Suicide in Children and Teens

Suicide (killing oneself on purpose) is very rare in young children. But it is the third most common cause of death in children from ages 10 to 19.

What are the risk factors?

Children are most likely to consider suicide if they suffer from depression, anxiety disorders, bipolar disorder, and alcohol or substance abuse. Stressful events can put kids over the edge. They are more likely to kill themselves on impulse than adults are. Many commit suicide within a few weeks of getting into trouble at school or with the police, breaking up with a girlfriend or boyfriend, or fighting with friends.

Risk factors include:

• depression
• previous suicide attempts
• alcohol or drug abuse
• history of disruptive behavior
• recently getting into trouble at school or with police
• relationship problems like breakups, humiliation or fights
• little communication with parents, or parents who are divorced or recently remarried

Girls attempt suicide more often than boys do. But boys are much more likely to actually kill themselves. Girls are more likely to try to kill themselves by overdosing on drugs or cutting their wrists. Boys most often try to kill themselves using guns, hanging, or jumping.

Firearms are the most common and fastest-growing method of suicide for males and females of all ages in the US. Having a gun in the house increases the chances that a young person in that home will commit suicide. An upset child or teen may impulsively use a firearm. Using a gun increases the chances that a suicide attempt will be fatal. Other methods are more likely to allow time for second thoughts and getting medical help.

What are the signs of suicidal feelings?

Signs that your child is considering suicide may include:

• sad or "empty" mood
• loss of interest or pleasure in activities that were once enjoyed
• withdrawal from family and friends
• change in appetite or weight
• trouble sleeping or oversleeping
• irritability or restlessness
• energy loss
• feelings of worthlessness or inappropriate guilt
• trouble thinking or concentrating
• letting the quality of his or her schoolwork go down
• risky behavior such as abusing drugs or alcohol, or driving too fast
• talking or joking about suicide or writing notes or poems about death
• giving away prized possessions or throwing away important belongings

What can I do to help my child?

If you are concerned about your child's behavior:

• Ask open-ended questions. If your child knows she can express her point of view to you, she will be more likely to talk to you about important things.
• Help your child get treatment if he or she has signs of depression, or problems with alcohol or drugs. If your child is especially grouchy, worried, withdrawn, sad, upset, or badly behaved for 2 weeks or more, get an evaluation by a healthcare provider.
• Ask your child if he or she is thinking about suicide. You will not cause suicide by talking about it. You show that you care when you ask. If he or she talks about death or mentions suicide, do not get mad or pass judgment. Get professional help. Reassure your child that you love him or her. Remind children that no matter how awful problems seem, they can be worked out, and you are willing to help.
• Remove or lock up lethal weapons in your home, such as guns, pills, and poisons.

Both medicines and therapy are useful to treat depression in children and adolescents. The only drug approved for use in children with major depressive disorder is fluoxetine (Prozac). Many parents are concerned about giving children antidepressants. Talk with your healthcare provider or mental health professional about this. Untreated depression can be fatal.

If your child is depressed, starting on a new antidepressant, or taking a different dose, be alert to any changes in behavior. Never take your child off an antidepressant suddenly without consulting with the prescriber. With some drugs you must taper off slowly to avoid physical and emotional symptoms.

Cognitive behavior therapy (CBT) helps children learn about depression, along with teaching specific skills for managing their physical symptoms, negative thoughts, and problem behaviors.

If you think your child is suicidal, get help immediately. Talk with your child's healthcare provider or a mental health specialist. Your local mental health association or county medical society can provide references. In an emergency, call the National Suicide Hotline at 800-SUICIDE.