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Depression and Suicide Among Children and Adolescents

Posted on Jul 08, 2019

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If you are thinking about suicide, or are concerned about a friend or loved one, call the National Suicide Prevention Lifeline at 1-800-273-8255. The Lifeline network is available for anyone at any time, 24/7. Additional crisis services and hotlines are available here.

Depression and suicide are becoming increasingly common in youth. Research suggests that roughly 1 in 8 kids between ages 12 and 25 have experienced a major depressive episode. Suicide is increasing as well and is a leading cause of death, with about 15 per 100,000 children and adolescents completing suicide. Jennifer Katzenstein, Ph.D., ABPP-CN, is the director of psychology and neuropsychology at Johns Hopkins All Children’s Hospital. As a pediatric neuropsychologist, she deals with a variety of patients who are suffering from depression. In this week’s On Call for All Kids, she discusses the issues.

What are symptoms of depression and suicidal thoughts in children and adolescents? As a parent, what should I be looking for?

Depression is characterized by sadness, but also hopelessness, irritability, changes in sleep and eating habits, and changes in previously enjoyed interests. Anxiety and depression also can go hand in hand and anxiety and increasing worry can come along with depression as well. Uncontrollable emotions and thoughts of death can be signs as well.

In terms of suicide, signs of suicide including someone threatening herself or himself, or talking about wanting to die, searching for ways to hurt himself or herself, not only online but also in their environment, and talking, writing and/or posting about death or suicide on social media or when talking with friends. Talking about hopelessness or having no purpose, talking about feeling trapped, or being in unbearable pain, talking about being a burden to others, increasing use of alcohol or drugs, increasing agitation/restlessness, withdrawing, or feeling isolated, displaying mood swings, and being impulsive.

What do I do if my child has suicidal thoughts?

Listen carefully when your child speaks, and observe his or her behavior. Stay calm. Don’t become angry and please don’t place blame for feelings of depression and/or thoughts of death. Respond with compassion and love, invite him or her to share feelings and experiences. This can be very scary for both parents and kids, and it is important for children to feel safe.

Avoid saying “don’t think this way” or “you shouldn’t feel that way” as these statements come across as critical. Listen carefully and without judgment. Respond empathetically with statements such as, “It sounds like that was really difficult,” or “What is it that you’re concerned about, and how can I help you?” Praise your child for talking with you, and discuss the plan for getting help together. Explain that mental health concerns and depression are like other illnesses, and that we can get treatment for them and overcome the symptoms.

What do I do if I am concerned about my child’s thoughts of death?

First and foremost, listen. Then, discuss opportunities for help from experts. This may mean an appointment with your pediatrician, or finding a psychologist or therapist to work with. If you have imminent concerns of your child hurting himself or herself, then go to your closest Emergency Center or call 911 for help. In the meantime, conduct a safety survey of the home, store knives, guns, and other potential weapons in a safe and locked place. Lock up medications, and monitor use of any tool that may dangerous. This can include things like cell phone charging cords or other potential hazards.

What resources can I give my child?

Beyond speaking with a family doctor or a psychologist or therapist, there are great resources to assist, including the Crisis Test Line (text HOME to 741741) and the National Suicide Prevention Lifeline (1-800-273-8255). 

How can I talk to my child after someone in his or her life has completed suicide?

Explain death and dying in a developmentally appropriate way. You are the expert about your child and knowing what they can understand. Keep it simple, factual and focused. Remember that talking about death is frightening. Keep an open mind to questions, and explain mental illness as you would physical illness, again without blame or judgment.

Death can be explained as when a person’s body stops working. Suicide can be explained as the act of killing yourself so that your body won’t work anymore. Sometimes people feel hopeless that things will never get better and that life is not worth living. They may feel there is no other way to solve their problems or end the pain they are feeling. 

Is there anything we can do to prevent suicidal thoughts?

Open communication, monitoring mood, and getting early intervention are keys to prevention of suicide. As we increase our knowledge of mental health and mental wellness, as well as decrease stigma, we can help prevent these acts and improve overall wellness for our kids and future generations.

On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital medical experts. Visit each Monday for the latest report.

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