I spoke with Nishtha Juneja at Teen Talk India on reasons why someone might feel suicidal and how to manage suicidal thoughts.

Could you share an experience of a teenager who has experienced suicidal thoughts?
I have had many cases where teens drop out of college or return to India if studying abroad due to the academic pressure and competition:

They cannot cope with the academic stress
They face tremendous peer pressure; the issue of not “fitting in”
They realise that their chosen field of study is not for them
There can be many more reasons why teens decide to leave college. But when they do, they feel ashamed for coming back. This can lead to anxiety and depression. Some symptoms to watch out for:

They face difficulty in getting out of bed.
Have little or no interest in normal activities such as going out with friends.
Erratic eating schedule.
Depression and anxiety are reasons why a teen might feel suicidal.

What are the symptoms of depression?
1. It starts slowly. A negative thought pattern takes root in the mind where gloomy thoughts persist. A teen can become negative about the past, present and the future.
2. Restlessness and agitation.
3. Sleeping too little or for too many hours.
4. No hunger pangs or over-eating. Teens become irritable.
5. These symptoms do not abate on their own; rather become worse.

What are the symptoms of anxiety?
1. Mild pangs of fear, it can manifest in several ways. One might be that they do not want to write exams or do not want to meet a friend.
2. Panic attacks, clammy/sweaty hands. For example, “I do not want to approach situations, they start avoiding new situations.”
3. Problems with sleep.
4. Nausea and frequent headaches.
5. These persist for a pro-longed period of time.

How do you help teenagers cope with suicidal thoughts?
1. Diagnose the problem: Talk to the teenager and understand the depth of depression or anxiety.
2. Tests: Several tests including blood tests.
3. Psychiatrist: If the teen has not eaten for days, lost a lot of weight or is crying continuously, then I refer them to a psychiatrist.
4. Therapy: This involves scheduling activities in an attempt to change their lifestyle.
5. Thinking patterns: The mind is the one who keeps depression where it is. Working with those negative thoughts is the key. The premise is that you can eliminate negative thoughts. The brain can balance out negative and positive data. However in a depressed person, the mind only retains negative thoughts and rejects positive aspects.

I try to make the negative thinking rational. Eg: I did not score 95 per cent and did not meet my expectations, but I did score 80 per cent and topped in English. I try to help them to view positive data.

Are there any side-effects of anti-depressants?
The benefits far outweigh the side-effects. Medicines cannot become addictive. You do not pop a pill and get instant gratification. It takes 4-6 weeks for anti-depressants to settle in the system. Addictive things give you immediate results. Antidepressants enter the blood stream and take time. Also, nobody gives medicine without prescription.

How can parents help their kids who are depressed?
Parents who are very educated also sometimes cannot understand what their kids are going through. A common response from parents is “padai pe dhyan nahi de raho hai, isliye yeh ho raha hai.” Parents can help their kids by being more compassionate and accepting of the fact that depression and anxiety are real problems that need professional help.

How can we combat the stigma surrounding mental health?
Awareness and education are the two ways to combat the stigma surrounding mental health. Teenagers are reading stuff on the internet that makes no sense. Teentalk India is one website that covers all issues and gives well-researched content.

This interview originally appeared in Teen Talk India.