How to recognize (and treat) avoidant restrictive food intake disorder

Writer: Hannah Sheldon-Dean

Clinical Expert: Jerry Bubrick, PhD

https://www.youtube.com/watch?v=Q7RM3z2ZDEM

What You'll Learn

- What is avoidant restrictive food intake disorder (ARFID)?

- How is ARFID different from picky eating?

- How is ARFID treated?

- Quick Read

- Full Article

- What does ARFID look like?

- Warning signs of ARFID

- ARFID and other disorders

- Treatment for ARFID

ARFID stands for “avoidant restrictive food intake disorder.” ARFID is a relatively new eating disorder that looks very different from other eating disorders like anorexia and bulimia. Kids with ARFID aren’t worried about how much they weigh, though they sometimes do lose too much weight. Instead, they have rigid and restricted eating habits for other reasons.

Many kids with ARFID avoid foods that have a certain taste, texture, color or some other specific quality. For example, they might refuse to eat anything green or anything crunchy. Others have an extreme fear of vomiting or choking that prevents them from eating. And some kids with ARFID just have very little interest in food. It’s common for kids with all kinds of ARFID to like only a very limited set of foods.

What sets ARFID apart from normal picky eating is that ARFID has significant negative impacts on the child’s physical and/or mental health. About half of kids with ARFID are underweight for their age. Many have nutritional deficits, which means that they’re not eating enough for their bodies to function normally. ARFID often gets in the way of kids’ daily lives too. They might avoid social gatherings or even school if eating is involved.

ARFID can show up in kids as young as six, and it’s diagnosed about equally in boys and girls. Symptoms of ARFID can overlap with other disorders and some kids have ARFID as well as another disorder. In particular, autism and OCD can have a lot in common with ARFID. If you think your child might have ARFID, it’s important to get a thorough evaluation from a mental health professional, ideally an eating disorder specialist.

Researchers are still exploring the best ways to treat ARFID. Early studies of forms of cognitive behavioral therapy (CBT) and family-based treatment have shown promising results. Kids with ARFID who don’t get treatment often continue to experience symptoms as adults, so seeking treatment early can make a big difference.

When we think of eating disorders, we think first of young women who are obsessed with losing weight, and go to unhealthy extremes of diet and exercise to do it.  But in the case of an eating disorder called ARFID (avoidant restrictive food intake disorder), the picture looks very different.

ARFID stands for “avoidant restrictive food intake disorder,” and it became a clinical diagnosis in 2013 with the release of the DSM-5. Because it’s a relatively new diagnosis, clinicians are still learning about the disorder and how to treat it. But a few key features set it apart from other eating disorders.

“Kids with ARFID don’t particularly care about weight or shape, definitely not in the way that young people with bulimia nervosa, typical anorexia nervosa or atypical anorexia nervosa do,” says Daniel Le Grange, PhD, director of the Eating Disorders Program at the University of California, San Francisco. “What distinguishes ARFID from those three eating disorder diagnoses is their worry about the taste, texture, color or even ‘movement’ (such as Jell-O) of food.” Kids with ARFID may or may not be underweight, but losing weight isn’t the motivation behind their eating habits. Instead, they avoid certain foods or groups of foods for a wide variety of reasons — which are often mystifying to their families.

Additionally, ARFID typically shows up in much younger kids than other eating disorders do. Signs can become clear by the time a child is six or seven, but because it can be hard to tell ARFID apart from normal picky eating, they may not get a diagnosis right away. And boys are diagnosed with ARFID about as often as girls are — unlike other eating disorders, where girls are much more likely to be diagnosed.

Lots of kids are picky eaters. So how is ARFID different?

What does ARFID look like?

The hallmark of ARFID (avoidant restrictive food intake disorder) is restriction or avoidance of certain foods or groups of foods in a way that is so extreme that it interferes with the child’s daily life and physical health. The specifics can look very different for different children.

Many kids with ARFID avoid foods that have a certain taste, texture, color or some other specific quality. For example, they might refuse to eat anything green or anything crunchy. They often have a very limited set of foods that they like and get intensely upset or even nauseated if they have to eat something else. This is often called “avoidant” ARFID.

Other kids with ARFID restrict their eating due to a fear of choking, vomiting or otherwise getting ill. They may have vomited or choked on a certain food before (or seen it happen to someone else) and developed extreme anxiety about having it happen again. For example, if they once got a piece of tomato stuck in their throat, they might refuse to eat not only tomatoes but all red things or things with a similar smell. This form of fear-based ARFID is sometimes called “aversive.”

Finally, some kids with ARFID simply have little interest in food or eating. They might forget to eat, get distracted easily during meals, or eat extremely slowly. They also tend to like only a narrow set of foods. This is often called “restrictive” ARFID.

It’s common for kids with all types of ARFID to have rigid habits or rituals around eating. For example, they might insist on eating things in a certain order or keeping foods they don’t like away from their plates.

For a child with any of these eating patterns to be diagnosed with ARFID, their eating habits must have a significant negative impact on their physical and/or mental health. Often, kids with ARFID lose an unhealthy amount of weight, or they fail to gain weight and grow as they get older. About 50 percent of kids with ARFID are underweight for their age. They may also have significant nutritional deficits, which means that they don’t get enough calories or a wide enough variety of nutrients for their bodies to function normally.

The social impacts of ARFID are profound as well. “You don’t go out with your family to a restaurant,” says Dr. Le Grange. “You don’t accept invitations from your friends if it involves eating. It can even get in the way of going to school.”

Warning signs of ARFID

In general, early symptoms of ARFID (avoidant restrictive food intake disorder) look like extreme forms of picky eating. Some behaviors to look out for in young children include:

- Liking very few foods

- Avoiding specific foods or groups of foods based on qualities like texture or color

- Pickiness that gets worse over time, including refusing to eat foods that they once liked

- Anxiety at mealtimes

- Intense fear of choking or vomiting

- Eating very slowly

- Lack of appetite or getting full quickly

- Complaints of feeling sick after eating

Because kids with ARFID are often malnourished, there may be physiological warning signs as well. These signs can also be indicators of other eating disorders, especially anorexia nervosa, and it’s important to seek medical treatment if your child shows any of them. Physiological warning signs include:

- Weight loss, or failure to gain weight and grow as expected for their age

- Digestive problems that don’t have another medical explanation

- Trouble concentrating

- Dizziness or fainting

- Sleep issues or feeling tired all the time

- Feeling cold

- Dry skin, brittle nails or hair loss

- Missing menstrual periods

- Weakened immune system

ARFID and other disorders

One of the things that can make ARFID (avoidant restrictive food intake disorder) difficult to diagnose is that its symptoms often overlap with other eating disorders (most likely anorexia nervosa) or another disorder altogether — and many kids have both ARFID and another disorder.

