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Tips for parents

Suicide Prevention: What to Know

by Stacey Gagliano, PhD September 9, 2024

Part 1: Children/Adolescents

Suicidal ideation is a serious concern that affects individuals across all ages and backgrounds. Suicide is the 11th leading cause of death in the United States. In 2021, suicides nearly doubled the number of homicides in the U.S. and in 2022, it was the second leading cause of death for those aged 10-14 and 25-34, and the third for those aged 15-24. Unfortunately, suicide rates have seen a troubling increase over recent years. From 2000 to 2018, the rate of suicides in the U.S. rose by 37%. 

Understanding who is at risk and recognizing the warning signs can be crucial in preventing tragedy and providing timely help. In this two-part blog, we’ll explore key factors that contribute to an increased risk for suicidal ideation, important warning signs to be aware of, as well as what you can do if someone you know is struggling with these thoughts and feelings.

Who is at Risk? – Youth

  • Identity questions: Struggles with sexual or gender identity can lead to increased risk.
  • Victims of bullying.
  • Access to lethal means: Availability of firearms or other means can heighten risk. Firearms were involved in over 50% of all suicide deaths in 2022.
  • History of self-harm or previous attempts.
  • Mental health diagnoses such as anxiety and depression, and/or struggles with chronic medical conditions.
  • Recent loss: Youth experiencing significant losses are at higher risk.
  • Witness to violence or family history of suicide.
  • Lack of social support: can increase feelings of isolation.
  • Lack of access to mental health resources or services.
  • Stigma: Cultural or societal stigma around seeking help can prevent individuals from reaching out.

Recognizing the Warning Signs

  • Verbal threats of death, seeking access to weapons, and/or talk of death/dying
  • Hopelessness and rage: Feelings of despair, rage, or seeking revenge
  • Changes: Neglecting personal appearance, changes in appetite, and/or withdrawing from friends/family
  • Engaging in reckless behavior
  • Feeling trapped: A sense of being trapped with no way out
  • Making arrangements: Preparing for end-of-life matters, like updating a will or saying goodbye
  • Increased substance use
  • Mood swings: Dramatic changes in mood or personality
  • Loss of purpose: Feeling that life has no meaning or purpose

What Can I Do to Help?

If you are the parent/guardian of a child who struggles with or is at risk for suicidal ideation,

  • Take steps to reduce access to lethal means in your home.
    • Remove all firearms from the home, or at a minimum, ensure that they are all locked and inaccessible to your child. Store bullets separate from the guns.
    • Secure all medications and sharp objects in your home as well.
  • Seek the support of a mental health provider. Ensure that an appropriate safety plan is created.
  • In the case of an emergency, call 911 or bring your child to your nearest emergency room for an evaluation. You may also wish to contact mobile crisis intervention services in your area.

Hotlines

  • Suicide Prevention Lifeline:  Call or text 988
  • Crisis Text Line: Text TALK to 741-741
  • National de Prevencion del Suicidio:  1-888-628-9454
  • The Trevor Project (Crisis line for LGBTQ+ youth): 1-866-488-7386
  • National Teen Dating Abuse Helpline: 1-866-331-9474
  • The National Runaway Safeline: 800-RUNAWAY (800-786-2929)

Check our social media for more resources and useful information.

Sources

Part 2: Adults

Understanding who is at risk and recognizing the warning signs can be crucial in preventing tragedy and providing timely help. In the following blog, you will find risk factors and ways to help that are specific to adults. For more information on this topic, please see the previous blog on Suicide Prevention in Youth.

Who is at Risk? – Adults:

  • Comorbid Diagnoses: People with multiple mental health conditions are at higher risk.
  • History of Self-Harm or Previous Attempts: Past behaviors are strong indicators of future risk.
  • Recent Losses: Significant life changes, such as losing a job, facing financial difficulties, or experiencing the death of a loved one, can increase vulnerability.
  • Chronic Problems: Ongoing issues with the legal system, unemployment, or troubled relationships can exacerbate mental distress.
  • Physical Disorders: Conditions affecting the central nervous system, such as epilepsy, Alzheimer’s Disease, or spinal cord injuries, can heighten risk.
  • Other Medical Diagnoses and Chronic Pain: Chronic illnesses like cancer, autoimmune diseases, or HIV/AIDS also play a role.
  • Substance Use: Abuse of alcohol or drugs significantly raises the risk of suicidal thoughts.

