Evolve Adolescent Behavioral Health

Suicide Ideation in Adolescence

One of the most heartbreaking losses for any parent is the death of a child.  When the cause of death is suicide, the gut-wrenching pain is often more pronounced and excruciating than ever.  To add insult to injury, the parents’ pain is inevitably accompanied by a barrage of guilt, unrelenting “what ifs”, and harsh self-judgments.

Adolescent suicide has been on the rise for the past several decades.  In the U.S. suicide is one of the top two leading causes of death among teens.  Teens are faced with more pressures and challenges today than ever before. Those who are emotionally fragile and lack sufficient support are especially vulnerable to suicidal thoughts and behaviors. 

Most teens who commit suicide give clear warning signs.  However, these signs can be easily overlooked or chalked up to “typical adolescent drama” if you, as a parent, don’t know how to identify them.  This brief guide is designed to help you know what to look for and what steps to take if you suspect your teen is struggling with suicidal thoughts or actively considering suicide.

Suicide in Adolescents – Statistics and Facts

Mental Health Issues and Suicide Ideation in Teens

Adolescents who suffer from an underlying mental health disorder are especially vulnerable to suicidal thoughts and behaviors.  These include (but aren’t limited to) the following psychiatric disorders:

It’s important to note that the risk of suicide is even greater for individuals who have both depression and another mental health disorder.  

Why Teens May Consider Suicide as an Option

Many parents naively assume that “my child” would never consider suicide.  This is a very common, but also very dangerous, assumption to make.  Adolescents today face myriad pressures and challenges that can leave them feeling more hopeless, alone, and overwhelmed than ever before.  Not only are their brains still developing, they also lack the maturity and life experience to see the bigger picture – that life can get better – when they experience a devastating loss or rejection or perceive their life to be imploding or ruined.  Many feel too ashamed or scared to reach out for help, leaving some with the tragically distorted belief that suicide is their only option for relief.  If no one is paying close attention, it’s easy to assume a struggling teen is coping far better than he or she really is. 

Risk Factors for Suicide in Adolescents

There are many potential risk factors for adolescent suicide.  These include, but aren’t limited to:

Recognizing the Signs of Suicidal Ideation and Behavior in Teens

While some adolescents wear their hearts on their sleeves, so to speak, far too many are quite adept at hiding painful emotions from adults.  If they’re seriously contemplating suicide, they may go to great lengths to hide their intentions from parents, siblings, and anyone else who may be inclined to pry or attempt to intervene.  Questions about their well-being (e.g. “How are you feeling?” or “Is everything okay?”) may be met with a casual “fine” or even “great”, accompanied by a forced smile – anything to thwart the suspicions of others. 

Following are several warning signs that your teen may be contemplating suicide:

Teens often make frequent verbal statements about suicide when they’re seriously thinking about it or actively planning it, such as:

It’s very important to note that statements such as those above aren’t always spoken out loud, but rather end up posted on social media, such as Twitter or Facebook.  They may also be sent via email or text messages.  Statements such as the above should never be taken lightly or dismissed as adolescent angst or “typical teen drama”. 

Knowing the First Steps to Take  

If you have reason to believe your teen may be contemplating or actively planning suicide, don’t assume it’s just a phase that will pass.  Take action.  Self-harm in teens is dangerous and unhealthy, and the scars can last a lifetime.  The sooner you intervene and get help for your teen, the better.  Following are the first steps to take:

1 – Talk to your teen.  Have a conversation with your teens regarding your concerns.  Don’t be dramatic.  Do your best to keep any feelings of panic in check.  Let your son or daughter know you want to help and are available to talk and listen.  Avoid pressuring your teen – that last thing you want to do is create more stress or push your teen away. 

Understand that your teen may attempt to brush you off by convincing you that everything’s “fine”.  Often this is due to fear and shame. 

2 – Schedule an evaluation with a mental health professional.  Suicidal thoughts should never be taken lightly, so make sure you have your teen evaluated by a psychologist, psychiatrist, or other qualified mental health professional.  Find someone who specializes in working with adolescents if possible.  A professional can determine if your teen’s suicidal thoughts are due to an underlying psychiatric disorder or specific stressors.  Either way, he or she can recommend an appropriate course of treatment for your struggling teen. 

