Most teens go through a period of growing pains. They’re learning to be independent and exploring who they are as people. However, sometimes changes in behavior may be more than just being a teen.

This is also the time when mental health concerns, such as depression, might start to surface. Mental health issues can affect anyone, with the onset for major depression commonly occurring during adolescence.

The 2017 Netflix series 13 Reasons Why drew scrutiny for its depiction of a teen who committed suicide and left messages for those around her. Many feared it would increase the teen suicide rate. A recent study published in the Journal of the American Association of Child and Adolescent Psychiatry reports that suicides in the 10-17 age group increased 28.9% in the month following release of the series. But researchers are quick to say the study did not conclude the series caused the increase and note the change was among boys while the lead character featured in the series was a girl. Suicides in the age group also were higher over the nine months following release of the series.

“Teens are exposed to a variety of scenarios on not only Netflix but social media in general. I would encourage parents and care givers to have open dialogue with their teens to best understand their individual needs and mental state,” explains Jasmine Reese, M.D., an adolescent medicine specialist and the director of the Adolescent and Young Adult Specialty Clinic at Johns Hopkins All Children’s Hospital. “Parents will then have to decide if their teen is mentally ready to process and interpret graphic shows especially as it pertains to suicide. Most young teens are likely not ready to process this on their own.”

Though many adolescents may not be ready to process such media, mental health concerns are a topic of growing importance. National high school student surveys have shown that about:

• 30% felt sad or hopeless every day for at least two weeks
• 14% had a suicide plan
• 7% attempted suicide

Depression is a serious, yet common mental disorder that involves a variety of symptoms including feelings of being sad, down or hopeless that interfere with daily life. It affects everyone differently, though in general, signs may include difficulty concentrating, change in appetite, trouble sleeping, loss of interest in activities or seeming tired, sad or irritable all the time. Some people may have frequent headaches, stomach aches or body aches. Signs of suicide include someone talking about wanting to die, searching for ways to hurt himself or herself, or talking about having no purpose, feeling trapped or being a burden to others.

“Listen carefully when your child speaks, and observe their behavior. Stay calm. Don’t become angry and don’t blame them for feelings of depression and/or thoughts of death. Respond with compassion and love, invite them to share their feelings and experiences,” explains Jennifer Katzenstein, Ph.D. ABPP-CN, pediatric neuropsychologist and director of psychology and neuropsychology at Johns Hopkins All Children’s. “This can be very scary for both parents and kids, and it is important for children to feel safe.”

As a caregiver, one of the most important things you can do is to be involved in your child’s life. Know who they are spending time with in school and outside of school and what they may be viewing online or on television.

Open communication about their day at school, their interactions with peers, and about their thoughts and ideas will allow you to learn about each other. With a good line of communication, you can start to discuss how they are feeling emotionally.

Take your child’s feelings seriously and be willing and available to listening. Seek help and resources from your pediatrician or local mental health providers. Offer to be there for them or even to help them find the right person to talk to whether it’s a counselor, the pediatrician or another trusted adult.

Katzenstein adds, “As we increase our knowledge of mental health and mental wellness, as well as decrease stigma, we can help prevent these acts and improve overall wellness for our kids and future generations.”