# data[].attributes.body
Written by the author of Speak

# data[].attributes.attachment_link.title
I've Talked With Teenage Boys About Sexual Assault for 20 Years. This Is What They Still Don't Know

# data[].attributes.attachment_link.description
Laurie Halse Anderson, author of the novel "Speak," has talked with boys across the country for 20 years. This is what she's learned

# data[].attributes.headline
Recovering from Rape/Understanding Rape Trauma

# data[].attributes.subject
Recovering from Rape/Understanding Rape Trauma

# data[].attributes.attachment_link.readable_text
Tips for Healing after Sexual Assault

The trauma of being raped or sexually assaulted can be shattering, leaving you feeling scared, ashamed, and alone or plagued by nightmares, flashbacks, and other unpleasant memories. But no matter how bad you feel right now, it's important to remember that you weren't to blame for what happened and you can regain your sense of safety and trust. Recovering from sexual trauma takes time, and the healing process can be painful. But with the right strategies and support, you can move past the trauma, rebuild your sense of control and self-worth, and even come out the other side feeling stronger and more resilient.

The aftermath of rape and sexual trauma

Sexual violence is shockingly common in our society. According to the Centers for Disease Control and Prevention (CDC), nearly 1 in 5 women in the U.S. are raped or sexually assaulted at some point in their lives, often by someone they know and trust. In some Asian, African, and Middle Eastern countries, that figure is even higher. And sexual assault isn't limited to women; many men and boys suffer rape and sexual trauma each year.

Regardless of age or gender, the impact of sexual violence goes far beyond any physical injuries. When you've been raped, the world doesn't feel like a safe place anymore. You no longer trust others. You don't even trust yourself. You may question your judgment, your self-worth, and even your sanity. You may blame yourself for what happened or believe that you're "dirty" or "damaged goods." Relationships feel dangerous, intimacy impossible. And on top of that, like many rape survivors, you may struggle with PTSD, anxiety, and depression.

It's important to remember that what you're experiencing is a normal reaction to trauma. Your feelings of helplessness, shame, defectiveness, and self-blame are symptoms, not reality. No matter how difficult it may seem right now, with these tips and techniques, you can come to terms with what happened and learn to heal and move on with your life.

Myths and facts about rape and sexual assault

Dispelling the toxic, victim-blaming myths about sexual violence can help you start the healing process.

Myths and facts about rape and sexual assault

Myth: You can spot a rapist by the way he looks or acts.

Fact: There's no surefire way to identify a rapist. Many appear completely normal, friendly, charming, and non-threatening.

Myth: If you didn't fight back, you must not have thought it was that bad.

Fact: During a sexual assault, it's extremely common to freeze. Your brain and body shuts down in shock, making it difficult to move, speak, or think.

Myth: People who are raped "ask for it" by the way they dress or act.

Fact: Rape is a crime of opportunity. Studies show that rapists choose victims based on their vulnerability, not on how sexy they appear or how flirtatious they are.

Myth: Date rape is often a misunderstanding.

Fact: Date rapists often defend themselves by claiming the assault was a drunken mistake or miscommunication. But research shows that the vast majority of date rapists are repeat offenders. These men target vulnerable people and often ply them with alcohol in order to rape them.

Myth: It's not rape if you've had sex with the person before.

Fact: Just because you've previously consented to sex with someone doesn't give them perpetual rights to your body. If your spouse, boyfriend, or lover forces sex against your will, it's rape.

Recovering from rape or sexual trauma step 1: Open up about what happened to you

It can be extraordinarily difficult to admit that you were raped or sexually assaulted. There's a stigma attached. It can make you feel dirty and weak. You may also be afraid of how others will react. Will they judge you? Look at you differently? It seems easier to downplay what happened or keep it a secret. But when you stay silent, you deny yourself help and reinforce your victimhood.

Reach out to someone you trust. It's common to think that if you don't talk about your rape, it didn't really happen. But you can't heal when you're avoiding the truth. And hiding only adds to feelings of shame. As scary as it is to open up, it will set you free. However, it's important to be selective about who you tell, especially at first. Your best bet is someone who will be supportive, empathetic, and calm. If you don't have someone you trust, talk to a therapist or call a rape crisis hotline.

Challenge your sense of helplessness and isolation. Trauma leaves you feeling powerless and vulnerable. It's important to remind yourself that you have strengths and coping skills that can get you through tough times. One of the best ways to reclaim your sense of power is by helping others: volunteer your time, give blood, reach out to a friend in need, or donate to your favorite charity.

Consider joining a support group for other rape or sexual abuse survivors. Support groups can help you feel less isolated and alone. They also provide invaluable information on how to cope with symptoms and work towards recovery. If you can't find a support group in your area, look for an online group.

Step 2: Cope with feelings of guilt and shame

Even if you intellectually understand that you're not to blame for the rape or sexual attack, you may still struggle with a sense of guilt or shame. These feelings can surface immediately following the assault or arise years after the attack. But as you acknowledge the truth of what happened, it will be easier to fully accept that you are not responsible. You did not bring the assault on yourself and you have nothing to be ashamed about.

Feelings of guilt and shame often stem from misconceptions such as:

You didn't stop the assault from happening. After the fact, it's easy to second guess what you did or didn't do. But when you're in the midst of an assault, your brain and body are in shock. You can't think clearly. Many people say they feel "frozen." Don't judge yourself for this natural reaction to trauma. You did the best you could under extreme circumstances. If you could have stopped the assault, you would have.

You trusted someone you "shouldn't" have. One of the most difficult things to deal with following an assault by someone you know is the violation of trust. It's natural to start questioning yourself and wondering if you missed warning signs. Just remember that your attacker is the only one to blame. Don't beat yourself up for assuming that your attacker was a decent human being. Your attacker is the one who should feel guilty and ashamed, not you.

You were drunk or not cautious enough. Regardless of the circumstances, the only one who is responsible for the assault is the perpetrator. You did not ask for it or deserve what happened to you. Assign responsibility where it belongs: on the rapist.

Step 3: Prepare for flashbacks and upsetting memories

When you go through something stressful, your body temporarily goes into "fight-or-flight" mode. When the threat has passed, your body calms down. But traumatic experiences such as rape can cause your nervous system to become stuck in a state of high alert. You're hyper sensitive to the smallest of stimuli. This is the case for many rape survivors. Flashbacks, nightmares, and intrusive memories are extremely common, especially in the first few months following the assault. If your nervous system remains "stuck" in the long-term and you develop post-traumatic stress disorder (PTSD), they can last much longer.

