As children grow and become more independent, it can be more challenging for parents to know what they are thinking and feeling. When do the normal ups and downs of adolescence become something to worry about?
Parents and family members can help teens cope when life feels too difficult to bear. If you see signs that your child’s mental health is under threat, tune in. Maybe your child is just having a bad day. When signs of mental health troubles last for weeks, though, don’t assume it’s just a passing mood.
Studies show that 9 of 10 teens who died by suicide were struggling with mental health conditions such as depression. But keep in mind that teens who haven’t been diagnosed with any mental health condition may still be at risk. In part, this is because it can be hard to pinpoint mental health issues at early ages. Occasionally teens who attempt suicide do not have underlying mental health issues. But they may give signs that they’re considering ending their own lives.
Your goal should be to remain calm, alert and ready to speak with your teen. Don’t wait for them to come to you. You might start by saying, “You seem sad. I’m open to talking about this, because I love you and I care what happens to you.”
Don’t be surprised if your teen turns away when you first raise the subject of mental health or suicide. Keep in mind that, even if your child is silent at first, actions may speak even more loudly than words.
Watch for major changes in your child’s sleep patterns, appetite and social activities. Self-isolation, especially for kids who usually enjoy hanging out with friends or participating in activities, can signal serious difficulties.
If your child is struggling more than usual with schoolwork, chores and other responsibilities, these are additional signs you shouldn’t ignore.
Some suicide risk factors include: loss of a loved one to death, divorce, deployment, deportation or incarceration; bullying in person or online; discrimination, rejection or hostility due to gender identity or sexual orientation; racism; stigma – the belief that it’s wrong or shameful to talk about mental health or suicide; or witnessing or suffering violence or domestic abuse. Additional risk factors include financial instability; suicide in their school or friend group; major life-changing events, such as a breakup with a dating partner or academic disappointment; and self-harming behavior.
Do not dismiss what you’re seeing as “teenage drama” or assume your child is exaggerating or playing games if they say or write things like “I want to die or I don’t care anymore.”
Many adolescents who attempt suicide will tell their parents ahead of time (though others do not). These words indicate an urgent need for help.
When your child talks or writes about suicide, you may feel shocked, hurt or angry. You may even want to deny what you’re seeing or argue with your child. These feelings are natural and valid. But it’s essential to focus on your child’s needs first and foremost.
Though you may feel this way, we suggest NOT responding to your teen this way:
- “That’s a ridiculous thing to say.”
- “You have a great life – why would you end it?”
- “You don’t mean that.”
- “I can’t believe what I’m hearing!”
Manage your own feelings so you can respond with empathy:
- “I’m sorry you are feeling this way—can you share a bit more?”
- “It sounds like you’re in tremendous pain and you can’t see a way out.”
- “Maybe you’re wondering how life got this complicated and difficult.”
- “Right now, you’re not sure of the answers to the problems you’re facing.”
- “You must really, really be hurting inside to consider ending your life.”
Risk for suicidal behavior is complex. Certainly, if you are concerned about depression, self-harm or vague references to suicide thoughts, seek care from your primary care provider as soon as possible. You can consider reaching out to a school therapist, local mental health provider or even a national suicide hotline for guidance.
If you have any concern that your teen is at more immediate risk for attempting suicide, take them to the emergency department of your local hospital or call 911. Fast action is crucial when things have reached a crisis point.
Health care teams can help you and your teen create a safety plan to decrease risk for suicide attempt. Planning may include: identifying warning signs, steps to help them cope when they have suicidal ideation; identifying sources of support such as family members, friends and mentors; and listing emergency contacts and steps to take if things get worse.
Make sure to remove or secure guns you have at home, as well as other potential lethal means.
Half of youth suicides occur with firearms—and suicide attempts with firearms are almost always fatal. Teens and adolescents almost always use a gun found in their house.
As your child enters treatment, focus on creating hope.
Your child’s care team will likely recommend a combination of steps to reduce mental health symptoms and thoughts of suicide. Medications, talk therapy and stress-reducing techniques such as yoga, mindfulness, meditation or journaling may be part of the plan.
Provide realistic reassurance for your child along the way. Remind them (and yourself) that difficult times don’t last forever. People do feel better when they receive effective treatment and support.
Social media may be the primary way some adolescents engage with their friends. It can be a point of connection and support, but at the same time, social media can be a source of bullying and triggers. Encourage an open dialogue around social media use and ask how your adolescent feels after using social media. Consider making a Family Media Plan.
Encourage healthy sleep habits. Physical activity also eases mental health symptoms and supports your child’s wellness plan.
Reassure your teen that self-care is never a sign of weakness. Everything we do in life is affected by our health. So, giving ourselves time to heal is essential. Big tasks can be divided into smaller, more manageable ones, and gradually, as your child’s confidence and strength grows, they’ll feel ready to take on more.
You and your child will benefit from knowing that progress will come at its own pace. Setbacks may happen—but they’re part of the healing process, too.
If your child is considering suicide, call or text 988 or chat on 988lifeline.org right away. Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones. Other resources include the National Alliance on Mental Illness and the American Foundation for Suicide Prevention.
Parents of LGBTQ2S+ children can visit the Trevor Project website for focused resources. Parents and teens facing racial stress can benefit from these strategies and tools offered by the American Psychological Association.
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Eric J. Sigel, MD, FAAP, specializes in Adolescent Medicine at Children’s Hospital Colorado. Dr. Sigel is a member of the American Academy of Pediatrics (AAP) Committee on Adolescence, Council on Injury, Violence and Poison Prevention and Violence Prevention Subcommittee.
Maria Rahmandar, MD, FAAP, is a board-certified pediatrician and adolescent medicine physician. She serves as the Medical Director for the Substance Use & Prevention Program at Lurie Children’s Hospital of Chicago and is an Associate Professor at Northwestern University Feinberg School of Medicine. Within the AAP, Dr. Rahmandar sits on the Council on Adolescents and Young Adults and co-facilitates learning collaboratives on suicide and mental health.