Attention and anxiety disorders can show up in ways that look like ARFID. Kids with ADHD might show less interest in food or eat slowly because they’re easily distracted. Or a child with social anxiety might be too scared to eat lunch at school in front of their classmates.

Moreover, ARFID can be confused with, and overlap with, autism. Like kids with ARFID, kids on the autism spectrum are often very sensitive to the sensory experience of eating. For instance, they might refuse to eat anything too mushy or too crunchy.  

Finally, because kids with ARFID often have ritualized behaviors and rigid habits around eating, their behavior can look like — and overlap with — obsessive-compulsive disorder (OCD). “Emetophobia, or fear of vomiting, is the main condition under OCD that might be confused with ARFID,” says Jerry Bubrick, PhD, a clinical psychologist who treated many children with anxiety and OCD at the Child Mind Institute. He gives the example of a child who eats too much at Thanksgiving and vomits, and then develops an intense fear of vomiting and everything else that reminds them of that incident. “They might throw away that outfit, refuse to sit at the same place at the table, and refuse to eat any Thanksgiving foods,” Dr. Bubrick explains.

Because this child’s fear of vomiting is causing them to compulsively avoid so many different things — not just foods — their diagnosis would more likely be OCD, even though their eating is restricted. “The nutritional deficits are often the thing that sets ARFID apart,” says Dr. Bubrick. “If that same child were eating far less overall and not taking in enough calories because of that experience, and they’re starting to suffer from a nutritional perspective, then the diagnosis would tend more toward ARFID.” It’s also possible for a child to be diagnosed with both OCD and ARFID.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Treatment for ARFID

Because possible signs of ARFID (avoidant restrictive food intake disorder) can be so hard to interpret, it’s important to get a thorough evaluation from an experienced professional if you think your child might have it. It’s best to start with an eating disorder specialist if possible, though other clinicians (such as those who work with kids with autism or gastrointestinal issues) may also pick up on signs on ARFID in kids who initially seem to have a different problem. And if you think that your child may have another diagnosis as well, such as OCD, it’s helpful work with a specialist in that field too, particularly during evaluation.

Because ARFID is a relatively new diagnosis, researchers are still exploring the best ways to treat it, and there’s not yet a clear evidence-based treatment model. “There are a couple of pilot studies, treatment development studies, but there are no randomized clinical trials,” says Dr. Le Grange. “So we can’t say with any certainty. But there are a couple of treatment candidates that are pretty promising.”

For cases where a child with ARFID is underweight or malnourished, a big part of treatment (as with other eating disorders) is helping them regain weight and maintain medical stability. This might involve working with nutritionists and endocrinologists, while occupational therapists can help children overcome sensory challenges related to eating.

Treatment for ARFID also has a lot in common with treatment for OCD and other anxiety disorders, especially in cases where the child is not underweight. There are several promising initiatives underway to adapt cognitive behavioral therapy (CBT) for use in kids with ARFID. These include a model called CBT-AR, as well as one that combines family-based treatment for eating disorders and an anxiety treatment model called the Unified Protocol (FBT-UP).

Dr. Bubrick notes that kids with ARFID often believe very strongly that their irrational fears are true — that is, they believe that they really will vomit if they eat something green, rather than being able to acknowledge that that outcome is unlikely. For that reason, it can be difficult to use exposure therapy for these children, since even the smallest exposure to the thing they fear triggers too much anxiety. Accordingly, Dr. Bubrick says that it’s often helpful for ARFID treatment to start with cognitive work to help kids view their fears in a more rational way. Then, they can proceed with exposure therapy knowing that the foods that make them anxious aren’t actually dangerous.

Despite the complexities, Dr. Le Grange emphasizes that whatever treatment children get, involvement of parents and support at home are key. And it’s clear that early intervention is important. While kids who are picky eaters usually outgrow their fussiness, kids with ARFID who don’t get treatment often continue to experience symptoms as adults (although ARFID rarely begins in adulthood). 

“When you look at the few studies that are available for ARFID, there are a significant number of young persons who, when they were six or seven, were already showing clear symptoms and signs, but the parents just thought they were picky eaters or awkward eaters,” he says. Because it can be so hard to pinpoint what’s ARFID and what’s not, it’s important to reach out for help if your child’s picky eating is having a negative impact on their physical, social or emotional well-being.

Frequently Asked Questions

What is ARFID?

ARFID is an eating disorder. ARFID stands for “avoidant restrictive food intake disorder.” Kids with ARFID have rigid and restricted eating habits, but they aren’t trying to lose weight. Kids with ARFID avoid certain foods or groups of foods. ARFID causes significant problems with kids’ physical and mental health.

How is ARFID treated? https://standingabovethecrowd.com/?p=16610

Tips that young kids might need support to thrive

Photo by Pragyan Bezbaruah on Pexels.com

Writer: Rae Jacobson, MS

Clinical Expert: Daryaneh Badaly, PhD, ABPP

https://www.youtube.com/watch?v=hyP7Fs7zd-w

What You'll Learn

- What are the earliest signs that a child might have learning challenges?

- How old do kids have to be to be diagnosed with a learning disability?

- What can parents to do help?

- Quick Read

- Full Article

- What is a learning disability?

- The earliest signs of learning challenges

- What parents can do

- What parents can do at home

- Supporting kids’ self-esteem

It can be hard to tell if a preschool-age child is likely to have a learning disability. When kids are young, they develop skills at different speeds, and kids have different strengths and weaknesses. As they get older their abilities usually even out.

But there are some signs in preschool and early school that a child may be diagnosed with a learning disorder later on. For example, children who struggle to pick up rhyming may later have difficulty with reading. Likewise, kids who have trouble grasping the basics of counting may have trouble with math.

Children who have trouble holding a crayon or using a fork may have issues with what is called fine motor control. Trouble understanding or using language can be a sign of a language-based learning disorder. Speech and language issues can also be an early sign of autism.

