In 2007, Jay Asher wrote 13 Reasons Why about a teenage girl who committed suicide but not before leaving 13 audio tapes explaining the ways in which 13 people in her life led to the decision to kill herself. The book really struck a chord with teenagers and became a best seller. In 2017, The book was made into a cable movie serial (with 13 episodes, of course). Teenagers LOVE it. The videos had to expand on content in the book to fill the 50-odd minute episodes but it follows the book in substance and spirit. I enjoyed the series (as I enjoyed the book before it). It’s a well written (if unrealistic) teen drama about important issues that does more than just skim over the surface and tidy it up at the end.
There has been a lot of discussion by people in the media (and, of course, by mental health professionals) about how this story effects teenagers. There is a lot of drama in the story (of course). Teens move through an environment that is virtually empty of adults who set limits, communicate with their kids or are even present in their daily lives. The kids seem to come and go at their whim. So, this series is a dramatization (fictionalized and written by an adult) about “teens these days.” Angst ridden (accurate), neglected (not the norm), without supervision (only when it is unavoidable) and talking like their dialogue was written by a screenwriter’s version of highly verbal, introspective, philosophical and emotionally complex 20 somethings (the word “existential” was used in a conversation between two teenage boys at least twice. Please. Have you TALKED to teenagers?). You can find the same scripted language (or its facsimile) on every “reality” TV show where real people are given dialogue to speak to each other in contrived settings (rather than having genuine, poorly constructed sentences with about a 6th grade vocabulary that even most adults speak). And, finally, there is a graphic depiction of the main character, who you come to like a lot, cutting her wrists and bleeding out in a tub in the last episode.
What’s a parent to do?
Since so many kids are watching the series, parents are faced with figuring out how to talk about the issues it raises. This series of blogs is intended to provide parents with some talking points (and some answers) to issues raised in each episode. So, this will be the beginning of 13 things to talk to your teen about 13 Reasons Why.
The best place to begin is to review the signs of a stressed-out teen and the warning signs of depressions, especially, of suicidal depression. You can use these to do a spot check on your kid to see if you should look closer into what is going on in their emotional and social lives.
To start with, kids need to be able to recognize when they are stressed. While everyone stresses in their own way, there are some common signs once you know what to look for. Start by helping your kid identify their personal stress reactions using the list below. The more things you check off, the greater the likelihood they are stressing out. Once you know what to look for you can help your kid become more aware of when they are stressing out. And, then you can help them find ways to relieve or deal more effectively with the stress they are experiencing.
- Physical symptoms can include:
- upset stomach or butterflies
- tense and uptight (e.g., hands tremble, shoulders or neck tight, etc.)
- sleep problems (too much or too little)
- appetite problems (too much or too little)
- low energy or motivation
- fast heart beat
- clenched jaw
- irritable and quick to anger (especially when interrupted)
- easily frustrated
- continuously anxious or worried
- sad or down
- negative about most things
- tearful “for no reason”
- unable to truly enjoy things
- Behaviors like
- difficulty concentrating or remembering
- letting things slide
- nervous habits (e.g., biting fingernails, pulling at hair, biting lip, etc.)
- talking about feeling overwhelmed, stressed or freaking out
- running out of time to get everything done
- withdrawing from people
- escapist behavior (e.g., avoidance, distraction, procrastination, etc.)
Knowing what to look for is the first line of defense against your kid following through with suicidal thoughts or plans. There are a number of factors associated with kids who have attempted suicide. Here is a system that can help you know how serious the risk might be.
Worrisome signs represent normal teenage experiences that are also associated with adolescent suicide attempts. Think about each of these as another brick in a bag weighing them down. Some kids are in better shape than others but even strong kids can end up with more than they can carry. It will be important to work with your kid to address these factors. Get whatever resources your family needs to resolve the problems so they don’t pile up.
- Major loss (especially social rejection or break up of important dating relationship), humiliation or blows to self-confidence
- Recent arrest or other embarrassing, failure experience
- Target of bullying or harassment
- Reactive aggression (This is a curious characteristic. Some kids are relatively peaceable and even generally happy but react aggressively if someone messes with them– for non-Southerners, “messing with” this means “provokes.” These kids can also be at risk for reacting to despair in the moment by considering suicide.)
- Decrease in grades and academic interest
- Alcohol or drug abuse
- Feeling stuck or trapped
- Dramatic mood changes
- Social withdrawal or isolation
- Loss of interest in things
- Stressed out overachievers
At risk signs are factors that can so easily overwhelm or demoralize a kid they might consider suicide as a way to resolve the situation. When these factors are present, it is important to monitor your kid’s emotional state on an ongoing basis. Working with a mental health professional who specializes in teens is strongly recommended. Even if you are not meeting with the counselor on a regular basis, you will have someone to call when you have questions or if your parent radar is going off.
- Previous suicide attempts
- Previous suicidal thoughts
- Prior psychiatric hospitalization
- Persistent bullying and harassment by peers
- Diagnosed with depression, bipolar disorder, or schizophrenia
- Family history of suicide
- Dangerous, reckless, or very high risk behavior
- Talking about or writing about being hopeless, worthless, the meaninglessness of life, etc.
- Increased energy and mood following a period of profound depression (i.e., they may have been suicidal but didn’t have the energy to do anything about it, until now)
- Running away from home or ongoing intense family conflict
- Acting out and rebelling (especially if it is uncharacteristic)
- Prominent news about someone committing suicide (because it can lower a suicidal person’s inhibition or stigma)
When danger signs are present, teens are seriously considering suicide. Put your kid under strict 24 hour watch (and this includes sitting up with them while they sleep) until you meet with a mental health professional or take a trip to the emergency room for an evaluation.
- Talking, writing, or drawing about suicide, wanting to sleep forever or death and dying
- Acting as if they will be leaving, not be around for long, or actually saying good byes.
- Giving away or throwing away favorite possessions
- Idealizing or romanticizing death as a solution to problems
- Joking about suicide
- Lots of worrisome and at-risk signs
Now that you have done a quick check on the state of your teen’s mental and emotional health and most of you have found that your kid is in mildly stressed with just a couple of worrisome signs of depression, the remaining blogs will focus on issues that are brought up in each of the remaining episodes of the show and, most importantly, ways to talk to your kid about how you expect them to respond to and deal with them. (If your kid is significantly stressed or significantly depressed do not pass GO, go directly to scheduling a consult with their primary care provider or a mental health professional. Better safe than; well, you get the idea.)
The next blog will address issues raised in the first episode: Peer suicide and rumors.