Coliseum Health System - April 28, 2017

The new Netflix original series "13 Reasons Why," which tackles the tough topic of teen suicide, has sparked much discussion about the issue.

The tragedy of a young person dying because of overwhelming hopelessness or frustration is devastating to family, friends and community. Parents, siblings, classmates, coaches and neighbors might be left wondering if they could have done something to prevent that young person from turning to suicide.

Learning more about what might lead a teen to suicide may help prevent further tragedies. Even though it's not always preventable, it's always a good idea to be informed and take action to help a troubled teenager.

Which teens are at risk for suicide?

It can be hard to remember how it felt to be a teen, caught in that gray area between childhood and adulthood. Sure, it's a time of tremendous possibility, but it also can be a period of stress and worry. There's pressure to fit in socially, to perform academically and to act responsibly.

Adolescence is also a time of discovering sexual identity, relationships and a need for independence that often conflicts with the rules and expectations set by others.

Young people with mental health problems - such as anxiety, depression, bipolar disorder or insomnia - are at higher risk for suicidal thoughts. Teens going through major life changes (parents' divorce, moving, a parent leaving home due to military service or parental separation, financial changes) and those who are victims of bullying are at greater risk of suicidal thoughts.

Factors that increase the risk of suicide among teens include:

  • a psychological disorder, especially depression, bipolar disorder, and alcohol and drug use (in fact, about 95 percent of people who die by suicide have a psychological disorder at the time of death)
  • feelings of distress, irritability or agitation
  • feelings of hopelessness and worthlessness that often accompany depression
  • a previous suicide attempt
  • a family history of depression or suicide
  • emotional, physical or sexual abuse
  • lack of a support network, poor relationships with parents or peers and feelings of social isolation
  • dealing with bisexuality or homosexuality in an unsupportive family or community or hostile school environment

Warning signs

Suicide among teens often happens after a stressful life event, such as problems at school, a breakup with a boyfriend or girlfriend, the death of a loved one, a divorce or a major family conflict.

Teens who are thinking about suicide might:

  • talk about suicide or death in general
  • give hints that they might not be around anymore
  • talk about feeling hopeless or feeling guilty
  • pull away from friends or family
  • write songs, poems or letters about death, separation and loss
  • start giving away treasured possessions to siblings or friends
  • lose the desire to take part in favorite things or activities
  • have trouble concentrating or thinking clearly
  • experience changes in eating or sleeping habits
  • engage in risk-taking behaviors
  • lose interest in school or sports

What can parents do?

Many teens who commit or attempt suicide have given some type of warning to loved ones ahead of time. So it's important for parents to know the warning signs so teens who might be suicidal can get the help they need.

Some adults feel that kids who say they are going to hurt or kill themselves are "just doing it for attention." It's important to realize that if teens are ignored when seeking attention, it may increase the chance of them harming themselves (or worse).

Getting attention in the form of ER visits, doctor's appointments and residential treatment generally is not something teens want - unless they're seriously depressed and thinking about suicide or at least wishing they were dead. It's important to see warning signs as serious, not as "attention-seeking" to be ignored.

Watch and listen

Keep a close eye on a teen who is depressed and withdrawn. Understanding depression in teens is very important since it can look different from commonly held beliefs about depression. For example, it may take the form of problems with friends, grades, sleep or being cranky and irritable rather than chronic sadness or crying.

It's important to try to keep the lines of communication open and express your concern, support and love. If your teen confides in you, show that you take those concerns seriously. A fight with a friend might not seem like a big deal to you in the larger scheme of things, but for a teen it can feel immense and consuming. It's important not to minimize or discount what your teen is going through, as this can increase his or her sense of hopelessness.

If your teen doesn't feel comfortable talking with you, suggest a more neutral person, such as another relative, a clergy member, a coach, a school counselor or your child's doctor.

Ask questions

Some parents are reluctant to ask teens if they have been thinking about suicide or hurting themselves. Some fear that by asking, they will plant the idea of suicide in their teen's head.

It's always a good idea to ask, even though doing so can be difficult. Sometimes it helps to explain why you're asking. For instance, you might say: "I've noticed that you've been talking a lot about wanting to be dead. Have you been having thoughts about trying to kill yourself?"

Get help

If you learn that your child is thinking about suicide, get help immediately. Your doctor can refer you to a psychologist or psychiatrist, or your local hospital's department of psychiatry can provide a list of doctors in your area. Your local mental health association or county medical society can also provide references. In an emergency, you can call (800) SUICIDE.

If you've scheduled an appointment with a mental health professional, make sure to keep the appointment, even if your teen says he or she is feeling better or doesn't want to go. Suicidal thoughts do tend to come and go; however, it is important that your teen get help developing the skills needed to decrease the likelihood that suicidal thoughts and behaviors will emerge again if a crisis arises.

If your teen refuses to go to the appointment, discuss this with the mental health professional - and consider attending the session and working with the clinician to make sure your teen has access to the help needed. The clinician also might be able to help you devise strategies so that your teen will want to get help.

Remember that ongoing conflicts between a parent and child can fuel the fire for a teen who is feeling isolated, misunderstood, devalued or suicidal. Get help to air family problems and resolve them in a constructive way. Also let the mental health professional know if there is a history of depression, substance abuse, family violence, or other stresses at home, such as an ongoing environment of criticism.

If your teen is ever in a crisis situation, bring them to the nearest emergency room or call (800) SUICIDE for help.

Original content on kidshealth.org