To reduce the stress of flashbacks and upsetting memories:

Try to anticipate and prepare for triggers. Common triggers include anniversary dates; people or places associated with the rape; and certain sights, sounds, or smells. If you are aware of what triggers may cause an upsetting reaction, you'll be in a better position to understand what's happening and take steps to calm down.

Pay attention to your body's danger signals. Your body and emotions give you clues when you're starting to feel stressed and unsafe. These clues include feeling tense, holding your breath, racing thoughts, shortness of breath, hot flashes, dizziness, and nausea.

Take immediate steps to self-soothe. When you notice any of the above symptoms, it's important to quickly act to calm yourself down before they spiral out of control. One of the quickest and most effective ways to calm anxiety and panic is to slow down your breathing.

Soothe panic with this simple breathing exercise

Sit or stand comfortably with your back straight. Put one hand on your chest and the other on your stomach.

Take a slow breath in through your nose, counting to four. The hand on your stomach should rise. The hand on your chest should move very little.

Hold your breath for a count of seven.

Exhale through your mouth to a count of eight, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.

Inhale again, repeating the cycle until you feel relaxed and centered.

Tips for dealing with flashbacks

It's not always possible to prevent flashbacks. But if you find yourself losing touch with the present and feeling like the sexual assault is happening all over again, there are actions you can take.

Accept and reassure yourself that this is a flashback, not reality. The traumatic event is over and you survived. Here's a simple script that can help: "I am feeling [panicked, frightened, overwhelmed, etc.] because I am remembering the rape/sexual assault, but as I look around I can see that the assault isn't happening right now and I'm not actually in danger."

Ground yourself in the present. Grounding techniques can help you direct your attention away from the flashback and back to your present environment. For example, try tapping or touching your arms or describing your actual environment and what you see when look around-name the place where you are, the current date, and 3 things you see when you look around.

Step 4: Reconnect to your body and feelings

Since your nervous system is in a hypersensitive state following a rape or assault, you may start trying to numb yourself or avoid any associations with the trauma. But you can't selectively numb your feelings. When you shut down the unpleasant sensations, you also shut down your self-awareness and capacity for joy. You end up disconnected both emotionally and physically-existing, but not fully living.

Signs that you're avoiding and numbing in unhelpful ways:

Feeling physically shut down. You don't feel bodily sensations like you used to (you might even have trouble differentiating between pleasure and pain).

Feeling separate from your body or surroundings (you may feel like you're watching yourself or the situation you're in, rather than participating in it).

Having trouble concentrating and remembering things.

Using stimulants, risky activities, or physical pain to feel alive and counteract the empty feeling inside of you.
Compulsively using drugs or alcohol.
Escaping through fantasies, daydreams, or excessive TV, video games, etc.

Feeling detached from the world, the people in your life, and the activities you used to enjoy.

To recover after rape, you need to reconnect to your body and feelings

It's frightening to get back in touch with your body and feelings following a sexual trauma. In many ways, rape makes your body the enemy, something that's been violated and contaminated-something you may hate or want to ignore. It's also scary to face the intense feelings associated with the assault. But while the process of reconnecting may feel threatening, it's not actually dangerous. Feelings, while powerful, are not reality. They won't hurt you or drive you insane. The true danger to your physical and mental health comes from avoiding them.

Once you're back in touch with your body and feelings, you will feel more safe, confident, and powerful. You can achieve this through the following techniques:

Rhythmic movement. Rhythm can be very healing. It helps us relax and regain a sense of control over our bodies. Anything that combines rhythm and movement will work: dancing, drumming, marching. You can even incorporate it into your walking or running routine by concentrating on the back and forth movements of your arms and legs.

Mindfulness meditation. You can practice mindfulness meditation anywhere, even while you are walking or eating. Simply focus on what you're feeling in the present movement-including any bodily sensations and emotions. The goal is to observe without judgement.

Yoga, Tai Chi, and Qigong. These activities combine body awareness with relaxing, focused movement and can help relieve symptoms of PTSD and trauma.

Massage. After rape, you may feel uncomfortable with human touch. But touching and being touched is an important way we give and receive affection and comfort. You can begin to reopen yourself to human contact through massage therapy.

A powerful program for reconnecting to your feelings and physical sensations

HelpGuide's free Emotional Intelligence Toolkit can help you recover after rape by reconnecting you to uncomfortable or frightening emotions without becoming overwhelmed. You can use the toolkit in conjunction with therapy, or on its own. Over time, it can make a huge difference in your ability to manage stress, balance your moods and emotions, and take back control of your life.

Step 5: Stay connected

It's common to feel isolated and disconnected from others following a sexual assault. You may feel tempted to withdraw from social activities and your loved ones. But it's important to stay connected to life and the people who care about you. Support from other people is vital to your recovery. But remember that support doesn't mean that you always have to talk about or dwell on what happened. Having fun and laughing with people who care about you can be equally healing.

Participate in social activities, even if you don't feel like it. Do "normal" things with other people, things that have nothing to do with the sexual trauma.

Reconnect with old friends. If you've retreated from relationships that were once important to you, make the effort to reconnect.

Make new friends. If you live alone or far from family and friends, try to reach out and make new friends. Take a class or join a club to meet people with similar interests, connect to an alumni association, or reach out to neighbors or work colleagues.

Step 6: Nurture yourself

Healing from sexual trauma is a gradual, ongoing process. It doesn't happen overnight, nor do the memories of the trauma ever disappear completely. This can make life seem difficult at times. But there are many steps you can take to cope with the residual symptoms and reduce your anxiety and fear.

Take time to rest and restore your body's balance. That means taking a break when you're tired and avoiding the temptation to lose yourself by throwing yourself into activities. Avoid doing anything compulsively, including working. If you're having trouble relaxing and letting down your guard, you may benefit from relaxation techniques such as meditation and yoga.

Be smart about media consumption. Avoid watching any program that could trigger bad memories or flashbacks. This includes obvious things such as news reports about sexual violence and sexually explicit TV shows and movies. But you may also want to temporarily avoid anything that's over-stimulating, including social media.

Take care of yourself physically. It's always important to eat right, exercise regularly, and get plenty of sleep -but even more so when you're healing from trauma. Exercise in particular can soothe your traumatized nervous system, relieve stress, and help you feel more powerful and in control of your body.

Avoid alcohol and drugs. Avoid the temptation to self-medicate with alcohol or drugs. Substance use worsens many symptoms of trauma, including emotional numbing, social isolation, anger, and depression. It also interferes with treatment and can contribute to problems at home and in your relationships.

