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Teens: Are you worried about a friend? Start with asking, ‘Are you OK?’

Crystal Graham
teen sad at Christmas
(© lelia_milaya – stock.adobe.com)

The topic of suicide and mental health seems to grip headlines today as more people are open to talking about depression, anxiety and other disorders.

Last week, a U.S. senator’s teenage daughter was hospitalized for reported self-inflicted wounds.

And TV series and movies often depict suicide or mental health struggles in shows like “13 Reasons Why,” “A Million Little Things” and “Suicide Club,” to name a few.

Celebrities and athletes including Demi Lovato, Serena Williams, Meghan Markle, Katy Perry, Selena Gomez and Naomi Osaka have opened up about their own mental health and helped to spread the message to teens and young adults that it’s OK to talk about your struggles, and it’s a sign of strength to get help.

For teens, the most common disorders are anxiety disorder and depression. One in three teens meet the criteria for anxiety order by the time they turn 18.

For a topic that is written about frequently, getting teens to talk about depression and mental health, still seems to be difficult.

However, for teens worried about a friend, loved one or even themselves, or adults worried about their children or teens, this explainer might be helpful.

Reaching out

Teens who are struggling are most likely to reach out to a friend if they need to vent about something in their life. It’s no different if a friend is having thoughts of suicide.

Some of the reasons teens don’t reach out to their parents is because they see their parents or other adults as being preoccupied or they may think that their parents don’t understand what they are going through.

While suicide and depression are heavy subjects, teens who listen to their friends and act appropriately could help save a life.


It can be challenging to start a conversation with a friend who may be struggling. But it’s important that they know they are not alone.

You could start by simply asking: “Are you OK?”

Here are some tips for you if you want to start a conversation with a friend:

  • Ask how you can help
  • Listen without judgement
  • Ask open-ended questions that require more than a “yes” or “no” reply
  • Support their feelings and offer support
  • Summarize their words to show you are listening
  • Don’t dismiss what they are saying
  • Don’t gossip: If a friend confides in you, don’t share with other friends. It is OK to ask an adult for help

Warning signs

If your friend needs help, it’s usually not as simple as them saying they need help – or holding up a sign asking for help.

It’s normal for everyone to feel sad, depressed, stressed or angry at times. There’s a lot of pressure on teens with school, work, family life, relationships, etc.

But when that feeling of sadness or hopelessness doesn’t go away, it might be time to have a conversation with your friend.

It’s rare for someone to die by suicide and not have shown warning signs first. By recognizing warning signs and getting help, you could save a life.

Warning signs may include:

  • Talking or writing about suicide or death
  • Looking online for ways to kill oneself; buying items to use in suicide attempt
  • Talking about feeling hopeless or having no reason to live
  • Acting recklessly: Alcohol, drugs, driving too fast
  • Anger
  • Low energy
  • Withdrawing from others, or activities
  • Cutting/self injury
  • Giving away possessions
  • Negative or critical self talk
  • Aches, pains or stomach issues


As a suicide prevention advocate and former state director of a national suicide prevention nonprofit, I get a lot of questions related to teens and young adults who self harm.

Often times, cutting is a way for someone to deal with strong emotions, pressure or relationship problems. When emotions don’t get expressed in a healthy way, the issue can build to something that seems unbearable.

While cutting is a warning side for suicide, usually it is an attempt to feel better – not an attempt to end one’s life.

If you have a friend who is self harming in any way, tell someone – a parent, counselor, teacher or coach.

And if it’s hard to talk about, that’s OK. Maybe try writing a note to an adult.

How can you help a friend?

The best advice I can give as a suicide-prevention advocate is to trust your gut. Don’t be afraid to have difficult conversations with your friend. Let them know how important they are to you.

You can even tell them why you are worried about them.

They may not be ready to talk, and that’s OK. Just let them know that you are there for them when they are ready.

Tips for talking to a friend:

  • Know suicide warning signs
  • Ask open-ended questions to help understand what they are experiencing
  • Don’t think you can keep them safe all by yourself; preventing suicide should involve an adult
  • Don’t promise to keep the conversation secret: You can promise to be discreet but your goal is to help them and saving a friend’s life is more important
  • Tell an adult: Even if you aren’t sure your friend is at risk for suicide, talk to someone: your parents, your friend’s parent, a counselor – any trusted adult

Worried about yourself?

If you are worried about yourself, there are things you can do to improve your own mental health.

  • Put your wellbeing first
  • Prioritize self care: watch a move, read a book, listen to music, take your dog for a walk
  • Exercise daily
  • Get plenty of sleep
  • Be kind to yourself: talk to yourself like you would talk to your best friend
  • Keep a journal
  • Do a technology detox
  • Talk to a parent or adult
  • Seek the help of a professional: a counselor or therapist

Exercise, really?

When teens think of exercise, they often think of gym class. But exercise when it comes to your mental health, is really finding an activity that you enjoy.

Studies have shown that 30 minutes of exercise or physical activity a day may significantly improve depression or anxiety, and any amount of physical activity helps.

Exercise could mean walking around the block, biking, running, playing basketball or even washing your car.

Here are some reasons exercise helps with mental health:

  • Releases good endorphins
  • Enhances your sense of well being
  • Gain confidence when your reach reasonable goals
  • Social interaction
  • Helps you cope in a healthy way

What to do if you are worried about a friend

Here are some ways you can help a friend if you are worried about their well being:

  • Check in with them more often
  • Offer to do enjoyable things together: This won’t eliminate depression but may bring a temporary sense of connection and happiness. Just being with other people instead of alone is usually a good thing. If they say no, that’s OK. Just keep asking.
  • Listen to your friend, ask follow-up questions, respond with supportive statements not advice
  • Encourage your friend to get help from a professional

What you shouldn’t do:

  • While it’s helpful to try to help your friend, you should never be on call 24/7. You are never responsible alone for your friend’s mental health
  • If you have a friend in crisis, never put yourself in danger. If a friend is threatening to hurt themselves, tell an adult. While you likely want to help, at this stage, they need professional help.

Take care of yourself

When you have a friend struggling, it’s more important than ever to take proper care of you. After all, it’s hard to help someone else, if you are run down or unhappy.

  • Don’t feel guilty about being happy even when a friend is struggling. It’s OK for you to be happy with your life.
  • Find time for things you enjoy: Yoga, dancing, running, shopping, etc.

988 Lifeline

988 hotline

If you need advice for how to talk to a friend or you are worried about a loved one, a lifeline is available 24 hours a day.

Unlike 911, dialing 988 doesn’t connect you to fire or police. Instead, 988 will direct you to a trained counselor to provide support and resources to the caller.


Project Mental Health, a service of Augusta Free Press

988 Suicide & Crisis Lifeline

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Crystal Graham

Crystal Graham

Crystal Abbe Graham is the regional editor of Augusta Free Press. A 1999 graduate of Virginia Tech, she has worked for nearly 25 years as a reporter and editor for several Virginia publications, written a book, and garnered more than a dozen Virginia Press Association awards for writing and graphic design. She was the co-host of "Viewpoints," a weekly TV news show, and co-host of Virginia Tonight, a nightly TV news show. Her work on "Virginia Tonight" earned her a national Telly award for excellence in television.