What Can I Do to Help?

Recognizing these signs early and offering support can make a significant difference. See the previous blog on Suicide Prevention in Youth for a full list of warning signs.

If you or someone you know is exhibiting these signs, seek professional help immediately. Suicide prevention is a community effort, and being informed is the first step towards making a difference. If someone you know is at risk:

  • Be sure to check in with them regularly.
  • Be a supportive listener and do not jump to problem solving.
  • Focus on validating their feelings and reminding them that you are there for them.
  • Provide them with resources (can be found below).
  • In the event of an emergency, of course, dial 911. You may also wish to contact mobile crisis intervention services in your area.

Hotlines

  • Suicide Prevention Lifeline:  Call or text 988
  • Crisis Text Line: Text TALK to 741-741
  • National de Prevencion del Suicidio:  1-888-628-9454
  • National Domestic Abuse Hotline:  1-800-799-SAFE (7233)
  • The Gay, Lesbian, Bisexual and Transgender National Hotline: (888) 843-4564
  • Trans Lifeline: (877) 565-8860

Check our social media for more resources and useful information.

Sources

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Pandemic Holidays: Different Doesn’t Have to be Bad

by Christina Carson-Sacco, PsyD November 17, 2020


This year has altered our lives in too many ways to count. The holidays in 2020 are sure to be impacted as well. With COVID restrictions, many of us will not be able to travel or gather safely. Traditions may not happen in the same way. For some there have been very real losses of family and friends, employment or financial insecurity, and estrangements over politics. Regardless of the reasons, this holiday season will likely present significant challenges at the end of an already challenging year.

Identify your Feelings: It is likely that you are more emotional than usual. Start by taking some quiet moments and sorting through the many emotions you are having. Try to identify what the exact emotions are and where they are coming from. You may be surprised to find that some of your emotions aren’t actually connected to the holidays, but are tied to other aspects of 2020.

Acknowledge your Losses: Whether it is loss of people in your life, financial security, freedom to gather/travel, routines like going into an office or participating in sports, or just a general sense of safety in the world, it is critical that you take some time and recognize what you have lost and how you’re feeling about it. It does not help to deny the significance of these losses, though once you have acknowledged your feelings, don’t get stuck dwelling on them.

Resist Romanticizing Past Holidays: It is normal to have an idealized vision of what the holidays are like. But if we are honest with ourselves it isn’t all wonderful. There is a lot of normal stress associated with our typical holidays; financial strain, relationship tension, an overwhelming number of additional chores, and trying to make things perfect. Too often, we try to make ourselves and others happy with material things. For some there are struggles with spending, food, alcohol and unhealthy relationships. Be realistic about the holidays.

Focus on What Is Really Important: Stop and take a moment to think about what is truly meaningful for you at this time of year. It may be family, but only certain ones. Maybe friends are higher on your list than family. Are the spiritual roots of the holidays the most important parts? Does charity figure heavily into what’s important to you? Maybe what you love best is having some time off for relaxation? How can you safely engage in what is most meaningful to you? Try to think outside the box. Come back to this when you lose focus.

Look for the Good: With so much negative noise in 2020, it is sometimes hard to hear the good. Turn down the television. Step away from your social media. Go outside and take a deep breath. Now, think of one thing that you are grateful for. Maybe it is small, like the smell of clean sheets. Maybe it is big, like having a safe home to shelter in. It could be a friend who checks in on you. Or it could be that you are grateful you are in a position to support someone else. Though you may have never planned to work from home, maybe you’re grateful to not have to fight traffic or pay for gas commuting to an office. If you’re a front line worker, while it is stressful, you may be grateful to be able to make a huge difference in the lives of so many vulnerable people. Your children could be sad about not attending school or activities, but they may appreciate slowing down and family time. Or maybe you’re just thankful for comfortable slippers, sweatpants and Netflix. Whatever it is for you, try to find the good.

