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Health Matters: Everything might not be alright

January 4, 2019

“Kid’s will be kids, right?” I’m often asked about how to know whether a youngster is truly struggling with something significant or if they’re just being a kid. Sometimes it’s hard to tell.

While we all do our best to raise them to grow up well, there are those moments when we’re not sure what’s happening. It’s especially challenging when our youngsters are in crisis and their emotions and behaviors have become unmanageable and are putting them in danger or at risk for harming themselves.

As with adults, a child’s resiliency and ability to thrive varies with each situation, developmental stage, cognitive abilities, life experiences and the quality of their relationships and connection with others. Some youngsters seem to work through stressful situations easily while others become overwhelmed and emotionally dysregulated.

Each stage of brain development brings strengths and self-awareness that are also accompanied by improved communication and problem-solving skills. A young person’s sense of self-worth, competency and hope for the future are all formed through their relationships and life experiences.

Strong and healthy relationships within the family and socially are key to healthy development and maturity. Unfortunately, even when those exist, sometimes a young person’s developmental stages can become compromised and stalled such as when a child experiences trauma or chronic adversity.

Kids aren’t always forthcoming with what’s happening in their lives. They can struggle letting us know they are suffering until there is a crisis. What might look like typical teenage angst and acting out might be a sign of overwhelming stress, despair over a relationship conflict or a sense of impending disaster.

Unlike most adults in crisis, teens in crisis often are experiencing more symptoms of intense anxiety than signs of depression. Because their brains are not fully developed yet, they’re not always able to understand the context of some situations or have hope for a positive resolution.

Adolescent brains, especially, are more prone to impulsivity than recognizing danger or thinking through intense, emotionally-charged situations. Although they may seem able to think logically and with the future in mind, they won’t have those skills fully developed until their mid-20s. In those moments of crisis, teens often tell us they feel disconnected with supportive adults and have often considered suicide as an option.

In the MT Youth Risk Survey (MT YRBS 2015), 15.5 percent of high school youth and 14.2 percent of our middle schoolers reported that they had made a plan to commit suicide at least once in the past 12 months. To learn more about what our youths are reporting, read the full MT YRBS, available on the office of public instruction website.

When we’re not sure if everything’s alright, consider that your youngster may be unable to resolve the situation or let you know that they are suffering. Don’t wait, watch and wonder. What may appear to be simply oppositional behaviors may also be a sign of despair or unbearable anxiety over a relationship gone awry.

Atypical behaviors, isolation, avoidance or edginess could signal an inability to address something that feels unresolvable. In those moments, it’s essential to show empathy and to focus on the present situation without making attempts to persuade them to have a different perspective. As we know, it’s difficult to think clearly when the stakes are high. The young person’s vulnerability may be heightened, and as such, is compromising their ability to work through the situation. That’s the signal that you both need help.

If you are concerned or unsure, seek out a mental health professional for an assessment. Ask your physician or schools for help in obtaining an assessment if you are not sure who to contact. Most crises can be resolved with teamwork and support, but some young people may need a more comprehensive intervention, hospitalization or longer term treatment. When the crisis presents with intense conflict, heightened emotions and irrational thoughts or behaviors, seek help from your local emergency room where a trained crisis response team can help. Also, all young people should be informed of the National Suicide Prevention Lifeline at 1-800-784-2433 or text “MT” to 741741 where trained crisis responders are available 24 hours a day

Once the crisis has passed, it’s essential to assure that the young person remains connected to supportive and caring adults and friends who will remain engaged. When a young person is in crisis, it’s often a signal that the family is also struggling. Family therapy is often helpful in identifying and resolving dynamics within the family that may be difficult for everyone. Working through the crisis and developing a pathway to healthier relationships may be challenging, but the outcome of a stronger family is rewarding for generations to come.

Kimberly Gardner, LCSW, LAC is the clinical director with Intermountain Children’s Services and serves as a clinician at St. Peter’s Health to provide behavioral health counseling to hospitalized pediatric patients. In her role at Intermountain, she provides clinical oversight of multiple levels of treatment for kids and families and also works to develop strategic partnerships with other child and family serving agencies, locally and throughout Montana, to improve access and availability of services where needed. She received her master’s in social work degree from the University of Denver and has worked in the field of children and adolescent mental health and the treatment of substance use disorders for the past 25 years.

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