Kids’ behavior can offer clues. If a child often gets frustrated during an activity, like drawing, it might mean those skills are a challenge for them. And if kids are more active, more impulsive, or more distracted than most of their peers, they could be signs of ADHD, which is usually not diagnosed until kids are older. Though ADHD is considered a behavioral disorder, it has a big impact on how kids learn, and many children with ADHD have learning disorders as well.

Some of these kids can benefit from early intervention. For instance, children with fine motor issues may be helped by an occupational therapist (OT). OTs can work with kids to improve their grasp, muscle tone, and hand-eye coordination. If you suspect your child is having speech or language issues, make an appointment with their healthcare provider. You may be referred to a speech-language pathologist (SLP) who will help them work on communication.

If you notice your child is struggling you can help by supporting their self-esteem. And you can work with them to build skills outside the classroom. Activities like reading, counting, or drawing together can help kids practice skills in a low-stress environment.

My daughter, age four, has been trying to write the number five. She wants to make a birthday card for a friend. “No, that’s not right…” she mutters, her squiggles snaking across the page. On attempt number six, frustration gets the better of her. “I just can’t do this!” she wails, throwing her pen to the floor. “Fives are too hard!”

This is hardly unusual for a preschooler just starting to her learn numbers and letters (and who still sometimes flops to the ground in distress if her banana accidentally breaks in half) but I can’t help feeling a little pang of worry.

Growing up, I had dysgraphia and dyscalculia. Seeing my daughter struggle, I wonder how I’ll know if she has learning challenges of her own. When children have learning issues, early intervention can be a big help. But how can parents tell if, and when, to be concerned?

What is a learning disability?

Learning disorders (LDs) are diagnosed when a child is having serious trouble with a specific academic skill or subject, like math or reading. LDs are defined by a gap between what it is developmentally expected for a child to be able to do, and what they’re actually able to do. For example, a child who has no trouble keeping up with their peers in other ways but is falling way behind in reading.

Though some disorders, like autism, can, and often are diagnosed during a child’s preschool and early school years, learning disorders usually don’t become apparent until kids are a bit older — when they’ve had a chance to be exposed to formal schooling.

This is partially because when it comes to early learning, kids develop skills at different speeds. A child who seems to be behind their peers when it comes to forming letters or reading short words may just need a little time to catch up. Being at the younger — or older — end of the class can mean some children are little ahead or behind other students. And, just like adults, different kids have different strengths and weaknesses. One child might excel at counting but struggle to write their name, while another might be reading basic words early on but have trouble with numbers. As they grow and mature their abilities usually even out.

For some children, however, those early learning struggles may signal future academic difficulties. And though kids may be too young for a formaldiagnosis in the preschool and early kindergarten years, support and, if necessary, early intervention can have big benefits. Daryaneh Badaly, PhD, a clinical neuropsychologist, explains that there are a few signs parents can be on the lookout for during children’s early learning years. 

The earliest signs of learning challenges

 “In younger kids, learning challenges don’t look the same as they do for older children, because the work they’re being asked to do is very minimal,” explains Dr. Badaly. “That said, there are some specifics issues that may suggest a child is struggling with some specific early skills.”

Fine motor control: “Issues with fine motor control can come out early on. You might see children struggling to learn how to hold a crayon correctly, having trouble using utensils, or shying away even from coloring or drawing shapes because it’s physically hard for them,” says Dr. Badaly. “Catching those issues early gives parents the chance to put supports like occupational therapy in place to strengthen those skills so they don’t become a barrier to learning later on.”

Language problems: Trouble understanding or using language can be a sign that a child may later be diagnosed with a language-based learning disorder. “There are different functions of language that can be impaired,” says Dr. Badaly. Children can have issues with receptive language, meaning they have a difficult time understanding words they’re hearing or reading. Or they can struggle with expressive language — trouble using words to express themselves. Children can also have issues with both. “If a kid is having trouble understanding oral language or expressing themselves, intervention can be helpful,” she says.

Early reading skills: Though most children are barely reading basic words during the preschool years, they’re building the skills that form the building blocks of reading in other ways. “There’s a lot of play with sounds, like rhyming games, or word and sound matching during this time,” says Dr. Badaly. “If a child is really struggling to pick up on the sounds, or doesn’t seem to grasp rhyming, that’s someone you should watch a bit more closely.”

Early math skills: “When kids are just learning to count, if the numbers just don’t come that easily to them, or they’re not seeming to grasp the fundamentals of counting, like putting things in order, that might be something to watch,” says Dr. Badaly. Issues with numbers can become especially clear around first grade, she explains: “If by the end of first grade a child wasn’t really grasping the basic concept of addition, that would definitely be cause for concern.”

Behavioral clues: If you notice your child frequently gets frustrated or upset during a certain activity, like drawing shapes or building with blocks, that may be a sign that the skills required for that type of learning are a challenge for them. “If there’s something that a kid is unwilling to do or is getting really upset when they’re asked to do it, it’s probably because it’s hard,” Dr. Badaly says. The question, she says, becomes: Why is it hard? “Is it that they haven’t been taught this skill? Or is it because the child is having a hard time staying focused, or because the task itself is hard?”

ADHD symptoms: Another behavioral clue worth considering during the early years is signs of ADHD. Though ADHD is considered a behavioral disorder, it has a big impact on how kids learn, and many children with ADHD have learning disorders as well. “In preschool, even though we likely wouldn’t make a diagnosis of something like ADHD, if you have a kid who’s bouncing off the walls and can’t sit still, you might say, well this kid might end up being diagnosed with ADHD, and might benefit from a behavioral intervention,” Dr. Badaly notes.

What parents can do

For children struggling with fine motor control, or receptive or expressive language, specific help is available.

- Children, even very young children, with fine motor issues may benefit from seeing an occupational therapist (OT). OTs can work with kids to improve their grasp, muscle tone, and hand-eye coordination, and help children build their social and self-regulation skills.

- If you notice your child is having speech or language issues, or has delayed speech, make an appointment with their healthcare provider. Your child’s doctor may ask for a hearing test and check your child’s throat and reflexes to rule out any other causes before suggesting next steps. If it seems like early intervention is necessary, your child may be referred to a speech-language pathologist (SLP) who will help them work on communication.