Control What you Can Control: Keep in mind that you do indeed have control over many aspects of what your holidays will look like. This may be a chance to let go of the parts of the holidays you don’t like; cut out the traditions that don’t work for you. This may be the excuse you need to take a break from unhealthy relationships. You have control over how you wrap up 2020.
• Be aware of your self-care. Especially this year, when emotions are running high, be sure to be on top of eating, sleeping, hydrating, and getting some time moving outdoors. Don’t
underestimate the value of taking a few deep breaths and doing some brief meditation. Many guided meditations are available free in apps or online. Set budgets for spending. Limit drugs and alcohol. Many support groups are now available online. If you are struggling, reach out to a psychologist or your family physician for help. Keep up good boundaries with others. Be aware of a tendency you may have to try to make others happy by forgoing your boundaries. It is ok to say no. If some family or friends challenge you, find ways to connect safely. Avoid hot-button topics or engage in structured activities with individuals that you may clash with.
• Find connection. If you’re alone, the end of the year gives you the opportunity to engage in some serious self care and restoration. Consider pushing outside your comfort zone and reaching out to others you’d like to be closer to. So many people are wishing for more connection this year. Religious institutions are offering community, even if virtually. Many online groups offer connection, as well. Volunteering to help others will help you meet likeminded folks.
• Different doesn’t have to be bad. If your loved ones are apart and you’re dreading another Zoom gathering, add some fun with competition. Who can make the best decorated cake, wreath, gingerbread house, cookies, or ugly sweater? Whose menorah made from things around the house does everyone like best? Which household can win the viral Tik Tok dance off? Play games over technology. If family is near by, do a socially-distant potluck. Have each household cook a dish and drop off portions on each other’s porches. Then zoom in and enjoy together. Traditionally, many families are so busy they rarely spend a lot of time talking during the holidays. This year, each member can take turns telling stories about the past or sharing their hopes and prayers for the new year. Maybe your loved ones can do a craft together over Zoom which they donate to a charitable organization. If we get lucky with mild weather, take a family walk or gather safely outside around a fire pit. Lastly, who says you cannot celebrate your holiday at a different time of year? Why not plan to have a holiday do-over as soon as it is safe to do so? Kwanza part two in February? Christmas or Hanukkah repeat in March? It may not be the same, but it can still be good and incorporate those parts of the holidays that you love the most.

With so much of the world feeling out of our control, if we acknowledge our feelings and shift our focus to what is important and positive, while taking good care of ourselves, we can take control of our holidays and have a meaningful end of 2020.

Other helpful resources:
https://www.cdc.gov/
https://findhelp.org/
https://suicidepreventionlifeline.org/
https://www.samhsa.gov/
https://www.aa-intergroup.org/
https://www.thetrevorproject.org/

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Supporting Pregnant and Postpartum Women

by Lorna Jansen, PsyD January 16, 2020

 
Dr. Lorna Jansen specializes in treating children, adolescents, and families. She helps clients manage stress, deal with relationship issues, and also offers academic coaching.

In mid-December, I attended a seminar on the topic of Postpartum Depression and Related Disorders. My interest in working with women who are pregnant and new mothers stems from a long-held desire to see each child loved and cared for well. That goal has carried me through 10 years of education post high school to my current profession as a Psychologist. I love nothing more than to help a family system run more smoothly, to further a connection between a parent and child so that they can communicate more freely, to help parents see each other in the best possible light so they can work together as a team.

Having recently navigated through the pregnancy, newborn, infant phase myself, I have a new appreciation for the unique time period this is in the life of a woman. It requires a new wardrobe, new vocabulary, and an entirely new way of thinking about oneself and the world. 

The presenter at my training, Hilary Waller, MS, LPC also knows about the challenges of this phase of life. Ms. Waller spoke about her work with women at the Postpartum Stress Center in Philadelphia. That facility is one of the few of its kind and is led by Karen Kleiman, who has written about every aspect of supporting this population. During the seminar, Ms. Waller shared the knowledge and insights she’s gained from working with pregnant and postpartum moms and their families. Some of what follows was gleaned from her presentation.

The postpartum phase represents a significant shift for everyone around a new baby. First of all, this includes the mother. It is likely she will be experiencing significant hormonal changes, as well as healing from the birth. She will also have a number of emotions related to her pregnancy, labor and delivery. Often, she’ll be attempting to heal, adapt, and cope on very little sleep. She may wonder what happened to her world, or she may be contemplating how to include another little one into her existing nest. Her partner is also likely tired, worn out, and trying to meet his or her own needs with fewer resources. The baby’s extended family and friends of the parents will likely be jockeying for time to spend with him, which may or may not be given in a way that is helpful to the parents. All in all, this is a complicated time of transition.

