Tag: depression

LGBTQ+ Mental Health Issues – familydoctor.org


The teen years are an important period for mental health. Many mental health disorders appear for the first time during those years. Unfortunately, the suicide rate is high among all people between the ages of 10 to 24. Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) teens and young adults are at an even greater risk for poor mental health.

Mental health issues can include depression and mood disorders, anxiety, and post-traumatic stress. There is also a risk of alcohol use and abuse and risky behaviors (such as unprotected sex). Much of this is due to the stigma associated with being LGBTQ+. LGBTQ+ teens and young adults fear not being accepted by family, friends, teachers, co-workers, their religious community, and the community overall. There also is a fear of being bullied or not being able to achieve certain things because of bias. This is called “minority stress.”

Path to Improved Wellness

Many LGBTQ+ teens and young adults are happy, confident individuals. They thrive in every area of their life. Often, this is thanks to a safe, loving, and supportive home and school environment. If you are the parent or educator of a LGBTQ+ teen, there are two areas you can improve your LGBTQ+ teen’s social, emotional, and physical wellness:

  • Some LGBTQ+ teens are fearful of telling their parents they are gay, lesbian, bisexual, or transgender. Children fear losing their parents’ love, support, and even being kicked out of the house. As a parent, the best thing you can do for your child is offer unconditional love and support. To help your teen, offer your support by:
    • Talking calmly and honestly about your child’s feelings.
    • Encouraging your child to talk with you at any time.
    • Inviting your child to talk with a counselor or therapist.
    • Resisting passing judgment based on your own choices.
    • Holding your child to the same values as you would if they were heterosexual.
    • Staying involved in your teen and young adult’s life.
    • Being resourceful. Help your child find the medical, educational, and emotional resources they need to thrive.
  • If your child decides to tell friends and classmates that they are LGBTQ+, make sure they are in a safe school environment. Talk to your child about their view of the school culture, see if they celebrate diversity, and look into their policies related to bullying and violence. Additionally, watch how your child’s school:
    • Identifies “safe spaces,” such as counselors’ offices or classrooms, where LGBTQ+ youth can go for support from administrators, teachers, or other school personnel.
    • Encourages school clubs that promote a safe, welcoming, and accepting environment (e.g., gay-straight alliances or gender and sexuality alliances. These are school clubs open to youth of all sexual orientations and genders).
    • Ensures health education about HIV and sexually transmitted diseases (STDs) that is relevant to LGBTQ+ youth.
    • Trains and requires school staff on how to create safe and supportive school environment for all students, regardless of sexual orientation or gender identity.
    • Facilitates access to community-based providers who have experience providing health services, including HIV/STD testing and counseling, social, and psychological services to LGBTQ+ youth.

The American Academy of Family Physicians (AAFP) believes mental health professionals are valuable for people struggling with emotional wellness. Many people continue to see their primary care physician for help. Promoting emotional wellness is an important part of family medicine. Early detection of mental health problems is more likely to happen through regular visits with your family doctor. Family physicians treat the whole family. They are often better able to recognize problems and provide interventions in the family system. Family physicians are also able to treat people who would not have access to traditional mental health services. Many times, this is because of the social stigma associated with mental illness.

Things to Consider

If you are concerned about your LGBTQ+ teen or young adult’s emotional wellness, here are things you can monitor to assess their mental health:

  • Sudden changes in your child’s personality, such as withdrawing from friends and social activities they have enjoyed in the past.
  • Unexplained drops in grades or school absences.
  • Unplanned weight loss. This could be the result of an eating disorder.
  • Signs of substance abuse (alcohol and drugs).
  • Signs of self injury, such as cutting (sometimes a person will wear long sleeves and pants during warm weather to hide the marks).
  • Signs of bullying, both physically and emotionally (bruises, cuts, fear, avoidance).
  • Headaches and stomach aches. These are common symptoms related to stress.
  • Giving away personal treasures (which could be a sign your child is considering suicide).

Questions to Ask Your Doctor

  • If I suspect my son or daughter is LGBTQ+, should I discuss it with them?
  • Can my child’s depression or anxiety be treated with medicine alone?
  • What should I do if I support my child’s choice but my spouse does not?
  • What are the signs that a teen is considering suicide?

