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Lydia and Melissa were identical twins. But from the time they were born, their parents realized some significant differences in the girls’ personalities. Lydia rolled with the punches, but Melissa met life’s frustrations with tears, and she always seemed fearful. Even as toddlers, their reactions to stress were not the same.

“If Lydia’s toy was taken away, she would just say, ‘Give that back,’” recalls her mother. “But if the same thing happened to Melissa, she would run into a corner and cry and cry. When I tried to help her handle the situation, she would just say, ‘No!’ and cover her head with a blanket.”

Her parents noticed that Melissa had more difficulty recovering from setbacks—even from ones as simple as falling off her bike. Lydia would fall off and get back up, but Melissa would need additional reassurance from her mom, and her mom would have to put her back on the bike to get her going again.

As the girls grew into their preteen and teen years, life became more complicated. While go-with-the-flow Lydia could bounce back from typical teen setbacks after a couple of days, Melissa would be emotionally hurt for weeks from the normal ups and downs of adolescence. During her long “down” times, which could last as long as six weeks, she would fall apart in every area of her life—physically, emotionally, and academically. With each friend breakup, bad grade, or other trouble during her teen years, Melissa sank lower and lower, until she ended up in a suicidal crisis.

While Lydia’s pattern of dealing with the stress of life was more typical of normal development, Melissa’s pattern pointed to a mental health issue.

Once children enter puberty and their teen years, it’s not always easy to know what’s normal behavior and what’s not. So how can we tell if our son or daughter may have a mental illness and be at risk of suicide? After all, adolescence can be a dramatic and volatile stage of life even under the best of circumstances. The good news is that you can distinguish between normal developmental challenges and serious mental disorders if you understand what you’re doing. It’s a question of knowing what to look for.

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