Preventing Adolescent Suicide: What You Can Do
If your adolescent child, family member, friend, or student were considering suicide, would you recognize the warning signs? If so, what would you do?
Recognize Adolescence as a Time of Upheaval
Adolescence is a time of hope and expectancy as well as extreme disappointment and moodiness. It’s normal for adolescents to experience stress, confusion, and self-doubt. In addition to normal physical, hormonal, and emotional changes, today’s adolescents confront many of the following challenges:
- Academic pressures
- Social demands (to find acceptance among peers, to be attractive, to date)
- Divorce, single-parent homes, or other instability in the home
- Negative peer pressure
- Exposure to violence, ]]>alcohol]]>, and ]]>illicit drugs]]>
- Confusion and shame about sexual identity or orientation
- Overburdened school systems
Many adolescents may have fleeting thoughts or fantasies about suicide from time-to-time when they are ]]>depressed]]>. But most do not make a suicide attempt or gesture. However, when the pressures seem too great and it seems there is no one to turn to for support, an adolescent may feel an overwhelming sense of helplessness, which can lead to serious thoughts of suicide.
How do you know when a young person is really in need of help?
Be Alert to Youth at Risk for Suicide
Most youth suicides are due to a combination of biological, psychological, cultural, and familial factors. A number of these factors can interact with a recent significant life event, such as the break-up of a relationship, leading to intolerable emotional pain in the young person. Common risk factors include:
- Previous suicide attempt
- ]]>Substance abuse]]>
- ]]>Conduct disorder]]>
- Disruptive and non-supportive family situation
- Relationship problems with a significant person
- Poor coping skills
- Other psychiatric illnesses (eg, ]]>schizophrenia]]>, ]]>anorexia nervosa]]>, ]]>obsessive compulsive disorder]]>)
- Taking antidepressants
- Having conflicted feelings about sexual orientation (the risk may be increased if the teen experiences social rejection or bullying because of sexual orientation.)
- Being bullied by peers
- Recent death of a loved one
- Chronic physical illness
- Early loss
- School failure
- Anniversary of a past loss or major life event
- Perfectionism and overachievement
Pay Attention to Warning Signs
Adolescent behavior is often perplexing, particularly to parents, who may not be able to tell what’s problematic and what is “normal.” The American Academy of Child and Adolescent Psychiatry recommends being alert to the following signs that may indicate a young person is at risk for suicide:
- Changes in eating and sleeping habits
- Withdrawal from friends, family, and regular activities
- Alcohol or drug use
- Violent or rebellious behavior, or running away
- Problems with the law (more common among adolescents with a diagnosed psychiatric problem)
- Unusual neglect of appearance
- Persistent boredom, difficulty concentrating, and decline in schoolwork
- Marked change in personality
- Frequent headaches, stomach aches, pains, or fatigue
- Lack of interest in pleasurable activities
An adolescent who is planning on committing suicide may:
- Refer to herself as a bad or rotten person
- Exhibit hopelessness in statements such as “I won’t be a problem much longer,” “You’ll never see me again,” or “There’s no use”
- Give or throw away important belongings
- Say “I’m going to kill myself” or “I’m going to commit suicide” (These threats should always be taken seriously, even if you think the person is just being manipulative.)
- Have hallucinations or strange thoughts
Get help immediately if someone you know has any of these warning signs.
A number of protective factors can help to prevent adolescent suicide. These include the presence of an important person in the youth’s life, good coping skills, a supportive and caring family, and interests and activities.
Parents and other significant adults can help prevent adolescent suicide in the following ways:
Develop a Good Relationship With the Youth
A good relationship is based on mutual trust, openness, and healthy communication. Although this is best established very early in life, it’s never too late. You can improve your relationship by:
- Providing a stable home environment that is both physically and emotionally safe
- Spending regular quality time and having fun together
- Listening to and really trying to understand what the youth is saying and feeling, without interrupting or trying to solve his or her problems
- Showing support and respect by allowing the youth to share their thoughts in a safe environment, when ready, and where he will not feel judged or criticized
- Encouraging the youth to express emotions, both positive and negative, in a healthy manner, by your own example
Intervene Early in Stressful Situations
Ask the adolescent about his feelings in a gentle and concerned manner. Don’t be afraid to ask about suicidal feelings as well, but avoid being judgmental. Having suicidal thoughts doesn’t mean a person is weak. Give the youth support, empathy, and time, especially if he is dealing with a family break-up, death, rejection, a problem at school, or other stressful situation. Seek professional help and locate resources in the community or school that can help the youth feel less isolated. The young person wants to know that someone cares about what happens.
Take Suicidal Threats Seriously
Take all threats seriously. At the very least, threats mean that the youth is not coping well and needs help. Never dismiss a suicide attempt as attention-seeking behavior. The youth should be assessed and treated immediately. The young person needs professional help and ongoing family support. In addition, researchers in Finland found that the time leading to suicide was relatively short among male youths without a diagnosed psychiatric disorder. This highlights the need to get help right away.
Get Help for Psychiatric Illnesses
Certain conditions increase the risk of suicide and should be treated as early as possible. These conditions include depression, schizophrenia, ]]>bipolar disorder]]>, eating disorders, and substance abuse. Be alert for any unusual behavior (eg, hallucinations, delusions) and seek help.
Remove Firearms and Potentially Lethal Materials From the Home
Guns, rifles, unnecessary medicines, poisons, and sharp kitchen utensils are often methods of choice for suicidal adolescents. Keep them out of your home, especially if the youth is depressed or stressed.
American Academy of Child and Adolescent Psychiatry
American Academy of Pediatrics
Canadian Mental Health Association
Canadian Psychiatric Association
Some things you should know about preventing teen suicide. American Academy of Pediatrics website. Available at: http://www.aap.org. Accessed July 25, 2008.
Suicide. American Academy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org. Accessed July 25, 2008.
Teen suicide. American Acedemy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org/cs/root/facts_for_families/teen_suicide. Updated May 2008. Accessed July 25, 2008.
Youth suicide. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncipc/dvp/Suicide/youthsuicide.htm. Updated September 2007. Accessed July 25, 2008.
7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Barbui C, Esposito E, Cipriani A. Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies. CMAJ. 2009;180:291-297.
7/2/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Schneeweiss S, Patrick AR, Solomon DH, et al. Comparative safety of antidepressant agents for children and adolescents regarding suicidal acts. Pediatrics. 2010;125(5):876-888.
Last reviewed June 2010 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.