Resources

Centers for Disease Control and Prevention: LGBT Youth

Substance Abuse and Mental Health Services Administration (SAMHSA): Lesbian, Gay, Bisexual, and Transgender (LGBT)

U.S. National Library of Medicine, MedlinePlus: LGBTQ+Health

Talk Saves Lives

Lifesavers Guide

LGBT Suicide Prevention





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Depression and Thoughts of Suicide


Suicidal thoughts are thoughts about hurting yourself or taking your own life. Suicide is the act of taking your own life. Suicide can be linked to depression. Suicidal thoughts can happen to anyone—young and old, male and female—for a number of reasons. Usually, suicidal thoughts occur when a person is in intense emotional pain and doesn’t see a way out. The things that cause this type of pain are different for everyone. Suicide is often preventable.

There are multiple risk factors for suicide, including:

  • Age
  • Gender
  • Poor physical and mental health
  • A history of violence
  • A family history of suicide
  • Having weapons in your home
  • Having recently been released from a long stay in prison or jail
  • Hanging out with others who talk about suicide or encourage you to take your own life
  • Traumatic events

Path to improved well being

Even though it feels like your pain will never end, suicidal thoughts often are caused by a treatable health problem. This includes physical medical conditions such as depression. Depression is a serious medical condition. It changes the chemicals in your brain. It affects your moods, thoughts, and emotions. It can make it hard or impossible for you to feel happy, remember good times, or see solutions to your problems. If you have been treated for depression in the past, you may need to try other treatments to find the one that works.

Some of the things you can do when you are feeling depressed include:

  • Reach out for help. Call the National Suicide Prevention Lifeline at 988. You are not alone. You may feel like your loved ones don’t care. But people want to help you. Tell someone what’s going on. Call a friend or family member, your family doctor, or your church.
  • Avoid things that trigger suicidal thoughts. These things are different for everyone. Common triggers include being alone, drinking alcohol, and doing drugs. Spend time with family or friends every day. Make your home safe by getting rid of alcohol, drugs, and the things that you used or planned to use to hurt yourself.
  • Give it time. You do not have to act on your suicidal thoughts. Make a promise to yourself that you will give yourself time to ask for help and seek treatment.
  • Take care of your health and wellness. Follow your doctor’s eating and exercise advice. Get plenty of sleep. Learn how to deal with stress. Find and do things that you enjoy. If you’re taking medicine to treat depression, don’t skip your medicine. Take the right amount at the right time.
  • Work with a professional. This could be a psychiatrist or a counselor. Don’t be afraid to open up to the professional. You should tell them what you are feeling and don’t hide anything.

Things to consider

Suicidal warning signs include:

  • Feeling trapped or hopeless
  • Feeling like you need an escape
  • Feeling unbearable physical or emotional pain
  • Focusing on death, dying, or violence
  • Feeling that friends and family would be better off without you
  • Making a plan or searching for a way to take your life
  • Feeling guilt or shame
  • Using drugs and alcohol more frequently
  • Increased anxiety
  • Withdrawing from family and friends
  • No longer having an interest in the things you used to enjoy
  • Changed eat and sleep patterns
  • Extreme anger, rage, or revenge
  • Giving away things that once mattered to you
  • Saying goodbye to friends and family
  • Writing a note, making a will, or putting your affairs in order

Questions to ask your doctor

  • What’s the difference between depression and feeling down?
  • Does everyone think about suicide at one time or another, even if it’s short-lived?
  • Is there medicine I can take?

Resources

After a Suicide Attempt

Lifesavers Guide

National Institute of Mental Health: Suicide Prevention

National Suicide Prevention Lifeline

Supporting Your Loved One after Suicide Attempt

Talk Saves Lives

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Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.





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Depression in Children and Teens


Path to improved health

It’s important to regularly talk with your teen. You can show you care and support them by doing these things:

  • Let them know you are there for them.
  • Always listen. Remain quiet so they feel like they are being heard.
  • Avoid bombarding them with questions and lectures after listening.
  • Help your teen create a healthy lifestyle with regular sleep, a balanced diet, and exercise.
  • Gently remind your teen to take their medicine.
  • Look for signs that their depression is getting worse.
  • Talk to your teen about substance abuse (alcohol and drugs). These substances make depression worse.
  • Keep your house safe for your teen by eliminating alcohol, remove guns and other weapons, and keep prescription medicines locked up.
  • Have a safety plan in place if your teen is suicidal or needs urgent help.

See your child’s doctor if you notice symptoms for 2 or more weeks. It might mean that your child is depressed. Your doctor can do an exam and refer your child to a specialist. This may include a counselor, therapist, psychologist, or psychiatrist. Your child can talk to them about what and how they feel. Family counseling can help everyone in your family. A combination of counseling and medicine can help treat depression in most young people.

