, either having joint sessions with the child or having individuals sessions just like the child is having, or both.

Negotiate Confidentiality Boundaries Beforehand
A tricky issue for children in therapy is confidentiality. It’s common for some kids to have hesitation talking to a mental health professional. For them, counselors are just their parents’ spies — a way parents can gather information about them. It’s important that parents (and maybe the mental health professional him or herself) clarify beforehand that all issues discussed within sessions are confidential, and that only the generic nature of issues discussed would be revealed to parents. Similarly, the mental health practitioner can specify what will remain confidential and what sorts of information cannot remain confidential, giving the child the opportunity to share or withhold information knowing the limits of confidentiality.

Tell your Kids that They can Terminate a Consultation Anytime
It’s important that kids actually enjoy their therapy experiences. Negative therapy experiences may affect them negatively throughout life as they refuse to get much needed help because of traumatic memories of therapy in childhood! Therefore, make sure that your child LIKES going to therapy or change the therapist, or the type of therapy, or even consider stopping therapy for the time being and trying again later. Usually, mental health professionals are good at establishing rapport with their clients and child and adolescent specialists are particularly skilled at making kids feel comfortable. Nonetheless, if your child remains uncomfortable after a couple of meetings, end the therapy. Adults also need to feel comfortable in therapy in order to benefit and they, too, have the right to “shop around” for a compatible therapist or therapy approach. Since there are so many different types of treatments and so many therapists, there; they will do their best to get your child feeling at ease before they start an actual intervention. But many factors can cause your child to be uncomfortable with a mental health professional. It’s helpful then that your child knows that you are at least willing to consider enlisting a different professional, or terminating sessions if there are significant concerns.

Helping Teens Who Hurt Themselves

Self-injurious behavior is any action that is intended hurt one’s own body. Teens engage in all sorts of self-injurious behavior, vialis 40mg including cutting their body, vcialis 40mg hitting themselves, dosage burning themselves, pulling out their hair, picking at their skin, poking at themselves and so on.

Why Do Kids Do It?
A teenager may use self-injury after a devastating or stressful event. The young person doesn’t always know how to deal with deeply troubling feelings in a healthy way.  Physical injury acts as a visible representation of emotional (internal and invisible) pain. It can also show others, without the use of words, that nurturing and solace is needed. Unfortunately, the act of self injuring only provides temporary relief, and once the physical wound heals the emotional pain returns full force.

More Reasons for Self Injury
Self-injury is often used to end the painful sensation of emotional apathy or numbness. It “wakes” a person up and allows some sort of feelings to flow again. Emotional numbing is an automatic defense process that occurs to people who have been badly emotionally wounded. For instance, many victims of physical, sexual or emotional abuse experience periods of numbing (sometimes alternating with periods of emotional flooding).

Moreover, the guilt and confusion that can occur from childhood abuse is often overwhelming. Sometimes adolescents “punish” themselves for being “bad” assuming that they must have deserved the abusive treatment they received. Self injury is then a form of self-abuse that is consistent with the youngster’s self-concept.

In addition, causing oneself pain can be a way of “taking control” of one’s situation. Sometimes a teenager feels very out of control, either due to abuse or due to other stresses. By initiating a physical injury, he or she has stopped being a helpless victim of circumstances. Instead of waiting for lightning to strike and burn them, these children strike the match themselves. In a superstitious sort of way, they might also think that the injury can prevent something worse from happening in their lives.

Teens also quickly discover that their behavior can control those around them. People react. Parents may stand up and take notice, seek therapy, feel guily. Friends may give extra attention or they may back off. The teen creates a tumult. It is a minor victory over helplessness.

Who Hurts Themselves?
Today, many kids hurt themselves. It is a social phenomenon. Once a teenager discovers a friend who engages in self-injury, she is more likely to try this form of communication herself. The most likely candidates for self injury include those whose expression of emotion (particularly anger) was discouraged during childhood, those who have a limited social support system, and those who have other mental health diagnoses such as OCD (obsessive compulsive disorder), eating disorders, substance abuse and depression.