Speech and motor issues (especially when also seen with social challenges) can also be signs of autism, which, unlike learning disorders, “can be accurately diagnosed during early childhood,” says Dr. Badaly, “and early detection and intervention can be extremely beneficial.” If you, or your child’s teacher or doctor, notice your child is showing some of the early signs of autism, make an appointment to have them evaluated by a professional.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

What parents can do at home

Supporting your child’s learning outside the classroom is key. Simple activities like reading, counting, or drawing together can help kids practice skills in a low-stress environment. “Taking time to build enjoyment of reading by letting your child choose the books you read together” can help, says Dr. Badaly, “Or even just helping them get used to how a book works, here’s the title, here’s the story.” Likewise, “math practice can be as simple as counting the apples when you’re making a pie together.”

The point, she explains, is to make learning feel more natural and less fraught. “All practice is good.” But she warns, parents should be careful not to overwhelm kids. “You really want to approach learning in a fun and enthusiastic way instead of turning it into work, which can backfire and make kids feel less engaged, not more.“

Supporting kids’ self-esteem

Learning differences can wreak havoc on kids’ confidence. If you suspect your child is struggling in school, supporting their self-esteem can be a huge help, whether or not they’re ever diagnosed with an LD. Learn more here about how help kids with learning challenges build self-esteem, gain confidence, and learn the skills they need to be more resilient when setbacks happen.

Frequently Asked Questions

What are early signs of learning challenges?

What are some signs a child might develop learning challenges?
If a child often gets frustrated during a particular activity, it might be a sign that those skills are a challenge for them.

What interventions can help young children who show early signs of learning challenges?

How can parents support kids who show early signs of learning issues?

Photo by Pragyan Bezbaruah on Pexels.com https://standingabovethecrowd.com/?p=16654

An aunt and her niece share their stories, their paths to healing, and their mission to help fellow survivors

By Katie Hurley and Dorrit Corwin

The Day It Happened

Katie, age 51

I was 23 years old and one day from completing the first year of my master’s in social work in Philadelphia. As I drove along the Schuylkill Expressway to meet a friend for dinner, the incessant beeping of my pager (did I mention it was 1998?) made me smile. It was my grandmother’s number on the tiny screen. Did Nana know how to page people? And how did she even know my number?

When I arrived at my friend’s house, I called her back.

“Katie?” said my mother’s voice. “You have to be strong right now. Dad died at work today.”

It was the only word that came to mind: “What?”

I remember every detail, the way we do in such moments: how the giant cordless phone rested between my ear and shoulder, the sound of Wheel of Fortune in the background. I sat on the edge of the sofa. A fly circled above me, making a low humming sound.

“What happened?” Two more words.

“We really don’t know. Maybe his heart. They’ll do an autopsy.”

We don’t know? People usually know, don’t they? Would knowing help?

I just talked to him. Five words took up residence in my brain as I blazed up I-95 en route to my childhood home. I remember none of that drive apart from those words. I pulled into the driveway to find more questions, and no answers.

For months, we dodged questions about the cause of death and hinted to each other that maybe it was his heart after all. Perhaps there was some truth in that, though not the scientific kind. Not the biological kind.

His heart wasn’t in it anymore. That was the closest we could come to saying suicide at a time when it was just not a word people said.

Dorrit, age 24

I was 21 and a junior in college, navigating the ambiguity of falling in love for the first time. Jameson and I had known each other since freshman year and had been seeing each other on and off for almost that long. He worked hard on improving his mental health, but dark thoughts made committing to a relationship difficult for him, he told me.

It was 2022, the summer before what would have been our senior year—if neither of us had taken time off during the pandemic. He seemed happy about returning to school, had genuine hopes for pursuing his many passions, and I felt his love for me more than ever. Still, he was never, it seemed, able to fully emerge from his depressive fog.

Mostly, but not completely.

Two days after we’d taken the train to Boston to see a concert, I was awoken by loud voices outside the house on College Hill where I lived. I opened the back door. Eight police officers stood there. They did not ask if I wanted to sit down. One of them asked if I was in a relationship with Jameson.

“Yes,” I said.

The cop told me that Jameson died early that morning.

Only seconds went by before they began questioning me:

“When was the last time you saw him?”

“Was he here with you at your house last night?”

“Was he acting weird?”

I could form neither sentences nor even words. All I could do was wail.

Katie

Courtesy of Hurley

Katie (Godbout) Hurley and her father, Jim GodboutCourtesy of Hurley

My father was the quintessential “good guy.” Friends and neighbors flocked to him when he entered a room, hungry for stories featuring characters that couldn’t possibly be real but hanging on his every word just in case. He knew to hold the punchline until his audience was rapt with anticipation, dropping a line to cue the raucous laughter at just the right moment. His college stories were the best, though I never knew if they were entirely true, like the time he allegedly rigged a toilet to deliver some kind of spiked purple punch when the handle was pressed and placed it on the front lawn for a summer party. He was generous with his time and friendship, and he was beloved in our community because of it.

I was the quiet child, the one who needed cajoling to go to a party or step even an inch outside my comfort zone. I couldn’t fathom what kind of a personality overhaul might be required to be more like him, so I studied him, practicing with my stuffed animals behind the safety of my locked bedroom door.

When my mom sat me and my three siblings down on her bedroom floor to tell us the results of the autopsy, I was stunned. For a moment, anyway. By age 23 I had battled my own demons enough to know that what we choose to show the world isn’t always how we feel inside of our own brains and hearts, so I moved quickly from shock to what I can only call despair. There I was, studying clinical social work, years after surviving my own flirtation with suicidal thoughts. How could I have missed the red flags?

Dorrit

When I first became close with Jameson in 2019, my mom urged me to be vigilant about checking in on him. I was hesitant to be overbearing. I had a huge crush on him and was intimidated by his striking good looks and the way he seemed to carry himself so confidently. I liked him even more when his confident facade came down, but I wasn’t expecting it to reveal such deep insecurity. The more suicide survivors I meet, the more I hear the same type of story: It’s often the people who appear the most perfect, happy, and confident who are fighting the most vicious inner demons.

The flip side of being raised by a suicide survivor is that my mother’s trauma afforded me the confidence to assume that I was equipped to help Jameson. I didn’t flinch when he told me about previous suicide attempts or childhood trauma. I knew him well for three years, yet there was so much more going on in his head than I could understand—waves crashing together and thrashing him below the surface, and sometimes all I could do was hold his hand and hope he made it to shore.

It’s often the people who appear the most perfect, happy, and confident who are fighting the most vicious inner demons.