The American Academy of Family Physicians (AAFP) recommends depression screening for teens, ages 12 to 18, who have symptoms. The AAFP does not have enough evidence to assess the benefits and risks of screening children younger than 11 years of age for depression.

Contact the National Suicide & Crisis Lifeline (988) if you think your child or teen is having thoughts of suicide. Call 911 if your child attempts suicide.

Things to consider

Young people can be depressed for many reasons. Genetics, health conditions, and life events can be factors. Below are other possible reasons for depression in children and teens:

  • Your family moves to a new place to live.
  • Your child has to change schools.
  • A pet, friend, or family member dies.
  • A loved one is seriously ill.
  • Your child is bullied or abused.
  • Your child has behavior problems. This includes attention-deficit hyperactivity disorder (ADHD).
  • Your child is dealing with gender identity or sexual orientation issues.

Questions to ask your doctor

  • How do I know if it’s something other than depression?
  • What can I do to help prevent depression?
  • What types of medicine can help treat depression in children and teens? What are the side effects?
  • Can you recommend a support group for my child or teen who is depressed?

Resources

National Institutes of Health, MedlinePlus: Helping your teen with depression

National Suicide & Crisis Lifeline: 988

National Institute of Mental Health: Depression Studies for Children

National Institute of Mental Health: Teen Depression

Talk Saves Lives

Substance Abuse and Mental Health Services Administration: Findtreatment.gov

U.S. Preventive Services Task Force: Clinical Recommendation for Depression and Suicide Risk in Children and Adolescents





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Depression Is Common and Treatable


My nurse asked Megan to fill out a simple questionnaire that helps identify whether a person may have depression. Megan’s high score on this questionnaire indicated a possible diagnosis of depression. After looking at her responses, I talked with her. Megan told me she felt a little embarrassed to be admitting out loud that she was struggling. Like many people, she had a hard time explaining exactly what she was feeling. She took several long pauses, but I was careful not to interrupt.

Megan told me that she was feeling both sad and anxious at the same time. “I feel like I’m coming out of my skin,” she said. Although she felt tired all the time, she couldn’t fall asleep at night. She would often toss and turn for hours, usually thinking about past mistakes. Sometimes, she wished she could just disappear. Fortunately, she had not thought about hurting or killing herself.

As Megan talked, I noticed her body language and speech patterns. She fidgeted with her hands a lot, and she looked mostly at the floor. I asked some questions to make sure she was safe and to rule out other things that can make depression worse. Megan said that she was not using drugs or alcohol or engaging in high-risk sexual practices. She said that she felt safe at home and elsewhere, but she wasn’t comfortable talking about her feelings with her parents. I thanked her for having the courage to come in and ask for help. She admitted it had been hard for her.

I let Megan know that it’s common for depression and anxiety to go hand in hand. I explained that they don’t just cause psychological symptoms. They can also affect you physically and cause symptoms like chest tightness, fatigue, headaches, and jitteriness. Since I could tell that Megan held a lot of her feelings in her body, I recommended taking a few minutes each day to put on music and dance. Dancing is a great activity to help relieve tension and improve your mood. I also taught Megan a relaxation technique to use whenever she was feeling anxious. It’s a simple, effective exercise called soft-belly breathing. It involves breathing slowly in through your nose and feeling your belly fill with air before breathing out through your mouth.

In addition to counseling, I prescribed a low dose of an antidepressant for Megan. (Learn more about antidepressants and how to take them safely.) I explained to Megan that it can take several weeks for an antidepressant to start working. Side effects from these medicines usually decrease after a couple of weeks.

When a person starts taking medicine to treat depression, there is a risk of increased suicidal thoughts, particularly in young people. Although this is rare, I discussed the risk with Megan and made sure she had a plan, just in case. She already knew about suicide hotlines that are accessible by phone, text, or online (for example, the National Suicide Prevention Lifeline at 1-800-273-8255). She also identified a friend to call if she had thoughts about hurting herself. I assured her that she could always call her counselor or my office, or go to an emergency room if she needed help right away.

I asked Megan to come back for a follow-up visit in 1 week so I could see how she was tolerating the antidepressant. She told me it was a relief to talk about her feelings. She felt hopeful that her symptoms would improve over time. As Megan’s family doctor, I’ll continue to guide her treatment for depression and provide needed care and support.

Reach Out for Help

People who have depression sometimes think about suicide. If you have thoughts about hurting yourself, tell someone. Tell your doctor, your friends, or your family. You can also call a suicide hotline, such as the National Suicide Prevention Lifeline at 988.

Get help right away. There are people who can help you. Depression can be successfully treated.





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