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A look at suicide: Baptist Health-Fort Smith doctors weigh in on youths and suicide

Times Record - 3/3/2019

March 03-- Mar. 3--There are no socio-economic boundaries to suicide, and even pre-teens are susceptible.

Recognizing signs of clinical depression in children may help save a life.

Depression is a disease, and not a result of some failure by a parent, experts say. Depression is also hereditary and can be triggered by some form of bullying. Suicide instructions spliced into children's videos on YouTube have also become a disturbing recent development.

Dr. Kristi Kindrick, M.D., of Baptist Health Senior Care/Behavioral Health-Fort Smith says although there are ways to professionally address depression in youths in the Fort Smith area, adolescent psychiatric care is lacking here.

"It's the most vulnerable, marginalized group, and the least access to care in this community right now," Kindrick said.

There is one psychiatrist in Fort Smith who treats adolescents, she noted. While anxiety medicines are not recommended in children, Kindrick said anti-depressants are "safe in kids." With many adolescents "self-medicating" depression with drugs and alcohol, Kindrick stressed that marijuana and alcohol use by children is extremely dangerous.

"Be open and honest with your children," Kindrick said. "Ask them about depression and suicide. Know your kids and their friends and their social app use. Be aware."

It is impossible to monitor everything the child watches, she concedes, but providing the child with some basic guidance could go a long way.

And what if your child is the bully? Kindrick said it is not helping the situation if a parent stands up for their child and supports their behavior. Accepting responsibility sets a good example for a child who has been a bully to another child, she explained.

A study conducted by Kindrick on school bullying and cyber-bulling in 2014 with other doctors at the University of Arkansas for Medical Sciences' Psychiatric Research Institute found that while high school age girls in the United States are more likely to report being bullied, particularly cyberbullied, high school age boys are only more likely to report exclusive school bullying.

Bullying was defined as "aggressive behavior intended to cause harm or distress" and it could either be verbal or physical. To qualify as bullying it has to be intentional, repetitive and show a "power imbalance." Bullying also commonly happens in homes between family members.

Emotional-stressed marginalized groups, including the LGBTQ community and children in foster care, are susceptible to depression because of potentially being exiled or ostracized, said Crystal Lougin, director of Behavioral Health at Baptist Health-Fort Smith.

Kindrick also points out there is a vast difference between what they would call "clinical depression" as a disease and someone just being sad.

"A lot of people think that depression is being sad, feeling sorry for yourself, and something just happened in your life and your not dealing with that well," Kindrick said. "That's not clinical depression. That might just be an adjustment disorder. When we talk about clinical depression, we're talking about prominent symptoms that last longer than two weeks and impair function."

Not eating, not sleeping, no motivation, apathy, suicidal thoughts, lack of focus or inability to complete tasks, and a general feeling of "walking through molasses," Kindrick said, are some symptoms of clinical depression.

"That has to be most days of the week for two weeks," Kindick added. "Nowhere is it mentioned that there has to be crying, or staying in bed and watching TV. That's not depression."

Warning signs in school age children of clinical depression may include a drop in grades and not interacting with other children as much as they had before. If a child is not willing to go to a therapist to see what is wrong, Kindrick suggested a visit with a school counselor or even their pediatrician as a first step.

When thoughts of suicide creep in for anyone, it has a strong pull, like a black hole, Kindrick explained. The person has feelings of intense guilt. They feel shame. They think they are a burden on their family and see their existence as painful for their family.

"They don't see the hurt that their death would cause their family," Kindrick said. "They just see themselves as a burden ... but suicide is the ultimate selfish act."

Lougin said because most suicides are reported as accidental deaths there is little knowledge of what she calls "a national crisis."

"Suicides take more lives than anything else, but people don't know that because it's reported as an accidental death," Lougin said.

Kindrick noted that a coroner or police officer sometimes feels pressure to not report a death as a suicide because of a lack of direct evidence such as a suicide note. For example, an accidental overdose on prescription medicine could have been a suicide, and a hanging may simply be reported as "asphyxiation," Lougin added.


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