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Literacy is a luxury that many of us take for granted. That is why SADAG created SPEAKING BOOKS and revolutionized the way healthcare information is delivered to low literacy communities.

The customizable 16-page book, read by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood by everyone across the world.

We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 100+ titles, such as TB, Malaria, Polio, Vaccines for over 45 countries.

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By Liesel Robertson

The stats tell a scary story: 9% of all unnatural youth deaths in SA are caused by suicide; 17% of teenagers have attempted suicide; and one in every four teens has experienced feelings of hopelessness. Why are our teens so depressed, and so anxious? And what can we do about it?

Epidemic is an appropriate way to describe it,' says psychiatrist Uschenka Padayachey, one of the experts CapeTalk's Pippa Hudson consulted for her segment on teen suicide, anxiety and depression. According to the South African Depression and Anxiety Group SADAG, depression is the leading cause of teenagers taking their lives. 'Not all children who children who are suicidal are depressed — that's an important distinction to make,' says Uschenka. Are some kids more likely to attempt suicide than others? 'There are risk factors we can look out for,' says Uschenka.

'Geneticswise, a family history of depression; how much social support and stress they experience... What we commonly see with these children is a trait called impulsive aggressiveness.' Impulsiveness and reactiveness, however, are common among teenagers. 'Young adults haven't fully formed their frontal lobe — their executive function — so everything that happens feels like "this is forever",' says child psychiatrist Dr Rebecca Hedrick.

'They often feel like there's no way out, and this can lead to impulsive acts.' So how do you know if your child is at risk? 'A drastic change in behaviour, a drop in their grades, getting in fights with their peers or authority figures, substance abuse — these are all signs to look out for.' The problem is, many of the so-called red flags can be written off as typical teenage behaviour, says Tamsyn Manuel, a clinical psychologist at KAYA, Akeso Kenilworth Clinic's adolescent unit. 'But you need to look out for isolating to the point where they're dropping out of social interests, there ‘Every warning sign, every symptom of depression should be taken seriously.' sleeping habits and they become more irritable or have outbursts they wouldn't usually have.' The use of drugs and alcohol are also a huge nono, especially if the teen has a history of depression. 'Substances can induce further depressive episodes, or make the depression worse,' says Uschenka. 'The child, now disinhibited, but feeling worse, is more likely to act on that.'

In some cases, drug use can even lead to psychosis. 'Sometimes substance induced psychosis is triggered with first time use; other times it comes with a family history of substance abuse,' says Tamsyn. 'Kids think marijuana, especially, is natural and harmless, but we see that kind of thing quite often. They start having delusions or hallucinations, become paranoid... or they'll see spirits.' TALK IT OUT As a parent, 'it's better to be overly involved and cautious,' says family therapist and social worker Talya Ressel, in a CapeTalk interview. SADAG echoes this sentiment. 'Take the signs seriously' is their number one tip, and for good reason: 75% of all suicides give some warning of their intentions to a friend or family member.

'We have to provide the space to talk,' says Talya. 'We're not born with emotional communication; it's a skill, so we've got to develop and practise it. Initiate a conversation: It can be as simple as: "You're looking worried", or "You seem down; do you want to talk about it?" You're just giving them the space [and putting some words to the feelings. That in itself is powerful because it validates that what they're feeling is real: I see you, I notice you, and I'm here to help you with it. 'This is what schools are scared of: that by talking about it we're putting ideas in their heads... But whether you're talking about it or not, it's out there... Thirteen Reasons Why — it's out there. ON NE TFLIX If you haven't heard of it, Thirteen Reasons Why is a Netflix show that tells the story of high school student Hannah Baker, who commits suicide and leaves behind tapes for all the people she blames for her death. The book by Jay Asher was made into a TV series in March 2017 and has caused an uproar, with critics arguing that it glamorises the idea of suicide, specifically the idea of using it as revenge. Some schools in the US have even sent warning letters to parents, calling it 'violent and graphic'. Netflix, meanwhile, has stood behind the show, saying they sought the help of medical professionals in developing the series.

'A number of people asked us why we had Hannah kill herself in the way we did, why we showed it,' says executive producer Brian Yorkey. 'We worked very hard not to be gratuitous, but we did want it to be painful to watch. Because we want it to be very clear that there's nothing, in any way, worthwhile about suicide.' Instead of trying to discourage your teens from watching the show more than likely they have already seen it or spoken about it to their peers', Talya encourages parents to educate themselves. 'You watch it; you talk to them about it. Open up those conversations, at school and at home.' SOCIAL MEDIA The show also brings to light another aspect of teen life that causes stress and anxiety: social media. 'They put themselves out there on social media and often they get a negative response,' says Tamsyn. 'The effect it has on their self-esteem is major.'

'Adults don't realise how hurtful cyberbullying is because it didn't exist when they were younger,' says Dr Rona Hu, a psychiatrist from Stanford University. 'Hopefully, sharing these stories can help parents pay attention to things that may be small to them but could be rocking the world of their kid,' says Thirteen Reasons Why producer, Mandy Teefy. When they check in for the three-week programme at KAYA, the teens' phones are confiscated. 'We do it for a reason: if I allow you to be on your phone here, you're still connected to the problems on the outside; you can't cut off and do a bit of introspection,' says Tamsyn. 'I ask every group the same question: have any of you recently had a conversation with someone without a phone present? None of them can say yes.' But, says Tamsyn, a three week break can change a lot. 'When they leave here they already engage better with others; they realise there's more to life than a phone. They say they have more fun because they're connecting with people and they feel more free. When they get their phones back, sometimes they aren't as interested in them anymore.'

After a stint at KAYA, Tamsyn suggests that boundaries be put in place. 'We recommend they spend no more than an hour and a half a day online — that includes social media, YouTube and chatting with their friends. If you look at the context of a day, an hour and a half is a lot, because they're supposed to be in school, doing homework, sport and having family time. 'Social media can be a positive platform but if it's not monitored, it can be detrimental. If you ask any kid here: "Where did you learn about self harming?" or "Where did you learn how to hang yourself?" they'll say social media.' ANXIETY Could an anxious child end up a suicidal or depressive child? 'Anxiety is definitely on the increase,' says Talya. 'What we're seeing is that talking about anxiety, acknowledging it, is not making it worse.

That's what I try to drum home to parents — let's talk about it, let's engage with it, because if left untreated, anxiety escalates and goes forward into adulthood. Then it can have a devastating impact if left ungauged or untreated.' Part of the problem, says Pippa Hudson during her Parent Talk segment, is that parents don't fully understand their role and what they're trying to achieve for their child. 'Many parents think their role is to make their child happy, to take away the anxiety and fix whatever is causing it. But we aren't doing them any favours.' Talya agrees. Building your kids' resilience, she says, is key in developing tools to manage anxiety.

'Resilience is a skill, so children have to practise it. They have to have a chance to experience failure because life isn't going to go smoothly, so they have to learn how to manage. As parents, we're doing them a disservice by trying to think ahead and stop any sort of disappointments or failures, because then they don't get to go through that experience.'

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