For years he told me he was in no mental space to start dating someone, but that summer he seemed like the best version of himself. He was teaching himself music production, learning Japanese, and taking computer science and AI courses he found online.

I’ll never forget sitting with him on the rug of my childhood bedroom as he explained that while he’d spent lots of time contemplating ending his life, he’d come to the conclusion that he was done thinking about suicide ever again. His tone was serious, yet calm, as he gazed at me warmly through his oversize wire-rimmed glasses.

I believed him. More important, I could tell he believed himself.

How did everything fall apart so quickly?

Picking Up the Pieces

Katie

In the weeks and months that followed my father’s death, we began to piece things together. Financial distress, kept hidden even from my mother, was likely a contributing factor. But there were the memories of a childhood that wasn’t honest (he only learned at age 14 that he was adopted by his father when a cousin used this information to publicly shame him), rejection by his family as an adult, and a biological father who resurfaced many hidden childhood traumas when he attempted to connect with him later in life.

We shed many tears together during those weeks, perched at the end of my parents’ bed, sifting through clues. We cried for the secrets he kept and the sadness we should have seen. We shared none of this with friends or even extended family. It wasn’t something anyone knew how to talk about. They didn’t ask and we didn’t tell.

We cried for the secrets he kept and the sadness we should have seen.

In the suicide prevention field, we are careful to say that suicide is multifactorial. To attempt to point to a single cause is to miss the larger picture, so we train people to look for what are considered the “red flags” of a mental health crisis. While that’s a very helpful framework for increasing awareness about what a mental health crisis looks like, what I’ve learned in more than 25 years of clinical practice is something that is not often advertised: Those red flags sometimes become a faded pink, and tattered. That makes them a lot harder to spot.

Dorrit

As soon as the cops left my house that morning, I called my parents. My mom got on the first flight to Providence, Rhode Island, and slept in my bed with me for 10 days. She carried the grief heavier than most, talking nonstop about how she could have done more to help Jameson. But I now know that you can only support, not save, someone.

Katie

As we cleaned out my childhood home to prepare to sell it, my mom and I found those tattered and faded flags: a note on a torn scrap of paper from a yellow legal pad (he was not a lawyer, but he loved those pads), detailing what my mom should do about one of the leased cars in the driveway; a stack of birthday cards from all of us dating 10 years back with some version of “I’m sorry this was a hard year, next year will be better”; and a cassette tape from a visit he made to a psychic medium exactly two years before his death.

He had cleaned out his closet shortly before he died, declaring many styles out of date, but when we opened the closet, we discovered that he didn’t leave much behind. We think he tried to help us.

Finally, the words he said over the previous couple of years took on new and revelatory meaning as we replayed them over and over in our minds.

If I die and you remarry, you’ll need to sign a prenup.

I’m probably worth more dead than alive.

When I’m gone, you’ll want to move to the beach.

We pieced the clues together and processed the depth of the loss side by side, but it would be months before we really began to call it what it was: loss by suicide.

Support for Survivors

Dorrit

Courtesy of Corwin

Dorrit Corwin and her boyfriend, Jameson

When it comes to processing and talking about suicide, some resources have improved over the past 25 years, and some stigmas have eroded, but others have not.

The best resource I used was a virtual support group through Coping After Suicide. This community is something Katie never could have found in 1998, most obviously because Zoom was not a thing, but also because there was not as much dialogue around suicide as there is now. I was in a group called “twentysomethings”; while each member of the group had different relationships to the people they lost (parents, siblings, partners, friends), we were bonded by all being in our 20s. We met once a week for 90 minutes over a 10-week period.

These 90-minute chunks became both a highlight and a challenge of my week. I felt seen by this group of people I would never meet in person.

Another wonderful resource I turn to again and again is Anderson Cooper’s podcast, “All There Is,” where he openly discusses the grief of losing his father (when he was 10), his mother (who lived to 95), and his brother, who died by suicide when Cooper was 21.

I felt seen by this group of people I would never meet in person.

He interviews guests from Stephen Colbert and Andrew Garfield to Whoopi Goldberg and Doris Kearns Goodwin. This podcast would not have existed 25 years ago, and while it is not entirely about suicide, survivors of all types of grief can benefit from listening and learning from Cooper’s brave vulnerability.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

The Right Words

Katie

Language matters. A lot. When people are sick with cancer or heart disease, we say it. When I was diagnosed with breast cancer, it was hard to wrap my head around my new reality, but it wasn’t hard to say the words. Mental health is different. There are “Fuck Cancer” T-shirts but no “Fuck Suicide” T-shirts. There should be.

We have worked hard to decrease stigma around cancer, diabetes, and many other medical diseases, but when I say I have depression, it’s always a showstopper. When people ask how my father died, the discomfort is palpable when I reply with four simple words: “He died by suicide.” I choose to believe that discomfort comes from a place of compassionate grief. It is unfathomable to consider a father of four dying by suicide at age 52, the age my husband just reached, and that makes it hard to respond in any kind of meaningful way. In the absence of knowing what to say, people tend to shuffle their feet, look down, and wait for the moment to pass.

We need to do better, in both responses and the words we use. Think about how often you hear phrases like “He’s crazy,” “I want to kill myself,” or “That’s social suicide” in casual conversation. Even the word combination of “commit suicide” is steeped in stigma. People commit crimes, but suicide is no crime. People use these phrases to make a joke or exaggerate a point, but for survivors of suicide loss, those words, and many others, hurt us inside.

There are simple swaps we can learn to speak in a more compassionate way:

- Instead of “committed/completed/successful suicide” say “died by suicide”

- Instead of “he’s suicidal” say “he has thoughts of suicide”

- Instead of “failed/incomplete/unsuccessful attempt” say “suicide attempt”

- Instead of suicide jokes, in words or gestures, just don’t do that. Given that we lose one person to suicide every 11 minutes, assume that someone in your presence has some experience with loss by suicide.

Words can hurt, but words can also heal. When someone opens up about—or even mentions—a loss by suicide, the simplest thing you can do is respond with, “I’m sorry to hear that. Do you want to tell me more about ?” or “How can I support you?”

A Clear Purpose: Prevention

Katie

Almost three years ago I was given the opportunity to join The Jed Foundation (JED), a leading nonprofit that works to protect emotional health and reduce suicide for teens and young adults. JED was founded in 2000 by Donna and Phil Satow, whose son, Jed, died by suicide while in college. My father died in April of 1998; Jed died that following December.