Given the various stressors and physiological changes in play, it’s not surprising that one in seven women will suffer from a perinatal mood disorder. A perinatal mood disorder is one that occurs during pregnancy or for up to two years after delivery, clinically speaking. It includes diagnoses of depression, anxiety, OCD, panic, PTSD, bipolar, and possibly even psychosis. Due to the sleeplessness and additional stress surrounding this time, it can be difficult to understand what is normal (e.g., feeling very hormonal the first few weeks after the birth) versus what might warrant further investigation (e.g., crying most of the day and feeling hopeless months after birth). In fact, many parents experience scary thoughts, such as wondering what it would be like if they ran away and never came back, or how easy it might be to harm the child, even accidentally. Oftentimes, these thoughts do not indicate the presence of a mental disorder.

Given the vulnerable and extremely dependent nature of a newborn, it is imperative to support a mother who is struggling at this time. A therapist who is trained in this area can come alongside a woman who is pregnant or in the postpartum phase and offer her a safe place to sort through her feelings. This professional will be able to assess the mother’s overall well-being and make a plan to help her cope with the various challenges she is facing. The therapist can help the mother find practical solutions to everyday issues such as when to eat, how to get enough water to support breastfeeding, and what adequate sleep looks like with an infant. The pair can also discuss what is important to the mother as a person who has her own needs, separate from her role as a caregiver, and how she can continue to meet those.

Ideally, the mother can ask for and receive the help she needs from her support network. Her partner and other extended family members may attend therapy sessions as well, as a way of enlisting support for the mother and strengthening the relationships therein. Often, a mother with a young baby has a number of fears and concerns, many of which are normal. However, a professional can help a woman identify where her thoughts or behaviors are indicative of something more serious and ensure she gets the help she needs.

To close, the period of time when a woman is pregnant and raising a young child is unlike any other time in her life. It is sweet and important and perpetually exhausting. Regardless of whether or not the mother is having her first or sixth baby, or adopting, she is forging a new path. Never before has she been a mother to this child. And, like any transition, there is a lot to learn and she can benefit from caring and thoughtful individuals in her life.

If you or someone you love are experiencing some of the following, you may benefit from therapeutic support: feeling overwhelmed or sad most of the day, having trouble sleeping due to anxiety, experiencing panic attacks, or having the urge to self-harm. Please call our office at 215.491.1119 to make an appointment with Dr. Jansen.

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Tips for Divorcing Parents

by Christina Carson-Sacco, PsyD October 23, 2018

So you find yourself going through the divorce process. If you are like most parents, you’re concerned about how to minimize the stress on your children and are aware that how you handle the divorce could greatly affect them.  Though many of these tips are not easy to follow, hopefully they will give you guidance during this challenging time.