Where to turn for help

Rape and sexual assault hotlines

National Sexual Assault Hotline - In the U.S., a confidential, free 24/7 hotline for one-on-one crisis support. Call 1-800-656-HOPE or chat online. (RAINN)

Find Your Nearest Rape Crisis Services - In England and Wales, call the rape crisis helpline at 0808 802 9999 or find your nearest facility (Rape Crisis)

Services and Support - In Australia, call the national helpline at 1800 737 732 or find services near you. (1800RESPECT)

Rape Crisis Centres - In Canada, find a hotline or crisis centre near you. (Canadian Women's Health Network)

# data[].attributes.attachment_link.description
Recovering from Rape and Sexual Trauma Tips for Healing after Sexual Assault The trauma of being raped or sexually assaulted can be shattering, leaving you feeling scared, ashamed, and alone or plagued by nightmares, flashbacks, and other unpleasant memories. But no matter how bad

# data[].attributes.attachment_link.title
Sexual Misconduct | Southern Connecticut State University

# data[].attributes.attachment_link.description
Southern Connecticut State University is concerned about the safety of all University community members. Sexual harassment and sexual violence (sexual assault, domestic violence, dating violence, stalking, and sexual exploitation) are not acceptable behaviors in our community and are violations of the law, University policies and Student Code of Conduct.

# data[].attributes.attachment_link.title
How Can I Improve My Self-Esteem? (for Teens) - Nemours KidsHealth

# data[].attributes.attachment_link.description
We all have problems with self-esteem at certain times in our lives. Here are some tips that might help.

# data[].attributes.body
Video: TEDx Talk

# data[].attributes.attachment_link.title
Not fitting in, just perfect | Sheron Shamuilia | TEDxLeuven

# data[].attributes.body
Explore the meaning of love from the perspective of a teenager.

# data[].attributes.attachment_link.readable_text
MedlinePlus links to health information from the National Institutes of Health and other federal government agencies. MedlinePlus also links to health information from non-government Web sites. See our disclaimer about external links and our quality guidelines.

# data[].attributes.attachment_link.description
MedlinePlus links to health information from the National Institutes of Health and other federal government agencies. MedlinePlus also links to health information from non-government Web sites. See our disclaimer about external links and our quality guidelines.

# data[].attributes.body
Explore information about healthy vs unhealthy teen relationships.

# data[].attributes.attachment_link.title
Characteristics of Healthy & Unhealthy Relationships

# data[].attributes.attachment_link.description
Respect for both oneself and others is a key characteristic of healthy relationships. In contrast, in unhealthy relationships, one partner tries to exert control and power over the other physically, sexually, and/or emotionally. Healthy relationships share certain characteristics that teens should be taught to expect. They include: Mutual respect.

# data[].attributes.body
What happens when teenagers fall in love?

# data[].attributes.attachment_link.readable_text
The singer of a plaintive hit song from the 1950s croons 'Each night I ask the stars up above, Why must I be a teenager in love?', as he bemoans the ups and downs of his romance, one minute on top of the world, next minute in the deepest slough of despondency. Such angst!

Has anything changed? In modern pop songs, young people still sing about their crushes, unrequited loves and romantic break-ups; about feeling awkward, unsure, in despair, overwhelmed, joyous and inspired, although these days the sexual imagery is much more obvious. And it can appear that the tender feelings of first love are at odds with today's world of 'out there' sexuality. Adolescents are heavy consumers of online pornography, they are sexting, and using 'apps' to meet partners for casual sex hook-ups. They may post on Facebook about their sexual and romantic successes and failures. Research has not yet caught up with the long-term implications of these new ways of courting, but it does seem that falling in love and romantic relationships are still part of the developmental timetable for many adolescents.

Let's look at what is known. The US-based National Longitudinal Study of Adolescent Health (Add Health), involving a representative sample of thousands of school children in Grades 7 to 12, found that over 80 per cent of those aged 14 years and older were or had been in a romantic relationship, including a small number (2-3 per cent) in same-sex relationships (Carver et al., 2003; Grieger et al., 2014). Many of these relationships were short term, especially among younger adolescents, but a significant number were a year or more in duration. Evidence that these relationships were socially normative was shown by the finding that in most cases, parents had met their child's romantic partner and the couples had told others of their romantic status. There is limited data on romantic relationships in other developed countries, but existing research suggests similar percentages to the US data, although with somewhat older age groups (e.g. Moore et al., 2012).

The normative nature of adolescent romantic relationships means that those young people without a girlfriend or boyfriend can feel stressed or 'different' (Scanlan et al., 2012). Given that adolescence is a time when there is a great deal of pressure to conform to peer norms, young people who are not linking up romantically can feel lonely and out of step with their peers. For example, on the internet site girlsaskguys.com, an anonymous young woman asks: I've never had a boyfriend or girlfriend. Would you assume that there is something bad or wrong with that person that makes people not want to go out with them? I think it's because I am ugly. I am not fat however. What is wrong with me?

On a different advice site (quora.com), this young man similarly questions why he is different:
I am 21 and never had a girlfriend. Most of my friends are in a relationship. I feel kind of depressed and that I would never have a girlfriend. What should I do? I've asked a couple of girls whom I like to go out with me in the past and they declined.

Of course, not every young person is interested in romantic relationships. Some feel they are not ready, some want to concentrate on their studies or sport, others are more tempted by the casual sex culture of temporary 'hook-ups'. Nevertheless, most adolescents begin their sexual lives within the context of a romantic relationship and generally, involvement in romantic relationships in adolescence is developmentally appropriate and healthy (Collins et al., 2009).

What happens when teenagers fall in love?
Falling in love is an emotional upheaval at any age, but for adolescents the feelings are likely to be even more difficult to manage. Teenage bodies and brains are maturing at a rate not experienced since infancy. There is a growth spurt, development of secondary sex characteristics and young people change in appearance from child to adult. Physical awkwardness often results from growth asynchronies; young people can feel embarrassed and self-conscious about the sexualisation of their bodies or their perceived inadequacies in terms of often-unrealistic body ideals. As well, the adolescent brain has been described as 'a work in progress', with certain areas maturing more quickly than others, leading to potential mismatches between physical, emotional and cognitive development. For example, there can be incongruities between adult bodily appearance, increasing sex drive and the brain development required for mature decision-making and self-regulation of behaviour and emotions. The 'executive functioning' area of the brain - the prefrontal cortex - is among the last areas of the brain to fully mature, usually sometime in the twenties (Petanjek et al., 2011). Adolescence therefore becomes a time of diminished prefrontal cortical control, with the heightened possibility of risk-taking and poor judgement decisions, especially in environments described as 'reward-sensitive', where the temptations of immediate feel-good experiences are high, such as in romantic and sexual situations (Braams et al., 2015; Suleiman & Harden, 2016).