3 – Get your teen into treatment.  Once your teen has been evaluated, get him or her into treatment based on the recommendations made during the evaluation.  With suicidal thoughts and behavior, the treatment approach and methods will depend on the underlying cause.  Ensuring your teen’s safety will be the initial primary goal of any type of treatment.  

Treatment for suicidal adolescents almost always involves some form of psychotherapy or “talk therapy”.  It may also include medication to help alleviate symptoms of disorders such as depression, anxiety, or another mental health disorder.  Hospitalization may be necessary if your teen has attempted suicide or is believed to be a high suicide risk.

Psychotherapy – There are several types of psychotherapy or talk therapy that can help an adolescent who’s struggling with suicidal thoughts.  These include:

Medication – Medication can play a key role in treating symptoms of depression and other disorders that may be contributing to your teen’s suicidal ideation.  Often, when troubling symptoms start to abate, the desire to end one’s life subsides as well. Unfortunately, medications typically involve trial and error, may take two or more weeks to start alleviating symptoms, and inevitably come with side effects. They should be used only in conjunction with other forms of treatment, such as psychotherapy.  

Hospitalization – Hospitalization in an adolescent psychiatric hospital may be necessary if your teen has made a suicide attempt or is considered a high suicide risk.  Medical staff can monitor your child 24/7 to help ensure safety until your teen is stable and no longer a danger to himself or herself.  

Supporting and Encouraging Your Child  

Teens grappling with suicidal thoughts need all the support they can get.  As a parent, there are several things you can do to help your teen feel understood, valued, and less alone.  They include:

What to Do When Things Escalate

Sadly, for some adolescents, thoughts of suicide can gradually or quickly turn into actively planning suicide.  Early intervention and treatment can and does help many teens, but for others, the suicidal ideation may get worse over time even with treatment.  If medication is prescribed for depression or other symptoms, it can take a lot of time and trial and error to find something that might work.  This can serve to add another level of frustration and hopelessness for your teen, and potentially escalate the desire to end the suffering they’re experiencing. 

It’s also important to note that it’s not unusual for someone who’s severely depressed to become actively suicidal after they start to feel better.  It’s essential for parents to refrain from assuming the worst has passed, as this can still be a high-risk time for their teen.  One of the reasons the risk may be even higher is because the individual now has the energy to act upon the suicidal thoughts with which they’ve been struggling.

If things do start to escalate at some point, don’t hesitate to reach out for help:

Or, if after hours:

When Individual Therapy isn’t Enough

Individual therapy doesn’t always adequately address the underlying issue in suicidal teens.  If your child doesn’t have a sufficient emotional support system, is battling a serious psychiatric disorder, and / or has experienced a devastating loss, trauma, or other crisis that is causing or exacerbating his or her suicidal thoughts and behaviors, you  may need to consider more intensive treatment.  Options include:  

Intensive outpatient treatment or psychiatric day treatment can vary in terms of the amount of time spent in treatment and how often your child is required to go.  These programs are the next step up from regular outpatient treatment that usually consists of an hour of therapy per week. 

Residential treatment involves having your teen stay at a non-hospital treatment facility that specializes in helping adolescents with psychiatric disorders.  Residential treatment typically lasts between 30 to 180 days, depending on the disorder and its severity. 

Inpatient psychiatric treatment is the highest and most intensive level of treatment for suicidal adolescents.  It involves admitting your child to an adolescent psychiatric hospital unit where patients are monitored by medical personnel around the clock. Inpatient treatment may last for a few days to a few weeks. 

Each of these intensive levels of treatment typically provides daily or bi-weekly visits with a psychiatrist and daily psychotherapy (often both group and individual, and a combination of several other types of therapy, such as art therapy, music therapy, etc.).

Taking Care of Yourself

While you may feel obligated to spend all your energy and focus on your teen during this time, it’s crucial that you don’t neglect your own self-care.  The stress can take a significant toll if you’re not doing things to keep it manageable.  Some things you can do include:

Your teen will be looking to you for unconditional love and acceptance, understanding, encouragement, hope, and the sense that he or she truly matters and has value in this world.  Taking care of yourself will help ensure that you can provide plenty of support for your child during this challenging time.