If your adolescent child, family member, friend, or student were considering suicide, would you recognize the warning signs? If so, what would you do?

Facing Challenging Times

Adolescence is a time of hope and expectancy, as well as extreme disappointment and mood swings. It’s normal for teens to experience stress, confusion, and self-doubt. In addition to normal physical, hormonal, and emotional changes, teens confront many of the these challenges:

    
  • Academic pressures
  • Social demands (eg, 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 drugs
  • Poverty
  • Confusion and shame about sexual identity or orientation
  • Overburdened school systems

    • Teens may have fleeting thoughts or fantasies about suicide from time-to-time when they are struggling. But most do not make a suicide attempt or gesture. However, when the pressure seems too great, a teen may feel an overwhelming sense of helplessness, which can lead to serious thoughts of suicide.

    How do you know when a teen is really in need of help?

    Looking at the Risk Factors

    Teen suicide is often due to a combination of factors. These factors may be biological, psychological, and cultural. Family issues also play a role. These factors can interact with a significant life event, like the break-up of an important relationship.

    Examples of factors that put a teen at risk for suicide include:

        
  • Previously attempting suicide
  • Having depression
  • Abusing drugs
  • Having conduct disorder
  • Having a disruptive and non-supportive family situation
  • Experiencing relationship problems with a significant person
  • Having poor coping skills
  • Having other mental health conditions (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.
  • Having a family member, especially a parent, who has committed suicide

    • Other risk factors include:

        
  • 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

    • Being Aware of the 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 an increased risk of suicide:

        
  • Experiencing a change in appetite (eg, eating more or less than usual)
  • Experiencing a change in sleeping patterns (eg, sleeping more or less than usual)
  • Withdrawing from people they care about
  • Abusing alcohol and drugs
  • Becoming violent or rebellious
  • Running away from home
  • Getting arrested or having other problems with the law
  • Ignoring personal hygiene and appearance
  • Feeling very bored, having a hard time concentrating, and doing poorly in school
  • Acting in a way that is unlike their usual personality
  • Having a lot of health complaints (eg, headaches, stomachaches, fatigue)
  • No longer being interested in hobbies or other activities they used to enjoy

    • A teen who is planning to commit suicide may:

        
  • Talk about being a bad person or feel terrible about himself
  • Say things like “I won’t be a problem much longer,” “You’ll never see me again,” or “There’s no use”    
  • If a teen makes comments about killing himself, always take these threats seriously.
  • Give away treasured belongings
  • Have symptoms of psychosis (eg, hallucinating or having bizarre thoughts)

    • Getting Help

    Pay attention if the teen in your life has any of the above risk factors and behaviors. Take all suicide threats seriously. In the very least, these threats mean that the teen is not coping well and needs help. Never dismiss a suicide attempt as attention-seeking behavior.

    The teen who is struggling should be assessed and treated right away. Professional help and ongoing family support are extremely important. In some cases, the time leading up to a suicide may be relatively short. This emphasizes the need to reach out to the teen and connect with mental health services.

    If you are unsure of how to get help, you can call:

        
  • A mental health therapist who specializes in working with teens—Working with an experienced therapist is crucial because the teen may have another condition that needs to be treated, like depression, bipolar disorder, or substance abuse.
  • A doctor or take the teen to the emergency room—In serious cases, the teen may need to be hospitalized.
  • A crisis hotline, such as 1-800-273-TALK

    • In addition to reaching out for help, take steps to keep your teen safe at home. For example, remove any guns, knives, medicines, and poisons from the area.

    Building Teen Support

    Whether you are a parent of a teen or are someone who plays an important role in a teen's life, you can help prevent suicide by developing a good relationship that 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 with the teen in your life by:

        
  • Providing a stable 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 problems
  • Showing support and respect by allowing the teen to share his thoughts in a safe environment
  • Encouraging the teen to express emotions, both positive and negative, in a healthy manner, by your own example

    • By being aware of suicide risk factors and warning signs, you can help a teen get the support he needs to survive this challenging time in his life. You can also help a teen become more resilient to life's struggles by showing your care and concern.