Hormonal changes, triggered by brain and body developments, are strongly implicated in the intense feelings of sexual attraction and falling in love. Testosterone and oestrogen - male and female sex hormones - are associated with heightened sexual urges, while the hormones oxytocin and vasopressin are implicated in attachment and bonding. During puberty, the volume of these circulating sex hormones in the body rises dramatically. In girls, the ovaries increase their production of oestrogen sixfold and in boys, the testes produce 20 times the amount of testosterone.

Both sexes have male and female hormones circulating in the bloodstream, but during adolescence a boy's testosterone level becomes 20 to 60 per cent higher than that of a girl, while her oestrogen level becomes 20 to 30 per cent higher than his. These hormones have strong effects on mood and libido. Young people are hormonally 'primed' toward being sexually attracted to others but, especially in early adolescence, they are not used to the feelings associated with the rapid increases and fluctuations in their hormone levels. High concentrations of certain hormones for one's age, or rapid fluctuations of hormone levels may trigger more negative moods and greater mood variability (Buchanan et al., 1992). Emotions associated with being 'in love' or 'in lust' are likely to be confused and confusing, even overwhelming for some (Temple-Smith et al., 2016).

It's not only the sex hormones that are involved in falling in love. Ortigue and his colleagues (2010) used brain imaging to show that when a person falls in love, 12 areas of the brain work in tandem to release euphoria-inducing chemicals such as dopamine, adrenaline and serotonin. Adrenaline is a stress hormone, causing sweating, heart palpitations and dry mouth - just catching a glimpse of the new love can trigger these bodily sensations. Dopamine stimulates desire and pleasurable feelings, and has been described as a 'feel good' hormone with similar effects to the drug cocaine. Fisher et al. (2006) found heightened levels of dopamine in the brains of couples newly in love. Further, Marazziti and Canale (2004) examined levels of serotonin in the bloodstreams of couples in love and people with obsessive-compulsive disorders. Their finding that levels were similarly heightened in the two groups led these researchers to conclude that serotonin level is associated with those constant thoughts about the loved one that are part of being 'love struck'.

In another illustration of how some of these effects are manifest, a study by Brand and colleagues (2007) compared newly 'in love' adolescents with a control group who were unpartnered. The 'in love' group scored higher than the controls on hypomania, a mood state (with accompanying thoughts and behaviours) in which emotions are more labile: euphoric one minute, in despair the next. The diary entries of the adolescent love birds showed they had more positive morning and evening moods than the controls, shorter sleep times but better quality sleep, lowered daytime sleepiness and better concentration during the day.

Falling in love takes some getting used to, all those different emotions, mood swings, needs and desires. Nevertheless, through their romantic relationships, adolescents have the potential for psychological growth as they learn about themselves and other people, gain experience in how to manage these feelings and develop the skills of intimacy. They also face new risks and challenges. These positive and negative aspects of adolescent romantic relationships are discussed below.

Psychosocial development
Lifespan developmental theorist Erik Erikson (1968) viewed crushes and youthful romances as important contributors to adolescent self-understanding and identity formation. He described teenage 'falling in love' as a form of self-development rather than true intimacy. Adolescents, becoming more self-aware as their cognitive powers develop, can try out their 'grown-up' identities with romantic partners and through feedback from the partners' responses and behaviours, gradually clarify self-image. The endless talking (and now texting) that often accompanies teen romances is a way of experimenting with different forms of 'self' and testing their effect on the other person.

As well as aiding identity development, adolescent romantic relationships - both short term and longer term - can provide positive learning experiences about the self, for example through influencing self-esteem and beliefs about attractiveness and self-worth, and raising status in the peer group (Zimmer-Gembeck et al., 2001; 2004). They can assist young people in renegotiating and developing more mature and less emotionally dependent relationships with their parents, as a precursor for independent living. When there is good will and warmth between the partners, romantic relationships offer a safe environment for learning about and experimenting with sexuality and sexual orientation (Collins et al., 2009). Teenage romantic relationships are, in a sense, a training ground for adult intimacy, providing an opportunity for learning to manage strong emotions, to negotiate conflict, to communicate needs and to respond to a partner's needs (Scanlan et al., 2012).

Challenges and problems
On the downside, romantic relationships can sometimes lead to unhealthy outcomes. Young people can become too exclusive when they pair up, cutting themselves off from friendship and support networks in ways that do not advance optimal development. Identity formation may be compromised if a teenager closes off developmental options through a partnership in which unhealthy living choices are made, or through early, unplanned parenthood.

Adolescents can be exposed to abusive and violent interactions or unwanted or coerced sexual activity within their romantic relationships (Mulford & Giordano, 2008). Aggression between romantic partners is common, with boys as likely to report abuse behaviour as girls. Collins et al.'s (2009) review indicates that, depending on the sample surveyed, 10 to 48 per cent of adolescents experience physical aggression and 25 to 50 per cent report psychological aggression from their romantic partner, including being sworn at, insulted and threatened. These days, aggression and bullying also occur online, for example, vengeful ex-partners have been known to share private photos or information on social media, causing embarrassment, humiliation or worse to the victim. Some teens appear to be more accepting of these situations than is healthy, for example interpreting jealousy and overly possessive behaviours as reflections of love.

Sexual coercion within romantic relationships is relatively common. A national survey of over 2000 Australian secondary students in Years 10, 11 and 12 found that among those who were sexually active, one-quarter had experienced unwanted sex (Mitchell et al., 2014). Reasons given for having sex when they did not want to included being too drunk to say no (49 per cent), frightened (28 per cent) or pressured by their partner (53 per cent). A US study of over 750 female students found almost 50 per cent had had at least one experience of unwanted sex, 70 per cent as part of a casual 'hook-up', and 57 per cent in a committed romantic relationship (Garcia et al., 2012). Regretted sex is also not an uncommon phenomenon among teenagers (e.g. Skinner et al., 2008).

Other challenges facing young people seeking or participating in romantic relationships include unrequited love and breaking up. In the case of unrequited love, fantasies about the other can be intense and obsessional, sometimes leading to misinterpretations that the feelings are reciprocated. In extreme cases this may result in maladjusted acting-out behaviours, such as aggression and stalking (Leitz & Theriot, 2005), but more commonly the distress is turned inwards, contributing to depression and low self-esteem, sometimes with the risk of self-harm.

