Normal or not? How to know when teens are in trouble.

Q: My 16-year-old daughter has been a great kid. She used to make A’s, bring her friends home, talk about what was going on in her life, wake up happy, and stay connected to both friends and family. Recently, it is as if a light has switched off. She dresses wearing dark colors and long sleeves no matter how warm it is. She no longer pays much attention to her looks and her grades are now C’s. She has let her friends from the past slip out of her life, and rarely talks with anyone on the phone. When she does she keeps all the details about these new friends secret. She is keeping to herself when she is home, and seems to spend more time in the bathroom. When I try to talk to her and mention the changes I see, she tells me to stop worrying, that she’s fine. She isn’t! I think she is cutting herself but my indirect attempts to find out have failed. What has happened to my daughter and what should I do?

A: You seem very much in touch with your daughter, both her personality in the past, and her recent changes. These are all alarming shifts and you are right to be observing very closely to really get a better feel for what may be happening with her. Has she cut off all communication with everyone? If there is any connection between you, try to let her know that you are noticing these changes and that you are worried.

When she tells you not to worry, let her know you need a lot more information in order to stop worrying. She is your responsibility and you take that seriously. Let her know that you love her enough not to let her drift too far away, while still respecting her space.

What do you need to see or hear in order to give you hope for your daughter? If passing grades are sufficient, then you won’t want to focus on schoolwork since she is passing. You might want to leave the color and style of her dress alone if you are worried about the possibility of her doing some self-harm through cutting. It also sounds as if her withdrawal from past friends and not knowing her current friends is a problem for you. Perhaps being able to create a routine for the two of you to check-in with each other, meet her friends, and see her wearing clothes that are short sleeved and shorts might help you address your fears of her cutting and possible depression. The best outcome includes her willingness to work with you. The worst outcome is her further retreat from you.

If she remains distant, you still have additional resources. First, enlist the help of teachers and staff at school. Are they noticing changes? Do they know the kids she now sees? Have they had any concerns at school? You may end up being less worried or more as a result of this step. Do they have any recommendations for you?

It sounds as if there was one time when you knew her friends. Can you call any of them and ask what they have heard is going on with your daughter? Would their parents have an idea? Would they being willing to share what they know with you?

You may have respected your daughter’s privacy in the past. If she is unwilling to work with you, and you continue to feel that she is in trouble, you may want to search her room for additional clues. This may violate every principle you believe in and past agreements you have made with your daughter. You would only do this if you feared for her mental health and stability.

Look for anything — notes, drug paraphernalia, safety pins, razors, scissors — that may have been used for cutting. Understand that if she confronts you over having done this, your most honest response will be to tell her you are desperate to help her and this was your last resort.

You are trying to determine what kind of problem you are facing with your daughter. Is she depressed and perhaps suicidal? Is she self-mutilating for some reason that you need to address?

If she is cutting herself, understand it is a way some people deal with feeling strong emotions. These can include perfectionism, anger, loss, hurt, rejection, shame, frustration, or isolation. Once started, it gives temporary relief and can become a habit. Problem solving, coping skills and therapy are extremely useful. Exercise often breaks the self-cutting habit by putting in a new behavior that stimulates great brain chemistry and an improved self-image. Some people use cutting as a way to cope with a history of physical, emotional, substance or sexual abuse. Cutting in others may be a sign of an obsessive compulsive disorder, eating or depressive disorder. Again, professional advice is needed in all these issues. Teens that cut are not as suicidal as teens who are severely depressed. Your first step, if you suspect depression, is not only to get help, but learn what you can do and what your community has as a safety net for both you and your daughter.

If you suspect she may be struggling with suicidal thoughts, be open and talk about it. Have you known anyone who ever attempted suicide? Is there a history of depression in either of her parents’ family history? Knowing that depression may have genetic components may be a source of great relief to your daughter. Let her talk about anyone she has known who has those thoughts. What does she believe about suicide? Is it an option or only an impulse to be ignored? Make sure your daughter knows that there is a 24-hour hotline in Tulsa called COPES (918) 744-4800 that will talk to anyone who is feeling suicidal or dealing with a friend who is suicidal. Assure her that COPES will make wellness checks on friends if she is concerned about them, and work with people age 6 and older who are suicidal. Suicidal thoughts are serious and never to be taken lightly. Counseling is available for any child who is severely depressed in Tulsa. Call Family & Children’s Services to set an appointment (918) 587-9471 if you do not have insurance or a mental health provider.

If you have the opportunity, talk about stress management and problem-solving skills when you are watching TV shows or movies. If you see your daughter using great coping skills, point them out as strengths she has. She may be so self-critical that she cannot see any of those within herself.

If you see your daughter doing any of the following: giving things away; taking a hopeless attitude about everything in life; refusing to eat; dropping out of school; not taking care of herself physically; joking about everyone being better off if she were dead; withdrawing from the few things that used to give her pleasure; getting into accidents; or starting to take big risks, you need to get help immediately. Ask for family therapy so that whatever happens, you are part of letting someone know there is a serious problem.

Verbally focus on your daughter’s strengths when you are with her. Feel free to share your worries and concerns. But, be careful not to treat her as if she is mentally unstable and out of control — even if you believe with good reason that she is. Make your decisions based on her behaviors without labeling her.

You are struggling with one of the hardest issues for parents: how do I know when my child is in real trouble and how do I respond without losing her? Know that you are not alone; there are groups for parents as well as your daughter. There are resources to help you both get through this. Good luck!

Web resources:

https://www.verywellmind.com/college-and-teen-suicide-statistics-3570768
http://www.teensuicidestatistics.com/
https://kidshealth.org/en/teens/cutting.html#
http://www.eqi.org/cutting1.htm