Suicidal Thoughts and Depression in Children

How to Know and What to Do If Your Child Has Suicidal Thoughts

Depressed Child
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While many people think of depression as an adult condition, roughly two percent of children reportedly experience depression as well. If that isn't heartbreaking enough on its own, suicidal thoughts, or thoughts of killing oneself can accompany depression even in children. How can you know if your child is having suicidal thoughts and what can you do?

How to Tell If Your Child Is Having Suicidal Thoughts

Suicidal thoughts, also known as suicidal ideation, may not always be completely obvious to others, not even to a child's parents. Part of the reason for that is that children with suicidal thoughts will probably not speak directly about them as an adult might.

Instead, suicidal thoughts in children may manifest through an interest in and/or preoccupation with suicide or death. You may notice signs of this preoccupation in your child's clothing, the shows she watches on television, the websites she visits on the computer, through what she writes in journals or even on homework, or in the way in which she identifies with others who are depressed or have spoken of suicide.

On the other hand, sometimes a child will speak directly about wanting to "die" or a wish to "kill herself." She might even speak indirectly about wanting "to make it all go away" or thinking "the world would be a better place without me."

Often, there are few signs of suicidal thoughts in children, especially in children who are shyer or more withdrawn. If this is the case with your child, how can you know as a parent if she is having suicidal thoughts? A key may be recognizing the signs of depression, knowing that suicidal thoughts and depression can go hand in hand.

Depression in Children Is a Risk for Suicidal Thoughts

If your child hasn't openly expressed any suicidal thoughts, it's important to recognize the possible symptoms of childhood depression, since these are often associated with suicidal thoughts. This may include feelings such as worthlessness, hopelessness, and social withdrawal.

While not all children who are depressed have suicidal thoughts (it's more common in children with early-onset depression and a longer duration of symptoms,) depression is considered a risk factor for suicidal thoughts and attempts.

Additionally, while suicidal thoughts do not always lead to an attempt of suicide, such thoughts are believed to increase a child's risk.

Suicide is one of the scary consequences of untreated depression in children, but depression in children can be devastating in other ways as well.

What to Do If Your Child Is Having Suicidal Thoughts

As mentioned earlier, a child's thoughts may not always be obvious, which is why seeking treatment for your child's depression is so important. A trained mental health provider may be able to pick up on subtle cues of suicidal thoughts by talking to your child, conducting psychological tests, and assessing individual risk factors, such as previous suicide attempts and the severity of your child's depression.

Additionally, therapeutic treatment for depression can help to decrease your child's suicidal thoughts if she is having them. If your doctor suggests medication, do your homework. Recent research actually shows that the use of certain selective serotonin reuptake inhibitors (SSRIs) can increase suicidal ideation in children. A multidisciplinary approach to managing your child's will likely be more effective.

Tips on Communicating With Your Child

If you decide to talk about depression with your child, you may be concerned about saying the "right" thing. However, just having an open and honest discussion with your child can provide her with much-needed support. With a few tips, concerned parents and caregivers can confidently talk about depression with their children.

Keep the Talk Age-Appropriate

  • Make sure that your child understands what you are saying and is not confused or bored by the discussion.
  • Use words that your child can understand. Words such as "depression" or "emotional reaction" are probably too complex for a younger child but may be appropriate for an older child or adolescent.
  • Try comparing her depression to something that your child is already familiar with — like another illness that your child has had experience with (e.g., flu, ear infection, etc).

Keep the Conversation Positive

  • Depression is a serious illness that causes emotional and physical pain, but try to keep the conversation focused on the positive.
  • Maintain a positive and hopeful outlook in your discussions, you will avoid unnecessarily alarming your child.

Be Honest

  • Don't make promises you cannot keep.
  • Don't go into detail about topics that you are not certain of.
  • Do tell your child what you do know.
  • Make a list of questions to discuss with your child's mental health professional.

Be Compassionate

  • Your child needs to know that you recognize and respect his feelings.
  • Even if you do not quite understand his thoughts, don't dismiss their feelings.
  • Avoid comments like "What do you have to be depressed about?" or "Don't be ridiculous."
  • Dismissive comments can cause a child to hide their feelings or become defensive.

Be a Good Listener

  • Allow your child to talk openly and express his opinions and thoughts.
  • Avoid interrupting, judging or punishing him for his feelings.
  • Knowing that he has someone he can confide in help to sort out his feelings.

If you are concerned, directly ask your child if she is thinking about suicide. Contrary to what was believed in the past, this will not give her ideas. Instead, she will feel supported if she has been depressed.

Parental support (taking the time to talk to your child about feelings such as those about suicide) is associated with a lower incidence of suicidal thoughts in middle school-age children.

If there are any safety concerns, do not provide judgment or discipline; simply remove her from immediate danger, do not leave her alone, and get her urgent help.

Never dismiss a child's suicidal thoughts in a child, and never promise to keep them a secret. Any suicidal thoughts or behaviors should be brought to the attention of your child's pediatrician or mental health provider immediately. If needed, bring the child to an emergency room or call an ambulance.

Bottom Line

Suicidal thoughts should be taken very seriously and it should never be assumed that your child is only seeking attention. Always seek help and address these thoughts as potential warning signs of suicide. Sometimes children are afraid to express these thoughts and may present them in a joking manner. Suicide is far too common in children, and any thoughts should be addressed.

Likewise, if you see a health care provider who doesn't believe your child's suicidal thoughts are serious even though you do, get another opinion. Trust your instincts when it comes to your child. You know her better than anyone.

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Article Sources

  • Cox, G., and S. Hetrick. Psychosocial Interventions for Self-Harm, Suicidal Ideation and Suicide Attempt in Children and Young People: What? How? Who? And Where?. Evidence-Based Mental Health. 2017. 20(2):35-40.
  • Glenn, C., Kleiman, E., Coppersmith, D. et al. Implicit Identification with Death Predicts Change in Suicide Ideation During Psychiatric Treatment in Adolescents. Journal of Child Psychology, Psychiatry, and Allied Disciplines. 2017 July 4. (Epub ahead of print).
  • Sood, A., and J. Linker. Proximal Influences on the Trajectory of Suicidal Behaviors and Suicide During the Transition from Adolescence to Young Adulthood. Child and Adolescent Psychiatric Clinics of North America. 2017. 26)2):235-251.