Break-ups are a very common feature of adolescent romantic relationships, some of which last only a few weeks. Among a large sample of young people in their early twenties in Australia and Hong Kong, 80 per cent had experienced a break-up (Moore et al., 2012). The impact of splitting up may not be particularly severe or long-lasting, especially in the case of short-term liaisons. Nevertheless, some teenagers are more vulnerable than others. Several studies have shown romantic break-ups associated with depression, particularly among those who have already experienced mood disorders (Davila, 2008; Welsh et al., 2003). In our 2012 study, 40 per cent of participants felt very hurt following their relationship break-up, even though the majority of these dissolutions were self- or mutually initiated. Break-ups were more distressing if they were partner-initiated, and among adolescents with more 'clingy' relationship styles and greater tendencies toward negative mood.

Usually, time heals and experience teaches. Connolly and McIsaac (2009) researched break-ups among Canadian adolescents and found that the most common reasons given for ending a relationship related to unmet affiliation, intimacy, sexual or interdependence needs. In other words, young people were 'moving on' when their relationships were not fulfilling, and in the process, hopefully, were learning more about themselves and others. Over time, and through talking with others, including parents, peers and partners, adolescents can develop cognitive frameworks for better understanding the nature of intimate relationships and learn to cope with their ups and downs. One example comes from a study by Montgomery (2005) of nearly 500 young people aged 12 to 24 years, in which it was shown that older adolescents were less prone to romantic idealisation than younger ones. They were more realistic in their expectations of a romantic partner, so less liable to be disappointed. With experience, if all goes well, love becomes a little less blind.

Protective factors
With age and maturity come more realistic expectations and, hopefully, stronger capacities to make discerning partner choices, communicate and negotiate with partners and recover from relationship set backs and break ups. 'Hopefully' is the operative word here, because we know that people of any age can be undone by their heartbreaks and poor romantic choices. Nevertheless there are some protective factors likely to assist young people to negotiate first romantic relationships and survive break-ups.

Early sex education is important, ideally emanating from the home and supported by the school curriculum. It's a bit late for 'the talk' on the eve of a young person's first date. Education that goes beyond the mechanics of sex and emphasises mutual respect, decision-making and the meaning of consent should help young people to resist relationship bullying and sexual coercion. School and community-based programmes that focus on teaching the characteristics of healthy romantic relationships, recognising gender-based stereotypes, improving conflict-management and communication skills, and decreasing acceptance of partner violence can effectively reduce dating violence in adolescent relationships (Foshee et al., 1998). In addition, parental modelling of respectful interrelationships sets a pattern for young people to aim for in their own interactions.

Family and peer discussions that normalise teenage romantic relations - and breaking up - also help young people to frame their expectations and experiences in context. Some teenagers may need extra encouragement to maintain links with their friends and peer group, and to keep up their sports and hobbies when they are in the throes of an intense romance. But it is important that they do maintain these support links in order to help them resist the kinds of relationships that are too interdependent and have an obsessional quality. When this kind of relationship breaks up, there is a greater risk of distress and depression. Maintaining links with friends provides a distraction from troubles and a sounding board for adolescents to discuss their romantic successes, failures and hopes.

In today's world, cyber safety is a key issue for all of us, but especially young people. Education about topics such as the potential dangers of sexting, online sexual predators and the distortion of romantic relationships depicted on pornography sites is essential for adolescents. Parental monitoring of online activity, especially among children and younger teenagers, may be advisable, and this requires that parents too become educated in new media - savvy about Facebook, Instagram, Tinder and the like. While adolescents need their privacy, it is important for parents to be watchful for warning signs of obsessive and secretive internet use. The heady emotions of falling in love can lead teenagers into unwise activity; the problem with the internet is that sexts and social media posts can come back to haunt them well after a relationship is over.

In summary, adolescent romantic relationships - with all their ups and downs - have the capacity to be growth-promoting, confidence-boosting and healthy experiences that teach young people about the give and take of intimacy. They also provide traps for young players. And while we cannot (and should not) shield the adolescents in our care from all the hurts and disappointments that life throws up, there are protective factors that limit the likelihood of serious harm from toxic partnerships or distressing break-ups. Watchful, kindly and respectful parenting, strong friendship networks and relationship-oriented sex education can all play their part in helping adolescents enjoy their romantic adventures and learn from them.

Meet the author
'It's a long time since my own adolescence, but like so many people I will never forget the heady emotions of first love, the embarrassing things I did and the mistakes I made. The world has changed greatly since "my time", but from over 40 years of research into the adolescent experience (as well as being a mother, step-mother and grandmother to adolescents) I can see that much remains the same. There is more freedom and tolerance of youthful romantic and sexual experimentation, but the risks of poor decision-making persist. Some of these are new, like being the victim of a sexual predator or experiencing "revenge porn" on the internet. Some are as old as history, like regretted sex or unplanned pregnancy. Parents, teachers and counsellors of young people can offer more effective support if they become familiar with the latest research on adolescent romance, including the role of brain development, social attitudes, and online culture. In a recent book, Sexuality in Adolescence: The Digital Generation (2016, Taylor & Francis) my co-authors and I examine these issues in detail."
Susan Moore References
is Emeritus Professor of Psychology at Swinburne University of Technology in Melbourne, Australia

