Because a first sexual experience can strongly influence a girl's feelings about herself, her partner, and future relationships, it behooves her to determine whether or not she is ready. Some issues she should consider are:

* Is she feeling pressured by her partner?
* Does she think that having sex is a way to get or to keep a boyfriend?
* Is she hoping that becoming sexually active will make her more popular?
* Is she feeling left out among more sexually experienced friends?
* Does she want to “get it over with” to figure out what the hype is about?
* Is she in a trusting, mutually respectful relationship?
* Does she experience emotional intimacy with her partner?
* Can they discuss openly sexual issues, including protection from pregnancy and sexually transmitted disorders?
* How will she feel if she has sex and the relationship ends?

What are the tools a parent can give their teen to help them make the right choices regarding sex?

The most important tool parents can give their children is themselves: developing close, trusting relationships that encourage honest discussion. Despite myths to the contrary, parents are their teens' number one influence, more powerful than their peers. Yet studies show that many teens are unsure how their parents feel about sex. That is why parents must first be clear in their own minds about their attitudes and values, and then convey these principles to their teens. Parents can educate their daughters about the powerful effects of hormones on sexual desire. Girls should know that sexual urges are normal and okay, but should only be acted upon when it is appropriate. Parents must be able to spell out their expectations: for example, at what age and under what conditions they would like their daughters to enter sexual relationships. All parental interactions with teens should empower girls to value themselves, protect their bodies, and make conscious, healthy choices. Girls should be taught that a sexual partner should know and respect them before being granted the privilege of knowing their bodies. Sex should be a two-way street; a girl should expect her partner to care about her pleasure, too, rather than simply expecting to receive pleasure from her. Parents should discuss facts about STDs and pregnancy, dispelling any myths girls might have. Since the majority of girls have sex for the first time in their own or their partners' homes, parents should be aware that supervision is crucial. Providing guidelines such as dating boys no more than two years older than herself also reduces the possibility of a girl feeling pressured to have sex prematurely. Above all, no matter what their decisions about sexual relationships girls should feel they can come to their parents for help in keeping themselves safe.

Are there resources available to teenagers struggling with this decision?

For more information, teens and their parents might try:
Stay Teen at: www.stayteen.org
Teen Pregnancy at: www.teenpregnancy.org or
or the new book, The Talk, by Sharon Maxwell, Ph.D., to be published in April 2008 by Avery/Penguin, New York.

Additional resources:

MedicineNet.com
Sex Education programs delay Teen Sex
http://www.medicinenet.com/script/main/art.asp?articlekey=85986

WebMD.com
How to Talk to Your Kids About Sex
http://www.webmd.com/parenting/news/20080116/how-to-talk-to-your-kids-about-sex

WebMD.com
Teen Pregnancy Prevention Program
http://www.webmd.com/video/teen-pregnancy-prevention

While adult depression is often associated with sleeping and eating disturbances, lethargy, and withdrawal, teens may be restless and irritable, unable to concentrate, indecisive, and as hyper-social as they are isolated. Negativity, feelings of worthlessness, and persisting fatigue are not uncommon. Teens may lose or gain weight, sleep more or less than usual, and complain that they simply “don't care anymore.” Feelings of not being understood, sulking, reluctance to cooperate in family plans, and refusing to leave their bedrooms are frequent symptoms. In some cases, morbid or suicidal thoughts occur. Teens who suddenly give away their prize possessions or say goodbyes are sending red flags for possible self-destructive behavior. Adolescents also may express macabre or suicidal ideas in their creative writing, diaries, or drawings. Many, if left untreated, begin to self-medicate with alcohol and/or drugs. School difficulties are extremely common. According to the clinical literature, teenage girls are about five to seven times more likely than boys to develop depression.

What first steps should be taken if you suspect your teenager is depressed?

As always, the first step is speaking directly to your teen. Ask if she is feeling discouraged, apathetic, sad, or bad about herself. Share your observations of her change in mood, attitude, and behavior. Encourage her to talk about her real feelings, whatever they are, without judging or trying to talk her out of them (e.g., “You shouldn't feel that way; you should be happy that . . .”). If in doubt about whether girls are truly depressed, parents should ask school guidance counselors for feedback on how they are doing in school and whether teachers have noticed any changes in their concentration, performance, appearance, or behavior. The best course of action, however, is to consult a mental health professional who can make a thorough, individual assessment of whether a teen is truly depressed.

Is there something that can be done to avoid depression?

Although depression tends to run in families, it doesn't mean your teen or her siblings will definitely develop the disorder. It's probably helpful to be aware of an increased familial risk so you can be on the alert for early symptoms. As always, it is crucial to maintain a close, trusting relationship with your daughter that will encourage her to express whatever feelings she has-good or bad-rather than bottling them up. With your love and support, your teen is best able to face whatever problems she has in order to develop good coping and problem-solving skills. Girls today are often becoming depressed when stressed-out by unrealistic expectations and pressures for success. Chronic feelings of being overwhelmed by never-ending work and exhausting commitments leads to girls believing they are-and never will be-good enough. So parents need to monitor the level of pressure their daughters are experiencing, support them in setting reasonable goals, and make sure they get plenty of rest and down time. Fortunately, depression is highly treatable.

If a teenager has a friend they think is having suicidal thoughts, what should she do?

