Understanding Suicidal Ideation in Teens

When Teenagers Have Suicidal Thoughts

A depressed young woman sits alone against a concrete pillar. Denmark

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Information presented in this article may be triggering to some people. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Suicidal ideation, sometimes referred to as suicidal thoughts, describes thoughts, fantasies, ideas or images related to committing suicide. Contrary to common belief, depression and suicidal thoughts are not limited to adults, but symptoms and warning signs are often different in teens.

As a parent, caregiver or friend, the most important thing you can do to support a loved one who is struggling is to learn to recognize what suicidal ideation is, what it looks like in teens, and how to intervene.

Passive vs. Active Suicidal Ideation

For teens, thoughts of suicide can range from fleeting to making actual plans to end their life. For this reason, mental health professionals discuss suicidal ideation in terms of being either passive or active.

Passive suicidal ideation about suicide includes experiencing vague ideas about committing suicide. Suicide is viewed as a possible way to end the pain, but usually, no action is taken. Active suicidal ideation is when a teen experiences persistent thoughts of suicide and continues to feel hopeless. When the ideation is active, a teen begins to take steps to carry out a suicide attempt.

According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death for children, teens, and young adults between the ages of 10 and 24. 

Causes in Teens

Suicidal ideation in teens is often caused by untreated depression or drug misuse and always needs to be taken seriously.

Suicidal thoughts and depression often have many causes. Social difficulties, stress, academic pressures, and other concerns facing teens may contribute to suicidal ideation.

Other risk factors include:

  • Bullying
  • Health issues
  • Lack of family support
  • Physical or sexual abuse
  • Poor social relationships
  • Substance and alcohol misuse

Genetic factors can play a role in depression and suicide risk as well. Teen that experience suicidal thoughts are often more likely to have family members who have died by suicide.

Warning Signs of Suicidal Thoughts

There are quite a few signs that your teenager may be experiencing suicidal ideation. Be on the lookout for:

  • Becoming extremely agitated, upset, depressed and/or anxious
  • Beginning to use alcohol and/or drugs, or using them more frequently
  • Changing obvious characteristics of their personality
  • Being self-destructive or engaging in risk-taking behaviors
  • Changes in sleeping, eating or other patterns
  • Expressing hopelessness or a feeling of being trapped with no way out
  • Extreme mood swings
  • Frequently talking about death or dying
  • Giving away possessions for no particular reason
  • Isolation and withdrawing from social contact, especially if it's sudden
  • Looking for and/or acquiring means to commit suicide, such as getting a gun or a lot of medication
  • Making a point to say goodbye to people
  • Saying things like, "I wish I were dead" or "I wish I had never been born"

Remember, warning signs can be different for every individual, and some teens keep these thoughts and feelings to themselves. If you feel like your teenager is showing any of these signs or are not acting like themselves, be sure to consult your physician as soon as possible.

Early intervention is important with any mental illness, and if suicide is something your teen is considering, it's an emergency situation. 

An Example of Suicidal Ideation

Ivana, age 15, feels very sad when her best friend moves away and she experiences a deep sense of loneliness and insecurity. One night she finds herself thinking about suicide as a way to end the painful feelings she is having.

She pictures herself taking a bottle of pills and drifting into a deep sleep she will not wake up from. When she wakes up the next day her suicidal ideation has changed, she knows it’s an option but is feeling better and decides to call a friend she hasn’t spoken to in a while.

What to Do

If a teen is experiencing suicidal thoughts, there are steps that parents, friends and guardians can take.

For parents:

  • Be supportive, understanding and nonjudgmental.
  • Keep guns and prescription drugs away from children and teens.
  • Know the warning signs of suicide and depression.
  • Talk openly with your teen and let them know that you recognize their pain.
  • Watch for signs of substance use and get help immediately if you suspect there is a problem.

Address Untreated Mental Illness

If your teen has symptoms of depression, anxiety or another psychiatric condition, talk to your child's pediatrician. While most people with mental health conditions do not attempt suicide, having an undiagnosed or untreated condition along with other risk factors can make suicide more likely.

Never Ignore Suicide Threats

Don't dismiss suicidal talk as "typical teen drama." If a child is making comments such as "I might as well kill myself" or "I wish I was dead," you need to listen and acknowledge their pain. Let them know that you understand that they are hurting, you are there to offer support and you will help them get the help that they need.

Get Them the Help They Need

If you are a parent or guardian, talk to your child's pediatrician and get a referral to a professional mental health provider. Your child's doctor or therapist may recommend psychotherapy, medications and lifestyle changes that can help reduce the risk of suicide.

If you are a teen and you are concerned that your friend is thinking about suicide:

  • Take signs of suicide seriously.
  • Encourage your friend to talk to their doctor or a trusted adult.
  • Talk to a teacher, parent or another adult about your friend and your concerns.
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  1. Coon H, Darlington TM, DiBlasi E, et al. Genome-wide significant regions in 43 Utah high-risk families implicate multiple genes involved in risk for completed suicideMol Psychiatry. 2018. doi:10.1038/s41380-018-0282-3

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