Braams, B.R., van Duijvenvoorde, A.C.K., Peper, J.S. & Crone, E.A. (2015). Longitudinal changes in adolescent risk-taking. Journal of Neuroscience, 35, 7226-7238.
Brand, S., Luethi, M., von Planta, A. et al. (2007). Romantic love, hypomania, and sleep pattern in adolescents. Journal of Adolescent Health, 41(1), 69-76.
Buchanan, C.M., Eccles, J.S. & Becker, J.B. (1992). Are adolescents the victims of raging hormones: Evidence for activational effects of hormones on moods and behavior at adolescence. Psychological Bulletin, 111(1), 62-107.
Carver, K., Joyner, K. & Udry, J.R. (2003). National estimates of adolescent romantic relationships. In P. Florsheim (Ed.) Adolescent romantic relations and sexual behavior: Theory, research and practical implications (pp.23-56). Mahwah, NJ: Lawrence Erlbaum Associates.
Collins, W.A., Welsh, D.P. & Furman, W. (2009). Adolescent romantic relationships. Annual Review of Psychology, 60, 631.
Connolly, J. & McIsaac, C. (2009). Adolescents' explanations for romantic dissolutions: A developmental perspective. Journal of Adolescence, 32(5), 1209-1223.
Davila, J. (2008). Depressive symptoms and adolescent romance. Child Development and Personality, 2(1), 26-31.
Erikson, E. (1968). Identity, youth and crisis. New York: Norton.
Fisher, H.E., Aron, A. & Brown, L.L. (2006). Romantic love: A mammalian brain system for mate choice. Philosophical Transactions of the Royal Society B: Biological Sciences, 361 (1476), 2173-2186.
Foshee, V.A., Bauman, K.E., Arriaga, X.B. et al. (1998). An evaluation of safe dates, an adolescent dating violence prevention program. American Journal of Public Health, 88(1), 45-50.
Garcia, J.R., Reiber, C., Massey, S. & Merriwether, A. (2012). Sexual hookup culture: A review. Review of General Psychology, 16(2), 161-176.
Grieger, L.D., Kusunoki, Y. & Harding, D.J. (2014). The social contexts of adolescent romantic relationships. Focus, 31(1), 15-17.
Leitz, M.A. & Theriot, M.T. (2005). Adolescent stalking: A review. Journal of Evidence-Based Social Work, 2(3), 97-112.
Marazziti, D. & Canale, D. (2004). Hormonal changes when falling in love. Psychoneuroendocrinology 29, 931-936.
Mitchell, A., Patrick, K., Heywood, W. et al. (2014). Fifth National Survey of Australian Secondary Students and Sexual Health 2013. ARCSHS Monograph Series No. 97. Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.
Montgomery, M.J. (2005). Psychosocial intimacy and identity: From early adolescence to emerging adulthood. Journal of Adolescent Research, 20(3), 346-374.
Moore, S., Leung, C., Karnilowicz, W. & Lung, C.L. (2012). Characteristics and predictors of romantic relationships in late adolescence and young adulthood in Hong Kong and Australia. Australian Psychologist, 47(2), 108-117. dating violence: A closer look at adolescent romantic relationships. National Institute of Justice Journal, No. 261, pp.34-40. Available via www.nij.gov/journals/261
Ortigue, S., Bianchi-Demicheli, F., Patel, N. et al. (2010). Neuroimaging of love: fMRI meta-analysis evidence toward new perspectives in sexual medicine. Journal of Sexual Medicine, 7, 3541-3552.
Petanjek, Z., Judaš, M., Šimić, G. et al. (2011). Extraordinary neoteny of synaptic spines in the human prefrontal cortex. Proceedings of the National Academy of Sciences of the United States of America, 108(32), 13281-13286.
Scanlan, F., Bailey, A. & Parker, A. (2012). Adolescent romantic relationships - Why are they important? And should they be encouraged or avoided? Headspace, Orygen Youth Health Research Centre: Australian Government Department of Health and Ageing. Retrieved 6 February, 2016 from tinyurl.com/h6s6prg.
Skinner, S.R., Smith, J., Fenwick, J. et al. (2008). Perceptions and experiences of first sexual intercourse in Australian adolescent females. Journal of Adolescent Health, 43(6), 593-599.
Suleiman, A.B. & Harden, K.P. (2016). The importance of sexual and romantic development in understanding the developmental neuroscience of adolescence. Developmental Cognitive Neuroscience, 7, 145-147.
Temple-Smith, M., Moore, S. & Rosenthal, D. (2016). Sexuality in adolescence: The digital generation. London: Routledge.
Welsh, D.P., Grello, C.P. & Harper, M.S. (2003). When love hurts: Depression and adolescent romantic relationships. In P. Florsheim (Ed.) Adolescent romantic relations and sexual behavior: Theory, research and practical implications (pp.185-212). Mahwah, NJ: Lawrence Erlbaum Associates.
Zimmer-Gembeck, M.J., Siebenbruner, J. & Collins, W.A. (2001). Diverse aspects of dating: Associations with psychosocial functioning from early to middle adolescence. Journal of Adolescence, 24(3), 313-336.
Zimmer-Gembeck, M., Siebenbruner, J. & Collins, W.A. (2004). A prospective study of intraindividual and peer influences on adolescents' heterosexual romantic and sexual behavior. Archives of Sexual Behavior, 33(4), 381-394.

# data[].attributes.attachment_link.description
The singer of a plaintive hit song from the 1950s croons 'Each night I ask the stars up above, Why must I be a teenager in love?', as he bemoans the ups and downs of his romance, one minute on top of the world, next minute in the deepest slough of despondency.

# data[].attributes.body
What is depression? How does impact teenagers? What are the signs?

# data[].attributes.attachment_link.readable_text
Introduction

Being a teenager can be tough. There are changes taking place in your body and brain that can affect how you learn, think, and behave. And if you are facing tough or stressful situations, it is normal to have emotional ups and downs.

But if you have been overwhelmingly sad for a long time (a few weeks to months) and you're not able to concentrate or do the things you usually enjoy, you may want to talk to a trusted adult about depression.

What Is Depression?

Depression (major depressive disorder) is a medical illness that can interfere with your ability to handle your daily activities, such as sleeping, eating, or managing your school work. Depression is common but that doesn't mean it isn't serious. Treatment may be needed for someone to feel better. Depression can happen at any age, but often symptoms begin in the teens or early 20s or 30s. It can occur along with other mental disorders, substance abuse, and other health conditions.

Why can't you just 'snap out' of depression?

Well-meaning friends or family members may try to tell someone with depression to "snap out of it," "just be positive," or "you can be happier if you just try harder." But depression is not a sign of weakness or a character flaw. Most people with depression need treatment to get better.

What Are the Signs and Symptoms of Depression?

Sadness is something we all experience. It is a normal reaction to a loss or a setback, but it usually passes with a little time. Depression is different.

If you are wondering if you may have depression, ask yourself these questions:

Do you constantly feel sad, anxious, or even "empty," like you feel nothing?

Do you feel hopeless or like everything is going wrong?

Do you feel like you're worthless or helpless? Do you feel guilty about things?

Do you feel irritable much of the time?

Do you find yourself spending more time alone and withdrawing from friends and family?

Are your grades dropping?

Have you lost interest or pleasure in activities and hobbies that you used to enjoy?

Have your eating or sleeping habits changed (eating or sleeping more than usual or less than usual)?

Do you always feel tired? Like you have less energy than normal or no energy at all?

Do you feel restless or have trouble sitting still?

Do you feel like you have trouble concentrating, remembering information, or making decisions?

Do you have aches or pains, headaches, cramps, or stomach problems without a clear cause?

Do you ever think about dying or suicide? Have you ever tried to harm yourself?

What Should I Do If I am Considering Suicide or Harming Myself?
If you are in crisis and need help, call this toll-free number for the National Suicide Prevention Lifeline (NSPL), available 24 hours a day, every day: 1-800-273-TALK (8255). The service is available to everyone. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. All calls are confidential. You can also visit the Lifeline's website at www.suicidepreventionlifeline.org.

