Trigger warning: discussions of suicide.
The realization that your child might be in a genuine mental health crisis is a situation no parent ever wants to face. Cases of depression, anxiety, eating disorders, and other mental health conditions have all reportedly spiked among tweens and teens in recent years, making it increasingly possible your child could be struggling. Even more alarming: a recent report by the Centers for Disease Control and Prevention (CDC) showed a 4% increase in suicides in the U.S. in 2021, with an 8% increase in suicide rates among males ages 15-24.
Perhaps you stumbled upon a troublesome text or a worrisome social media post, or maybe your child has flat-out told you they are struggling. Maybe you’ve noticed things are amiss, or perhaps you had no idea something might be going on behind the scenes. No matter the situation, how you handle it is crucial to ensure the safety and well-being of your child, who likely needs your support now more than ever.
Signs Your Child Might Be Struggling
Unfortunately, suicidal ideation is a very real concern among tweens and teens, says Tracy Livecchi, LCSW, psychotherapist and author of Healing Hearts and Minds. Livecchi notes that any suicide concerns (even seemingly off-hand jokes or one-off comments) should be taken seriously, as these thoughts and feelings “often come from experiences of rejection, shame, hurt, isolation, and hopelessness.”
What’s more, “Kids don’t always come to their parents when they are feeling badly, or are in a low mood,” says Livecchi. “Some of the nonverbal ways tweens/teens may communicate that they are thinking of suicide may be very subtle, and will require parents to really pay attention.”
Here are some of the warning signs your child might be struggling, according to Livecchi:
- An abrupt change in behavior, especially if related to a stressful or painful event
- Feeling hopeless, low, or irritable
- Isolating and spending less time with friends and family
- Rebellious behavior/suddenly acting out
- Taking an interest in firearms or prescription pills
- Change in sleeping habits
- Change in appetite, rapid loss or increase in weight
- Decline in grades/academic performance
- Self-harming behaviors, such as cutting themselves
- Substance use
- If they are a target of bullying or are bullying others
- Loss of interest in things they previously enjoyed
- Feelings of anxiety or depression lasting more than two weeks
Rashmi Parmar, M.D., a psychiatrist with Mindpath Health, notes some other ways tweens and teens might express suicidal thoughts or intent:
- Making vague comments during conversations or on social media, including phrases like: “don’t want to wake up ever,” “wish to be gone forever,” “want to not exist or disappear”
- Making joking comments about dying or killing oneself
- Writing goodbye notes or saying goodbye out of context to close friends and family
- Drawing pictures depicting suicidal themes
- Secretive behaviors around family in context of planning or execution of suicidal thoughts, such as researching possible ways of suicide on the internet, hoarding medication bottles, etc.
- Taking inventory of personal things and giving away prized possessions for no clear reasons
- Change to a reckless or careless attitude about things
- Lack of self-care or attention to personal hygiene
With all of the above scenarios, Parmar says, “It is important to understand that some of these warning signs and expressed thoughts may be related to a different underlying problem or stressor in the child’s life and may not necessarily mean that the child is suicidal. However, it is better to err on the side of caution and explore these feelings with the child rather than assuming anything.”
That said, she urges parents to take even a passing comment seriously. “Don’t assume it is a misleading or false piece of information or that the child may have made an off-remark and did not really mean it.”
Here’s What To Do — And Not Do
Your approach and reaction is important, no matter how panicked or worried you might feel about your child’s well-being. If you find out in an indirect way (by reading something on your child’s devices, or by someone else expressing concern about your child), Livecchi recommends “staying calm and approaching them promptly in a loving, respectful, and non-judgmental manner. Do not wait for them to come to you. Your child may not want to talk about it, but you should let them know that you love them unconditionally and that you’re there to help them get through this tough period in their life.”
Staying calm is crucial, says Parmar. “You may naturally feel a range of emotions (like sadness, guilt, anger, etc.). Some parents may feel helpless in such a situation, not knowing what to do further. Try not to blame yourself because it will cloud your thinking and will interfere with your ability to act appropriately.”
After you approach them gently, Parmar recommends listening openly, “allowing them enough time and space to open up about their thoughts and feelings. Give them breaks from the discussion if the situation becomes too overwhelming.”
“If your child reveals suicidal thoughts directly to you, then it’s a good sign,” says Parmar. “This means they trust you enough to be willing to share their thoughts and feelings with you. First, respond to them with a calm and supportive attitude.”
Some things you can say in the moment, per Parmar:
- “Thank you for sharing your feelings with me, I am glad we started this conversation.”
- “I am here for you no matter what. I love you and care about you.”
- Please know that it is not your fault that you are having these thoughts.
- “I want to help you feel better in whatever way I can.”
- “We will figure this out together.”
- “Nothing you’ve said changes my love for you and the fact that you are an amazing person.”
- “Let’s work together to seek the help you need. I’ll be with you every step of the way.”
Ultimately, “Your goal should be to find out how serious these thoughts are and possible ways you can protect your child against them,” says Parmar. You can ask questions like:
- “How long have you been feeling this way?”
- “How bad are these thoughts?”
- “How often do you get them?”
- “What are some of the triggers for these kinds of thoughts?”
“If you know that your child is having active suicidal thoughts with specific plans, don’t be afraid to ask about it directly,” says Parmar. “Research has shown that asking about these thoughts directly is not necessarily going to plant ideas in their mind, which is what most parents fear.” Possible questions include:
- “Does it ever get so tough that you think about ending your life?”
- “What sort of plans come to your mind?”
- “Have you ever come close to acting on these thoughts?”
- “Have you ever felt scared of having these thoughts?”
- “What do you do to safeguard yourself from these thoughts?”
- “Does anything seem to help make them go away?”
There are plenty of things to avoid saying, notes Levicchi. These include: “You have nothing to be depressed about,” “toughen up,” “you are just looking for attention,” “I don’t believe you,” ”You don’t mean that,” “You have so much to be grateful for,” and the like. Parmar adds: “I am disappointed in you. I expected better from you,” “Why didn’t you tell me before? Is that how much you trust me?” and “Think about how everyone in our family would feel if you ever hurt yourself.”
If Your Child Is In Imminent Danger
“If you sense that they are at an immediate risk for attempting suicide, get them help right away by taking them to the local hospital emergency room or by calling 911 or 988,” the new mental health emergency hotline number, says Levicchi. “Even if you don’t sense an immediate crisis, you still need to take action by reaching out to their pediatrician and/or a local mental health professional who specializes in seeing tweens and teens. Mental health professionals can get them into appropriate treatment and work with you and your child to make a safety plan for when they are able to come home.”
For serious, immediate emergencies, “You will need to assess the situation by having a direct conversation with your child and come up with a safety plan that is agreeable to both of you,” says Parmar. “Identify a few trusted adults for the child to connect with when feeling unsafe. Know where your child is at all times. Let your location and contact details always be known to your child as well in case they need you during an emergency. Remove access to any potentially dangerous objects at home which can be things like knives, scissors, razors, belts, cleaning products, medication bottles, etc. If you keep firearms at home, make sure they’re kept locked and out of the child’s reach and store the ammunition separately as well.” For older teens, “Encourage them to seek professional help for their underlying depression or anxiety symptoms from their pediatrician, or a child psychiatrist or a therapist/counselor.”
It might feel scary, but you are not in this alone, and there are resources available to help no matter what you need.