Awareness now is higher than it’s ever been, and while that’s not saying much, there’s at least a foundation to build on. In 2025, people working in the suicide prevention field know a lot more about what to look for and how to help someone in crisis and, because of that, we have a better chance of helping someone through a crisis. Warning signs can include:

- Talking about suicide, with or without a specific plan

- Verbalizing or writing about feeling alone, disconnected, or empty

- Feeling like a burden; mentioning that others will be better off when they’re gone

- Noticeable changes in sleep and eating habits

- Noticeable changes in personal hygiene

- Social withdrawal, not engaging in activities they usually enjoy

- Reckless behavior

- Increased agitation, irritability, anger, and/or anxiety

- Mood swings

- Feeling numb or disinterested

- Persistent sadness or depression

- Hopelessness

People often ask me what it’s like to work in suicide prevention. They wonder if it’s sad, overwhelming, or all-encompassing. The truth is that it can be one or all of those things at times, but the emotion I feel most is hope.

Gen Z is talking more openly about mental health, and that’s a very good thing. There’s still a stigma around help-seeking, particularly for young males, and we have work to do to build trust with young people, to show them that caring adults are willing to decenter themselves to help them. But we need to work faster and we need to work together.

Gen Z is talking more openly about mental health, and that’s a very good thing.

JED’s signature “You Can Help” workshops are adapted to meet the needs of many audiences, and Mental Health First Aid, ASIST (Applied Suicide Intervention Skills Training), and QPR (Question, Persuade, Refer) are all examples of trainings that can help people learn to identify the warning signs, support a person in need, and refer for professional help.

Beyond collective learning, a small but mighty action we can all take to improve our understanding of and relationship with mental health is to learn how to talk about it. When parents are worried about their kids but can’t find the words to discuss their fears, I often task them with spending time in the mirror practicing the words they need to say:

- How is your mental health?

- Do you want me to help you find a therapist?

- Are you having thoughts of suicide?

A fear I frequently hear is that talking about depression and suicide will plant the ideas in kids’ heads, thereby causing depression and, potentially, suicide. That isn’t the case. The more we practice using these words and phrases, the more trust we build with the young people who need us to listen with empathy and compassion. We can only destigmatize language if we use it, and that’s a task we need to take on as a whole.

Courtesy Hurley and Corwin

Katie Hurley and her niece, Dorrit Corwin

“If I Had One Wish”

Katie

I would love to say that Dorrit faces less stigma when talking about Jameson’s death than I did when talking about my dad, but I know enough to know that open conversation about depression and suicide only exists in some small settings. It’s a club, this group of us survivors of loss by suicide. With fellow survivors we can share without burden or worry and talk openly about the wounds that never quite heal in the way we hope. We can listen to one another and create the brave spaces we’ve needed all along.

But if I had one wish, it would be that we wouldn’t need a secret club of silent understanding, that all people could find a way to talk openly about mental health and suicide and listen without judgment when others share their story. When that day comes, we’ll find that we have more in common than we think and that we have more support than we could ever imagine. Only when we can talk honestly about mental health, like we talk about any other disease, and provide the same kind of support that we would provide a family enduring any other kind of illness (pass the casserole, please) will we have eradicated the stigma and learned to truly comfort one another through any kind of storm. https://standingabovethecrowd.com/?p=16641

Kids often keep their worries hidden, or express them in ways that are hard to read

Writer: Stephanie Cornwell

Clinical Expert: David Friedlander, PsyD

What You'll Learn

- How does depression look different in children, teens, and adults?

- How can parents help their kids deal with depression?

- Quick Read

- Full Article

- Symptoms of depression

- Depression in young children and pre-teens

- Depression in teenagers

- How parents can help with treatment

- How Depression Affects Kids in School

Depression can affect people of any age, but it can be confusing because it often looks different in children, teens, and adults. Depression is typically characterized by feeling sad, empty, or hopeless most of the day, nearly every day. For kids and teens, however, irritability can replace sadness.

The biggest thing to look for in kids is a change in behavior — It’s not just that the child is cranky or down, but that those behaviors are not typical for that child. For children, the change could be a heightened sensitivity to criticism, withdrawal from activities they used to enjoy, and somatic complaints like stomachaches and headaches. In teenagers, social isolation, poor school performance, substance abuse, and self-harm can be symptoms of depression.

If you hear your child talking about attempting suicide, it’s important to talk to them. Depression is treatable, with cognitive behavioral therapy (CBT) being the most common and evidence-based treatment. Medications may also be used in combination with therapy.

Depression can affect people of any age, but it can be confusing because it often looks different in children, teens, and adults. And since teens are already prone to moodiness, it can be especially hard to tell if they are struggling with depression.

Knowing the signs of depression and how they differ across age ranges can better equip you to get your child help if they need it.

Symptoms of depression

For a person of any age, adiagnosis of depression is typically based on feeling sad, empty, or hopeless most of the day, nearly every day. Other common symptoms include diminished interest in activities they once enjoyed, eating more or less than usual, not sleeping enough or too much, withdrawing from friends and family, and having thoughts of suicide.

For kids and teens, however, irritability can replace sadness. If your child is unusually irritable for no reason, that could be a sign of depression. But it’s more about changes in their behavior than the symptoms themselves.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Depression in young children and pre-teens

The key is spotting depression in young kids is to look for a change in behavior, explains David Friedlander, PsyD, a clinical psychologist at the Child Mind Institute. It’s not just that the child is cranky or down but that those behaviors are not typical for that child.

Say your child used to put their homework neatly in a folder in their backpack, and now it’s crumpled in a ball at the bottom of the bag. Maybe they’re suddenly getting into fights or breaking rules in school when they’ve never done that before. Also, a heightened sensitivity to mistakes or criticism, like crying over getting an answer wrong when they used to shrug it off, can be a sign of depression.

Withdrawing from things they used to enjoy is a telltale sign of depression. Young kids rely heavily on their parents to get them to and from activities. So, withdrawal in young kids can look like asking to skip dance class repeatedly or telling their parents not to sign them up for sports anymore.

If kids frequently say something like, “I don’t want to,” or “I can’t,” it could signify that they are struggling with depression, “especially if you’re dealing with a kid who used to have joy for life and age-appropriate participation in activities,” Dr. Friedlander says.

Another sign of depression is sudden and frequent somatic complaints that weren’t there before, like stomachaches and headaches. Stomachaches generally don’t mean your child is depressed, but suddenly having a lot of stomachaches when they didn’t before might. 