The Crisis Text Line is another free, confidential resource available 24 hours a day, seven days a week. Text "HOME" to 741741 and a trained crisis counselor will respond to you with support and information over text message. Visit www.crisistextline.org.

Not everyone with depression experiences every symptom. Some people experience only a few symptoms. Others may have many. The symptoms and how long they last will vary from person to person.

How Do I Get Help?

If you think you might have depression, you are not alone. Depression is common, but it is also treatable. Ask for help! Here are a few steps you can take:

Step 1: Try talking to a trusted adult, such as your parent or guardian, your teacher, or a school counselor. If you don't feel comfortable speaking to an adult, try talking to a friend. If you are not sure where to turn, you can use TXT 4 HELP Interactive (www.nationalsafeplace.org/txt-4-help), which allows you to text live with a mental health professional. For more ideas and a list of health hotlines, visit https://www.nimh.nih.gov/ (search words: children and adolescents).

Step 2: If you're under the age of 18, ask your parent or guardian to make an appointment with your doctor for an evaluation. Your doctor can make sure you don't have a physical illness that may be affecting your mental health. Your doctor may also talk to you about the possibility of seeing a mental health professional, such as a psychiatrist, counselor, psychologist, or therapist. These practitioners can diagnose and treat depression and other mental disorders.

How is Depression Treated?

Depression is usually treated with psychotherapy, medication, or a combination of the two.

What is psychotherapy?

Psychotherapy (sometimes called "talk therapy") is a term for treatment techniques that can help you identify and manage troubling emotions, thoughts, and behavior. Psychotherapy can take place in a one-on-one meeting with you and a licensed mental health professional. Sometimes you might be part of a group guided by a mental health professional.

Read more about psychotherapy at www.nimh.nih.gov/health/topics/psychotherapies.

What medications treat depression?

If your doctor thinks you need medicine to treat your depression, he or she might prescribe an antidepressant.

When you are taking an antidepressant, it is important to carefully follow your doctor's directions for taking your medicine. The medication could take up to six weeks to work and you should not stop taking it without the help of a doctor. You should also avoid using alcohol or drugs that have not been prescribed to you so that your medications can work.

When it is time to stop the medication, the doctor will help you slowly and safely decrease the dose so that your body can adjust. If you stop taking the medication too soon, your depression symptoms may return. Another reason to stop medication gradually is that stopping suddenly can cause withdrawal symptoms like anxiety and irritability.

Antidepressants can have side effects. These side effects are usually mild (possible stomach upsets or headaches) and may go away on their own. But talk to your doctor about any side effects that you experience because your doctor might adjust the dose or change the medicine. For more information about side effects, visit www.fda.gov.

Although antidepressants can be effective, they may present serious risks to some, especially children and teens. Anyone taking antidepressants should be monitored closely, especially when they first start taking them. Severe anxiety or agitation early in treatment can be especially distressing and should be reported to the doctor immediately.

For many people, the risks of untreated depression outweigh the side effects of antidepressant medications when they are used under a doctor's careful supervision. Information about medications changes frequently. Talk to your doctor and visit the U.S. Food and Drug Administration (FDA) website ( www.fda.gov) for the latest safety information.

What else can I do to help manage my depression?

Be patient and know that treatment takes time to work. In the meantime, you can:

Stay active and exercise, even if it's just going for a walk.

Try to keep a regular sleep schedule.

Spend time with friends and family.

Break down school or work tasks into smaller ones and organize them in order of what needs to get done first. Then, do what you can.

What Can I Do If Someone I Know Might Have Depression?

If you think your friend might have depression, first help him or her talk to a trusted adult who can connect your friend to a health professional. You can also:

Be supportive, patient, and encouraging, even if you don't fully understand what's going on.

Invite your friend to activities, social events, or just to hang out.

Remind your friend that getting help is important and that with time and treatment, he or she will feel better.

Never ignore comments about death and suicide, even if it seems like a joke or overdramatic. Talking about suicide is not just a bid for attention but should be taken seriously. Talk to a trusted adult such as a parent, teacher or older sibling as soon as you can.

What Should I Do If Someone I Know Is Considering Suicide?

Often, family and friends are the first to recognize the warning signs of suicide and can take the first step toward helping the person find help.
Remember:

If someone is telling you that he or she is going to kill himself or herself, do not leave him or her alone.

Do not promise anyone that you will keep his or her suicidal thoughts a secret. Make sure to tell a trusted friend or family member, or an adult with whom you feel comfortable.

Get help as soon as possible. Call 911 for emergency services and/or take the person to the nearest hospital emergency room.

You can also call 1-800-273-TALK (8255), the toll-free number for the National Suicide Prevention Lifeline (NSPL), which is available 24 hours a day, every day. The service is available to everyone. All calls are free and confidential. You can also chat with the NSPL online ( http://www.suicidepreventionlifeline.org).

The Crisis Text Line is another free, confidential resource available 24 hours a day, seven days a week. Text "HOME" to 741741 and a trained crisis counselor will respond to you with support and information via text message. Visit https://www.crisistextline.org.

What if someone is posting suicidal messages or something disturbing on social media?

If you see messages or live streaming suicidal behavior on social media, call 911 immediately, contact the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text the Crisis Text Line (text HOME to 741741).

Some social media sites also have a process to report suicidal content and get help for the person posting the message. Each offers different options on how to respond if you see concerning posts about suicide. For example:

Facebook Suicide Prevention webpage can be found at www.facebook.com/help/594991777257121/ [use the search term "suicide" or "suicide prevention"].

Instagram uses automated tools in the app to provide resources, which can also be found online at https://help.instagram.com [use the search term, "suicide," self-injury," or "suicide prevention"].

Snapchat's Support provides guidance at https://support.snapchat.com [use the search term, "suicide" or "suicide prevention"].

Tumblr Counseling and Prevention Resources webpage can be found at https://tumblr.zendesk.com [use the search term "counseling" or "prevention," then click on "Counseling and prevention resources"].

Twitter's Best Practices in Dealing With Self-Harm and Suicide at https://support.twitter.com [use the search term "suicide," "self-harm," or "suicide prevention"].

YouTube's Safety Center webpage can be found at https://support.google.com/youtube [use the search term "suicide and self-injury"].

Because help via these processes may be delayed, it is still important to call 911 if someone is posting suicidal messages or something disturbing on social media. People-even strangers-have saved lives by being vigilant.

For More Information

For more information on depression and suicide prevention, visit the National Institute of Mental Health (NIMH) website ( www.nimh.nih.gov).