Telling your child about the divorce is difficult and needs to be handled sensitively. Both parents should set aside their own feelings and deliver the message together, in an age appropriate manner, simply, and without any blaming or anger. Focus on your child’s needs at this time.
Stress that even if you are divorced, that you will never stop loving your child and will always be her parents. Sometimes children worry that if parent’s can stop loving each other, then maybe they can stop loving them.
Stress that they did not cause the divorce. Often, children assume things are about them. They may have overheard you arguing about them. Be clear that there is nothing they could have done to prevent the divorce.
Realize that all children have different reactions. Some will be very upset, while others may seem to have little reaction. Children may have specific questions about how the divorce will affect them. You may not have the answers, but you can assure them that you will do your best and that the family will get through this.
Set aside your feelings toward your former spouse, so that you both can focus on what’s best for your children. Let go of control and the need to ‘win.’ Think of it as a business relationship, which may make it easier to be polite, communicate effectively, compromise, and remember that the other parent loves the children and is doing their best.
Never criticize the other parent to or around your children.  Know that children are always listening and even at a young age, understand that they are made up of half of each parent.  Putting down your former spouse can damage your child’s self-esteem, as they can feel you don’t like of a part of them.
Refrain from using your child as a messenger. It is tempting to ask a child to relay a message or to report what is happening at the other house. However, this puts strain on your child and they can feel trapped in the middle.
Do not fight or argue in front of your children (or within earshot.)  Your fighting can be frightening. Role model appropriate expressions of feelings in front of them.
Do not discuss money matters with your child, no matter the age.  If the child is concerned, assure her that the adults will make sure she is taken care of. If you are ordered to pay child support, do so in a timely manner.
Stability in home and school is not always possible, but it is the ideal. If you have to move, maintain rituals, relationships with friends and extended family, or activities to create continuity.
Foster a healthy relationship between the child and their other parent, as well as that side of the family. Remind the child that even if their parent does things differently than you or disappoints them, they love them.
Transfers can be difficult for everyone. Understand that on transition days, your child is likely to be a little “off.” Strive to be courteous, be on time, and bring all the things your child needs for his stay. Do not linger or use this time to work out conflicts.
Out of guilt or fear of the child liking the other parent more, some parents will forgo rules and limits, or will buy their children lots of gifts.  This strategy will backfire, as it undermines your authority and is not in the best interest of your child.
Try to create as much consistency as possible. No two households will run exactly the same, and kids will adjust. Try to avoid power struggles with the other parent and do not disparage their parenting around your child. Unless agreed upon ahead of time, do not expect the other parent to carry out a punishment you’ve given the child. If you are having difficulty co-parenting effectively, consider working with a psychologist on ways to better co-parent.
Find a support system and take care of yourself.  It is normal to grieve the end of your marriage. If you are having trouble sleeping, eating, are relying on drugs or alcohol, having significant mood issues or need unbiased support, call a psychologist. Surround yourself with people who will support you and encourage a healthy divorce. Never use your children as confidants, caretakers, or companions. Remember, caring for your children means making sure you are a healthy, as well.

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Stop Tearing Down and Start Building: 5 Ways to Enrich your Relationships Today

by Lorna Jansen, PsyD September 10, 2018

Frustrated by the way your relationships are going? Feeling like you’re always at odds with someone at home or at work? Here are a handful of tips you can use to revitalize your relationships and improve your interactions with others.

  1. Look for the positives and focus on the other person’s strengths. For example, you might start by noticing how well your spouse manages his or her job, commitments at home, balance between free time and family time, or anything else. As you observe him or her, begin commenting about what you’ve seen like this: “You do a really good job with __________” or “I’m impressed that you were able to accomplish _________ today.” John Gottman says the magic ratio is 5 positive interactions for every 1 that is negative. In order to compensate for the inevitable bumps along the way, make a concerted effort to recognize the positive qualities of those around you each and every day.
  1. Employ active listening skills. Active listening initially includes paying attention, withholding judgment and reflecting the other person’s words by repeating them back to him or her. This is especially important—and challenging—when there is conflict. As you take the time to slow down and focus on your co-worker’s point of view, you may find yourself less focused on making your case and more willing to reach a mutually beneficial solution. If you want additional information on this topic, look here: https://www.ccl.org/multimedia/podcast/the-big-6-an-active-listening-skill-set/
  1. Take care of yourself. As you are able, focus on eating well, getting enough sleep, drinking water throughout the day, exercising, and managing your stress. This will have a positive impact on yourself and everyone around you. If you need help remembering to do these things, enlist some support partners. You might also use an app like Wunderlist to organize your goals and set reminders.
  1. Look for common interests and seek to engage in those whenever possible. When you think of your relationships, consider whether there are any favorite activities, interests, or even favorite foods that could bring you and the people you love together. For example, you might consider setting up weekly, bi-weekly or monthly dates to spend time with each of your children. Enlist their help to come up with ideas of things they’d like to do or explore with you, and work your way through the list you compose.
  1. Before you speak, consider the things you often say. If you are frequently at odds with someone in your life, think about the phrases you find yourself repeating to that person. Perhaps you need to change what you are saying so your family member can really hear the message. For example, if you find that you are constantly telling your dad that he’s embarrassing you in some way, maybe you could tell him some things you appreciate about him (see #1) and then give him a few tips about what he could say or do when he’s around your friends.

These five tips may seem simple, but will require a concerted effort on your part. If it seems overwhelming to implement all five at once, start with the one that seems the most likely to create positive change and work your way through the rest as you are able. Though you may encounter resistance at first, you will soon notice small differences in the relational atmosphere. If you or someone in your life would benefit from the help of a trained therapist as you work to improve your relationships, please call our office at 215.491.1119.