This is one situation when teenage girls must put the health and well-being of their friend ahead of their typical, loyal promises to keep secrets. If there is any suspicion a girl may be at risk for suicidal behavior, friends have to act fast. First take her to a school guidance counselor or school psychologist, professionals who are trained to deal with potential crises. If a friend refuses to see school personnel, girls should see a parent, trusted teacher, or guidance counselor on their own to get advice on handling this serious problem. Teens who have friends who are depressed and/or suicidal are often preoccupied and weighed down by their concerns; they need adults with more experience to help shoulder this burden and get their friends whatever assistance they need. If your daughter is afraid her friend will get angry at her if she divulges her problems, she should know that when suicidal people get treatment and feel better they are invariably grateful for such expressions of love and support. It is no exaggeration to say that telling someone about a friend's suicidal thoughts can save her life.

If you or anyone you know are considering suicide, call 911 or these hotlines: 1-800-SUICIDE
1-273-TALK

For more information on depression and suicide:

http://www.nimh.nih.gov/health/publications/depression/complete-publication.shtml
http://www.cdc.gov/ncipc/pub-res/Suicide%20Fact%20Sheet.pdf

Additional Resources

Teen Depression
A comprehensive site for troubled teens, and parents of teens, about the warning signs, and various treatment options available for depression.
http://www.teendepression.org/

DepressedTeens.com
An educational site offering help to teenagers and their parents to understand the signs and symptoms of teenage depression, and resources for those looking for help.
http://www.bpkids.org/site/PageServer?pagename=index

AboutTeenDepression.com
From the difficulties in diagnosing teen depression, to adolescent depression symptoms, treatment options, and teenage depression statistics, this site has answers for both teens and their parents.
http://www.about-teen-depression.com/

In teens, hyperactivity may be expressed as restlessness, fidgeting, hyper-social behavior (e.g., excitability, over emotionality, and risk-taking to compensate for poor academic performance and to seek peer acceptance). Students typically have trouble with skills known as executive functions: understanding directions and getting started; organizing their work; focusing, shifting, or sustaining their attention; staying on task; controlling frustration and other emotions; and monitoring their ongoing behavior. They often rush their work, make careless errors, fail to finish things they start, and seem unmotivated. They find it hard to develop and stick with plans and long-term goals, especially because more immediate gratification is hard to pass up. Group situations, boredom, and fatigue usually worsen inattention and other symptoms. Girls are not diagnosed with ADHD as often as boys because they are usually less disruptive, hyperactive, and defiant in class. Parents and teachers may not associate shyness, anxiety, poor concentration, distractibility, and spaciness with ADHD. That is why girls are more likely to be identified when their symptoms are extreme or when they are difficult to manage-that is, when they fail to follow routines at home or school, seem to ignore requests, or don't respond to corrections. Unless ADHD is diagnosed and treated, girls' learning, behavior, and emotional development are affected. While hyperactivity and fidgetiness often abate during the later adolescent years, the disorganization, poor judgment, and difficulty managing emotions may continue.

Although checklists have been developed to identify youngsters with ADHD, they can easily result in over-diagnosis. That is because occasional inattention, distractibility, and impulsivity are highly common in teens, especially during periods of intense emotional or academic pressure. Most people, in fact, experience symptoms of ADHD when anxious or stressed. For this reason, girls who are suspected of having ADHD should have a thorough evaluation by a mental health clinician. The diagnosis should be based on detailed academic, social, and behavioral histories; neuropsychological testing; and observations of their behavior in school, at home, and in the clinician's office. The good news is that once identified, there are many treatments and strategies that can help teens with ADHD become more attentive, organized, productive, and socially accepted.

Are drug treatments usually the first line of defense or are there other options?

In this era of intense competition for college, teen girls who are struggling in high school or their concerned parents may be eager to find a specific reason for poor achievement. A diagnosis of ADHD can be appealing because of the possibility of accommodations such as extra time on the SATs and the promise of a simple pill that will “fix” the problem of underachievement. In fact, however, medication is usually not recommended as the first step in treatment. Typically, coaching in organizational and study skills, cognitive strategies, psychotherapy, and behavior modification programs should be tried before medication is considered.

What measures can be taken in school to help a student with ADHD?

When a neuropsychological evaluation is performed to assess ADHD, teens and their parents should learn a great deal about their strengths, weaknesses, and styles of learning-along with specific recommendations for improving their academic performance and social functioning. These more general strategies are typically among those teens find helpful:

* Provide preferential seating in the classroom * Administer directions multi-modally (oral and written)
* Make rules and expectations clear and specific
* Provide grading rubrics
* Organize study space for completion of homework
* Coach to prioritize and organize assignments
* Teach use of daily, weekly, and monthly calendars
* Reduce distractions
* Positively acknowledge and reward desirable behaviors
* Break down assignments into smaller, more manageable parts
* Alternate low-interest and high-interest tasks
* Take frequent breaks
* Self-reward for each accomplished tasks
* Intersperse quiet desk work with brief physical exercise (e.g., stretching)
* Make maximum use of computer
* Give extra time for tests, if needed
* Teach proofreading skills
* Stress personal satisfaction over competition with others

Additional Resources

CHADD.org
Founded by parents of children with AD/HD, this site is a great place to get educated on the disorder and find much-needed support.
http://www.chadd.org/

ADD-ADHD.org
A straight-forward site that gives the where, why and how of ADD in a clear, easy to digest format.
http://www.add-adhd.org/ADHD_attention-deficit.html