Related Resources:

Reprints

This publication is in the public domain and may be reproduced or copied without permission from NIMH. Citation of NIMH as a source is appreciated. We encourage you to reproduce it and use it in your efforts to improve public health. However, using government materials inappropriately can raise legal or ethical concerns, so we ask you to use these guidelines:

NIMH does not endorse or recommend any commercial products, processes, or services, and our publications may not be used for advertising or endorsement purposes.

NIMH does not provide specific medical advice or treatment recommendations or referrals; our materials may not be used in a manner that has the appearance of providing such information.

NIMH requests that non-Federal organizations not alter our publications in ways that will jeopardize the integrity and "brand" when using the publication.

The addition of non-Federal Government logos and website links may not have the appearance of NIMH endorsement of any specific commercial products or services, or medical treatments or services.

Images used in publications are of models and are used for illustrative purposes only. Use of some images is restricted.

If you have questions regarding these guidelines and use of NIMH publications, please contact the NIMH Information Resource Center at 1-866-615-6464 or e-mail at nimhinfo@nih.gov.

National Institute of Mental Health
Office of Science Policy, Planning, and Communications
Science Writing, Press, and Dissemination Branch
6001 Executive Boulevard
Room 6200, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or
Toll-free: 1-866-615-NIMH (6464)
TTY Toll-free: 1-866-415-8051
Fax: 301-443-4279
E-mail: nimhinfo@nih.gov
Website: www.nimh.nih.gov
U.S. Department of Health and Human Services
National Institutes of Health
NIH Publication No. 20-MH-8089

# data[].attributes.attachment_link.description
Being a teenager can be tough. There are changes taking place in your body and brain that can affect how you learn, think, and behave. And if you are facing tough or stressful situations, it is normal to have emotional ups and downs.

# data[].attributes.body
What is bullying? Who is at risk? What are the effects of bullying?

# data[].attributes.attachment_link.readable_text
Bullying is unwanted, aggressive behavior among school aged children that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time. Both kids who are bullied and who bully others may have serious, lasting problems.

In order to be considered bullying, the behavior must be aggressive and include:

An Imbalance of Power: Kids who bully use their power-such as physical strength, access to embarrassing information, or popularity-to control or harm others. Power imbalances can change over time and in different situations, even if they involve the same people.

Repetition: Bullying behaviors happen more than once or have the potential to happen more than once.

Bullying includes actions such as making threats, spreading rumors, attacking someone physically or verbally, and excluding someone from a group on purpose.

Types of Bullying

There are three types of bullying:

Verbal bullying is saying or writing mean things. Verbal bullying includes:

Teasing

Name-calling

Inappropriate sexual comments

Taunting

Threatening to cause harm

Social bullying, sometimes referred to as relational bullying, involves hurting someone's reputation or relationships. Social bullying includes:

Leaving someone out on purpose

Telling other children not to be friends with someone

Spreading rumors about someone

Embarrassing someone in public

Physical bullying involves hurting a person's body or possessions. Physical bullying includes:

Hitting/kicking/pinching

Spitting

Tripping/pushing

Taking or breaking someone's things

Making mean or rude hand gestures

Where and When Bullying Happens

Bullying can occur during or after school hours. While most reported bullying happens in the school building, a significant percentage also happens in places like on the playground or the bus. It can also happen travelling to or from school, in the youth's neighborhood, or on the Internet.

Frequency of Bullying

There are two sources of federally collected data on youth bullying:

The 2017 School Crime Supplement to the National Crime Victimization Survey (National Center for Education Statistics and Bureau of Justice) indicates that, nationwide, about 20% of students ages 12-18 experienced bullying.

The 2019 Youth Risk Behavior Surveillance System (Centers for Disease Control and Prevention) indicates that, nationwide, 19.5% of students in grades 9-12 report being bullied on school property in the 12 months preceding the survey.

See also " Frequency of Cyberbullying."

# data[].attributes.attachment_link.description
Bullying is unwanted, aggressive behavior among school aged children that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time.

# data[].attributes.attachment_link.provider_name
National Sexual Violence Resource Center

# data[].attributes.attachment_link.description
Learn more on our Questions and Answers page.

# data[].attributes.body
Information about teenage suicide.

# data[].attributes.attachment_link.readable_text
Suicide in Children and Teens

No. 10; Updated October 2017

Suicides among young people continue to be a serious problem. Suicide is the second leading cause of death for children, adolescents, and young adults age 5-to-24-year-olds.

The majority of children and adolescents who attempt suicide have a significant mental health disorder, usually depression.

Among younger children, suicide attempts are often impulsive. They may be associated with feelings of sadness, confusion, anger, or problems with attention and hyperactivity.

Among teenagers, suicide attempts may be associated with feelings of stress, self-doubt, pressure to succeed, financial uncertainty, disappointment, and loss. For some teens, suicide may appear to be a solution to their problems.

Depression and suicidal feelings are treatable mental disorders. The child or adolescent needs to have his or her illness recognized and diagnosed, and appropriately treated with a comprehensive treatment plan.

Thoughts about suicide and suicide attempts are often associated with depression. In addition to depression, other risk factors include:

family history of suicide attempts

exposure to violence

impulsivity

aggressive or disruptive behavior

access to firearms

bullying

feelings of hopelessness or helplessness

acute loss or rejection

Children and adolescents thinking about suicide may make openly suicidal statements or comments such as, "I wish I was dead," or "I won't be a problem for you much longer." Other warning signs associated with suicide can include:

changes in eating or sleeping habits

frequent or pervasive sadness

withdrawal from friends, family, and regular activities

frequent complaints about physical symptoms often related to emotions, such as stomachaches, headaches, fatigue, etc.

decline in the quality of schoolwork

preoccupation with death and dying

Young people who are thinking about suicide may also stop planning for or talking about the future. They may begin to give away important possessions.

People often feel uncomfortable talking about suicide. However, asking your child or adolescent whether he or she is depressed or thinking about suicide can be helpful. Specific examples of such questions include:

Are you feeling sad or depressed?

Are you thinking about hurting or killing yourself?

Have you ever thought about hurting or killing yourself?

Rather than putting thoughts in your child's head, these questions can provide assurance that somebody cares and will give your child the chance to talk about problems.

Parents, teachers, and friends should always err on the side of caution and safety. Any child or adolescent with suicidal thoughts or plans should be evaluated immediately by a trained and qualified mental health professional.

# data[].attributes.attachment_link.description
Suicide in Children and Teens No. 10; Updated October 2017 Suicides among young people continue to be a serious problem. Suicide is the second leading cause of death for children, adolescents, and young adults age 5-to-24-year-olds. The majority of children and adolescents who attempt suicide have a significant mental health disorder, usually depression.