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Increasing My Productivity, Reducing My Stress: A quick overview

by Christina Carson-Sacco, PsyD December 10, 2016

I think most people would say they’d like to be more productive, but also would love to be less stressed. As we are looking at a new year, it’s a good time to think about ways we can do this.

First, I’d like you to think about the roles you play in your life. Is it as a business owner? Parent? Partner? Community activist? Friend? Now, in light of that role, answer this question, “What’s my Mission Statement?” Draft your mission statement and write it down.

  • What do I do?
  • Who do I do it for?
  • How are they better off because of me?
  • What do I want them to feel?

Why do you need a mission statement? It keeps you on track. For example, if you’re thinking of yourself in your role as an activist helping homeless families, your mission statement might be, “I will increase awareness of homelessness in our county and support organizations that are providing shelter for displaced families.” If an opportunity to assist abused animals comes up, while you think it’s a very worthy cause, it does not fit with your mission statement, so you might delegate this task to another person, but not let it dilute your resources or take up your energy. Look at the questions above when examining whether or not to do something to test whether it fits with your mission statement for a particular role. This will keep you focused and help you to say “no” to requests that might distract or detract from your goals.

Next, how do we tackle those pesky to-do lists? Having lists of your tasks is a helpful way to organize and keep track of what needs to get done. Hopefully, you’re crossing tasks off on a daily basis. What many people are challenged by are the tasks that never seem to get done. Let’s take a moment to examine those tasks, by putting them into this chart. This will help you to examine why the task is never completed.

screen-shot-2016-12-10-at-11-16-03-am

For example, a task might be “organize my financial records.” The obstacles might be “need to get files from work.” You can then choose to either get the files or maybe ask someone at work to pull them together for you. Putting tasks on this chart can help clarify the obstacles, making it easier to decide how to handle them.

Some tasks have bigger obstacles, though. Beware of the “shoulds.” Is there a task that is on your list merely because you feel you should do it? However, you don’t really want to do it; you just think you should. For example, maybe one of your never-completed tasks is “Sign up to coach my child’s soccer team.” You may not really want to do that, but you feel you should because you believe “a good parent coaches their child’s team.” Examining that belief and making a conscious decision will help you to make a choice to either do it or remove it from your list. Be careful; the “shoulds” can be draining. You don’t need to do everything you feel you should do. For example, an incomplete task could be “fix things around the house.” You may believe “it’s frivolous to pay others to do household chores” or “responsible adults take care of these things,” but you never complete these tasks. Seeing them on your list could makes you feel drained or like you’re failing. It may be beneficial to either take some of these tasks off of your list or to hire someone else to do them.

Another other reason some tasks never get done is that we have fear connected to them. Looking at your never-completed to-do items, are any of them incomplete because there is some fear holding you back? For example, one of your tasks might be “go to the gym regularly.” It’s easy to think that you’re not crossing that off your list because you don’t have enough time. However, if you pause to consider a possible fear, maybe the roadblock is really, “I’m afraid that I won’t be very strong and will embarrass myself at the gym.” Identifying and facing these fears head on can help you overcome them.

Third, being productive and reducing your stress means taking good care of yourself. Remember, while some people may boast about how much they are doing, there is no pride in being busy. Being “busy for busy’s sake” can get out of control, feel overwhelming, and at times make you feel powerless over your life. Be conscious of how you’re filling your days and when you can say “no” to tasks. Ask for help when you need it.

Self-care must be on your to-do list. If your friend said they were feeling really stressed out, what advice would you give them? Treat yourself as well as you would your best friend. Doing these things regularly will help you manage your stress:

  • Sleep 8+hours
  • Eat 3+ nutritious meals
  • Hydrate
  • Go outside a little each day
  • Unplug from technology for portions of each day by setting designated work times and space
  • Exercise or just move
  • Avoid too much caffeine, alcohol and other drugs
  • Create a good support system
  • Remember to care for yourself before caring for others; are you at the top of your priority list?

If you are struggling with any of these tasks like focusing, managing your life, overcoming fears, or any of the self-care items, a psychologist can help. While reading this may have added to your to-do list, the goal is to improve how productive you feel while keeping stress in check.

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