Children and adolescents who have suicidal feelings should be encouraged to confide in a trusted adult. Keeping a teen’s suicide attempt a secret only increases the risk of acting on these feelings in the future.
Often there are warning signs that can be recognized by parents and teachers. These can include:
Depression
A major risk factor for suicide is depression, which can make youths prone to self-destructive behaviors. Depression can cause feelings of hopelessness, loss and worthlessness and make it difficult to cope with life’s problems.
Other mental health issues can also contribute to youth suicide, such as bulimia and anorexia, schizophrenia (although these disorders account for only a small percentage of suicides) and bipolar disorder. Comorbidity (the presence of multiple disorders) also significantly increases suicide risk.
Teens need to know that they are not alone and that others care about them, including their mental health clinicians. They need to be reassured that their depression and suicidal thoughts are treatable. They should also be made aware that they will need ongoing medical and psychological care to manage their symptoms.
Anxiety
A teen suffering from an anxiety disorder may begin to believe that they will never get relief from their symptoms and might conclude that suicide is the only way to end the pain. Studies have shown that people with anxiety disorders are more likely to engage in suicidal behaviors than those without an anxiety disorder.
However, previous research on the relationship between anxiety and suicidality has typically only considered generalized anxiety or broader measures of anxiety severity or symptomatology. So, the possibility that specific anxiety disorders have different relationships with suicidality warrants further exploration.
Warning signs that a teen is at risk include: a lack of interest in family or friends, poor eating habits and changes in sleep patterns. Family violence also appears to be a major factor in many youth suicide cases.
Drug or Alcohol Abuse
Acute drug intoxication can impair judgment and decrease impulsive control, making the risk of suicide much higher. Substance abuse can also interfere with daily responsibilities such as school work, and may cause problems with peer relationships. In addition, chronic substance use can have a negative impact on brain development.
Adolescence can be challenging enough with the hormonal changes and growing independence, but experimenting with drugs or alcohol adds an extra layer of difficulty that can lead to depression and suicidal thoughts. A recent study found that adolescent substance abuse contributes to suicidal behavior in both girls and boys, with a stronger contribution from alcohol than from cigarette, heroin or ketamine use.
Adolescents who report drinking at least five times per week are at high risk for attempting suicide. These adolescents have an elevated risk for suicide in the 24-hour period following alcohol intoxication and are at an increased risk of attempting suicide using more lethal means, such as firearms or hanging.
Relationship Issues
Several youth suicides occur in the context of family or intimate partner problems. These may include physical or sexual abuse, teen dating violence, family conflicts, and adolescent separation and divorce.
Adolescents who are satisfied with their family relationships are less likely to experience depression and suicidal thoughts than those who are not. Several studies have shown that adolescents who are dissatisfied with their families often have negative stress-coping styles and more frequent episodes of defeat, which increases their risk for suicide.
If you have concerns about a youth’s mental health, trust your judgment and take immediate action. In an emergency, call 911 or your local crisis center. Otherwise, remove any weapons from the home and make sure the youth has no access to lethal substances or objects.
Agitation
During the teen years, a young person is faced with major changes including rapid physical growth; conflicts between parental and peer values and ideals; emotional intimacy with opposite sex; uncertainty about their future career. These changes can generate great stress that leads to feelings of hopelessness and despair.
Agitation is a common warning sign that may be indicative of suicide and should not be ignored. A teen who paces the floor or has other signs of agitation should be seen by a mental health professional immediately.
All suicide attempts should be taken seriously. The person may need to be hospitalized for evaluation and possible treatment. If they have a gun or other weapon, they should be removed from the scene. Parents should be familiar with local, state and national resources that are concerned with youth suicide.