What are the Most Common Ways that Teens Hurt Themselves?

  • Cutting – When one makes cuts or scratches on their body with sharp objects such as knives, needles, razor blades or fingernails. The most frequent parts of the body that are harmed are the arms, legs, and the front of the torso because they are easy to reach and can be concealed under clothing.
  • Branding – When one burns themselves with a hot object or, Friction burn which is rubbing a pencil eraser on one’s skin.
  • Picking at skin or reopening wounds (Dermatillomania) – This is an impulse control disorder which is recognized by the constant impulse for one to pick at their own skin. It is usually done to the point that injury is caused which acts as a source of gratification or stress reliever.
  • Hair Pulling (trichotillomania) – An impulsive control disorder which appears to be a habit, addiction, or an obsessive compulsive disorder. It involves pulling hair out from any part of the body. When hair is pulled from the scalp the results are patchy bald spots on their head. Usually they wear hats or scarves to cover up their baldness. Irregular levels of serotonin or dopamine play a possible role in hair pulling.
  • Bone breaking, punching, or head banging – Usually seen with autism or severe mental retardation.
  • Numerous piercings or tattoos – Can be a self injurious activity if it involves pain and/or stress relief.

Is Self-Injury a Suicide Attempt?
When a person causes injury upon themselves it is usually done without suicidal intentions, yet there have been cases where accidental deaths have happened. When a person self injures they do it as a means to reduce stress. People who self injure themselves usually possess a faulty sense of self value and these harsh feelings can whirlwind into a suicidal attempt. Often the intentions of self harm can go too far and it is at that point where professional intervention is necessary.

How to Help a Self Injurer:

  • Understand that self injurious behavior is a need to have control over oneself and it is a self comforting act
  • Show the person that you care about them and that you want to listen to them
  • Encourage them to express their emotions, especially anger
  • Spend quality time doing activities that are pleasurable
  • Help them seek out a therapist or support group
  • Avoid judgmental remarks

How Can Teens Help Themselves?

  • Realize that it is a problem and that there are probably issues that are hurting on the inside that need professional guidance
  • Realize that self harm is not about being a bad person, rather understanding that this behavior which is seemingly helping is becoming a significant issue
  • Seek out a mentor that can help. This could be a friend, Rabbi, minister, counselor, or relative or any other person you feel comfortable talking to about this issue
  • Seek help to understand what triggers these behaviors
  • Understand that self inuring behaviors are a way to self calm and learn better ways to calm yourself

Treatments for Self Injury
Psychotherapy is recommended for kids who hurt themselves. Sometimes medication will also be helpful. A psychological assessment by a qualified mental health practitioner can determine the most appropriate course of action in each case. Here are some of the common treatments for teens who self injure:

  • Cognitive-behavioral therapy. This helps a person understand why they hurt themselves in healthier ways.
  • Therapies that deal with post traumatic stress disorder such as EMDR (Eye Movement Desensitization and Reprocessing)
  • Hypnosis or self-relaxation
  • Group therapy which helps minimize shame, and helps express emotion in a healthy way
  • Family therapy which can trace back to history of family stress and helps families deal with their family member who self injures in a non judgmental way. It also teaches them how to communicate more effectively with each other and reduces parent-child conflicts and relationship difficulties.
  • Antidepressants or anti anxiety medications to reduce the impulsivity of the of the action while the self injurer is going for therapy
  • In critical situations, a self injurer needs to be hospitalized with various approaches along with a team of professionals

Do Teens Recover From Self-Injury?
Yes! With proper treatment, the prognosis is excellent. Self-injury can be the crisis that brings a family to therapy. This is often a turning point in the family’s life, helping not only the self-injuring teen, but also other members of the family to reach higher levels of emotional well-being than ever before.