If your child is unusually irritable for no reason, even without sadness, that could be a sign of depression. However, there’s also a related mood disorder that’s sometimes diagnosed in extremely irritable kids called disruptive mood dysregulation disorder, which presents as extreme tantrums combined with irritability.

Depression in teenagers

Teenagers are notoriously moody, and often their mood swings aren’t a cause for concern. But if your teenager is much more irritable than they used to be, it could also be a sign of depression. “That’s really the key differentiator,” Dr. Friedlander says. “Teens are sometimes going to be irritable, but if they’re irritable most of the day, nearly every day, that’s one of the criteria for depression.”

As in younger children, social isolation is a major sign of depression in teens. Social isolation and attempts to withdraw can be more than just staying in their room. If they are usually with their friends after school but suddenly start coming home right after, it’s worth talking to them about it. While it’s not unusual for teens to have problems with friends, if your child says, “I’m not friends with so-and-so anymore,” you may want to ask about it.

Another change in behavior to look for in teens is school performance. If they’re suddenly getting D’s and F’s when they used to get good grades, and they’re blaming fatigue or an inability to concentrate, it might be a sign of depression.

Another thing to worry about in teens is self-harm; the most common form is cutting. Teens may cut because they are in intense distress, and the cutting makes them stop ruminating on whatever upsets them.

The most serious thing to look for is if your child is thinking about or attempting suicide. If you hear your child talking about dying, wishing they could disappear, or hurting themselves, it’s important to take it seriously and have an open and honest conversation about what’s happening. Though parents often worry that talking about suicide will make the problem worse, in fact, the evidence is clear that it helps kids to express their feelings, and it gives you an important opportunity to gauge whether they are at risk of hurting themselves and should be taken to the emergency room.

Substance abuse may also be a symptom of depression in teens. Dr. Friedlander notes that parents would have to determine the purpose of the substance use to find out if it’s linked to depression. What is your teen trying to achieve by smoking or drinking? What are they trying to avoid? “Anhedonia, the inability to experience pleasure, is a symptom of depression,” Dr. Friedlander explains. “If being high is the only way the child can have fun, that’s a sign they may be depressed.”

How parents can help with treatment

Depression is treatable. The most common, evidence-based treatment for depression is cognitive behavioral therapy (CBT), which teaches kids to notice and challenge negative, destructive thought patterns. There are several forms of CBT adapted for children and teenagers with depression, including DBT and IPT.

Medications are also used, sometimes in combination with therapy. The most frequently used antidepressant medications include SSRIs (selective serotonin reuptake inhibitors), like Zoloft, Prozac, and Lexapro, and SNRIs (serotonin-norepinephrine reuptake inhibitors), like Strattera and Cymbalta. 

When it comes to treating younger kids, the parents usually need to be involved more. Parents of an eight-year-old, for example, will need to help schedule activities, make sure the child attends them, and provide incentives to continue completing the activities. With teens, parents’ involvement in the treatment of their depression varies. “Some are motivated enough to follow through on a treatment regimen with minimal support and prefer privacy over involving their parents,” Dr. Friedlander notes. Others need more support or incentives.  

If you think your child or teenager is suicidal, you can call the National Suicide Prevention Lifeline at 1-800-273-8255 or 911 if there is an emergency. Don’t wait — the risk of suicide in children and teenagers is very real.  https://standingabovethecrowd.com/?p=16652

Kids often keep their worries hidden, or express them in ways that are hard to read

Writer: Roy Boorady, MD

Clinical Expert: Roy Boorady, MD

What You'll Learn

- What does childhood anxiety look like?

- Why is it difficult to diagnose childhood anxiety?

- How is childhood anxiety treated?

- Quick Read

- Full Article

- Outward signs of childhood anxiety

- Consequences of untreated anxiety

- Avoidance reinforces anxiety

- Anxiety leads to depression

All kids worry sometimes. But when worry makes it hard for them to participate in daily life, they may have an anxiety disorder. Because anxiety often affects a child’s thoughts and feelings more than it affects their behavior, it can be hard to spot. It’s also possible for a child to be generally happy but still so anxious that it interferes with some aspect of their life, like school or socializing.

Common outward signs that a child might be anxious include troubling sleeping, lots of stomachaches or headaches, clinging to parents, and throwing tantrums. Some of these symptoms may look like oppositional behavior, but really the child is struggling to deal with overwhelming worry. Anxiety can also make it hard to focus or sit still, so it can be hard to tell anxiety apart from ADHD.

Untreated anxiety in childhood can lead to more anxiety in adulthood, so it’s important to get anxious kids help. The good news is that childhood anxiety is very treatable. Most anxious kids respond well to a kind of therapy called cognitive behavioral therapy (CBT). Medication can also help. By getting treatment early, kids can learn to manage their worries and keep anxiety from interfering with their lives.

It is a natural thing to have anxiety. It is normal for very young children to be afraid of the dark, or for school-age children to worry about making friends. But sometimes normal childhood anxiety morphs into something more serious. A young girl might be afraid to ever leave her mother’s side, even to get on the school bus, or an anxious boy may need frequent reassurance over things that happened a month ago.

Even young children can develop an anxiety disorder. Eventually the disorder can start interfering with a child’s friendships, life at home, and work in school. Even so, the anxiety still might not be noticeable to parents and caregivers.

For one thing, being anxious doesn’t necessarily mean that you can’t function — it might just make some kinds of functioning more difficult. A homework assignment that should take 20 minutes might take an hour, for example. With anxiety, it’s important to remember how internal it is. It dominates a child’s thoughts, but it might not be obvious to the people around them.

It’s also worth noting that in my work as a child psychiatrist I see a lot of anxious kids who are still basically happy and enjoying life. Maybe they are only struggling in certain situations, which may make their anxiety all the easier to overlook.

Outward signs of childhood anxiety

When anxiety is expressed outwardly, there can be a wide range of signs and symptoms, which often complicates identification.

- Kids may have trouble sleeping or complain about stomachaches or other physical problems.

- They may become avoidant and clingy around parents or caregivers.

- They might also have trouble focusing in class or be very fidgety — I like to say, “Not all that moves is ADHD,” even though that’s often the first thing we suspect from a hyperactive or inattentive child.

- They may have explosive outbursts that make people think they are oppositional, when their fight-or-flight mechanism is triggered.

The words we use to describe our anxiety can distract, too. People use a lot of different words to describe what they’re feeling — kids might say they are self-conscious, shy, apprehensive, worried, or afraid. These words do a good job capturing what they are struggling with, but fixating too much on them can distract from the fact that anxiety is underlying factor — not some personal failure in personality. 

Consequences of untreated anxiety

If you look at the prevalence rates of anxiety disorders, you’ll see that the numbers rise as children get older. That makes sense because anxiety disorders are cognitive, so they develop as our cognitive ability develops. Separation anxiety, for instance, develops early, where as social anxiety disorder usually develops after puberty. A study of more than 10,000 kids, interviewed by trained professionals, shows that more than 30 percent had developed an anxiety disorder some time before they were 18.

Anxiety frequently recurs, too, and childhood anxiety is often a precursor for adult anxiety, especially for kids who don’t receive treatment. The same study showed that 80 percent of kids with anxiety do not get treatment. Many adults seeking help for anxiety remember feeling anxious when they were younger, which means that they’ve been struggling for a long time and could have benefited from treatment as children.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Avoidance reinforces anxiety

Kids with untreated anxiety also begin to develop poor coping skills. A common example is avoidance — people who are very anxious will try to contain it by avoiding the thing that makes them anxious. It’s a short-term solution that unfortunately reinforces their anxiety instead of acclimating them to it.

Similarly, untreated anxiety can lead to lower self-esteem, academic dysfunction, and self-medication through substance abuse.

Anxiety leads to depression

People living with anxiety for extended periods of time are also more likely to develop depression. It isn’t uncommon to meet patients who come seeking treatment for depression or depressive symptoms and it turns out that they have been dealing with lifelong anxiety as well. In cases like this people need treatment for anxiety and depression.

Fortunately, we know a lot about how to treat anxiety. It responds very well to cognitive behavior therapy, and there are medications that work, too. Getting help makes a big difference, and treatment doesn’t need to be a lifelong thing — although its positive effects will be.

Frequently Asked Questions

What does anxiety look like in a child?

Anxiety in a child can look like many different kinds of symptoms. Anxious children may have trouble sleeping, complain about stomachaches, avoid certain places or things, cling to parents, have trouble focusing in school, or have extreme tantrums when they get overwhelmed. https://standingabovethecrowd.com/?p=16644

The former wide receiver’s passing comes as suicide rates among young Black men climb sharply, especially in Georgia

by Alyssa Johnson

Rondale Moore warms up prior to a game between the Atlanta Falcons and the Carolina Panthers in Atlanta

We can bring these stories to you!

When news broke last week that Rondale Moore, a 25-year-old former Atlanta Falcons player, died by a suspected self-inflicted gunshot wound, it stunned fans and coaches while raising alarm with mental health professionals. 

Authorities in New Albany, Indiana, said Moore was found dead in the garage of a property in the area and that his death is under investigation.

Moore’s death highlights a broader public-health crisis: the rise of suicide among young adults, especially young Black men, in the U.S. and in Georgia.

Analysis from Stateline using federal data shows that suicide is claiming more lives among Gen Z adults, roughly ages 18 to 27, than it did a decade ago when millennials were the same age. 

The report found that the increase is not evenly spread across populations, as 85% of the growth in suicide deaths among Gen Z is among Black and Hispanic men, with the largest spikes occurring in Southern and Midwestern states, including Georgia.

In Georgia, the increase in suicide among men 18 to 27 was among the highest in the nation, rising by 70% between 2014 and 2024.

Michael Giglio, executive director of Giving Health, a nonprofit organization that offers free virtual primary care and mental health services for low income and uninsured residents, said that the majority of its clients are Black and face barriers to accessing mental health services.

“It can be very difficult to access affordable mental health services, and in Georgia, further complicating the challenges, there’s a significant shortfall in the number of mental health providers for population size,” Giglio said. 

Giglio said that the lack of access to mental health services and support from community or individual relationships play a large role in male suicides.

“Those three things can really overwhelm and overcome someone who’s struggling, that doesn’t have a trusted, intimate relationship with a friend, a family member, a partner, and doesn’t have the resources to seek out counseling, or there may be cultural hesitation to pursue counseling as well,” Giglio said.

Giglio said some of the stressors facing men who may be experiencing suicidal thoughts could be anything from finances to a history of abuse and trauma — and for Black men in particular, race-related trauma. 

A study from the University of Georgia in 2024 revealed that being raised in an environment with limited resources and facing racial discrimination in early adulthood can hinder the ability to form healthy, trusting relationships. Deep mistrust and wariness toward others may result in social isolation, which can ultimately lead to thoughts of death and suicide.

“I think we often don’t look at where the disparities are and who the individuals most at risk are when we’re talking about suicide ideation,” Michael Curtis, co-author of the study, told UGA Today. “We just know it’s bad, and particularly among young Black men.”

“Historically, research has not invested a lot of time and effort in looking into what are the unique cultural contexts that make certain men more at risk for suicidal thoughts than other men,” Curtis said.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

In an interview last year with Capital B Atlanta, Morehouse College President F. DuBois Bowman said that the all-male HBCU is working to increase services to address the mental health issues of its students after a spate of suicides in recent years.  

“One of the things we’ve seen shifting very rapidly is the demand for increased mental health support. That is on college campuses, but in society more broadly,” Bowman said.

“We see issues of anxiety. We see issues of depression show up on our campus with excellent students who are very capable of succeeding, but we have to make sure we figure out how to support them in their journeys,” he said. “I think it’s our responsibility at Morehouse, and in the higher education landscape more generally, to think about how best to do so.”

A standout at Purdue University, Moore was selected in the second round of the 2021 NFL Draft by the Arizona Cardinals. After three seasons in Arizona, he was traded to the Atlanta Falcons in 2024 but suffered a knee injury during training camp, preventing him from ever playing a game for Atlanta. 

He was remembered by the team on social media: “Rest in peace, Rondale Moore. Our thoughts and prayers are with Rondale’s family and friends.”

If you or someone you know is thinking about self-harm, call or text 988 to connect with the National Suicide & Crisis Lifeline, and speak with a compassionate, trained counselor 24/7. This service is free and confidential. https://standingabovethecrowd.com/?p=16639

https://www.youtube.com/watch?v=c0rVwulxZ8k

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog https://standingabovethecrowd.com/?p=16634