Suicide rates are rising in the U.S., specifically among kids between the ages of 10 and 14, according to the National Center for Health Statistics. That's true for depression, too: One recent Centers for Disease Control study of depression found that 5.7% of kids ages 12 to 17 met the criteria. Causes traditionally range from the increased use of cell phones and social media to major transitions or life events like family stress or family history.
A 2018 survey by the American Psychological Association found that youth ages 15 to 21 are increasingly stressed by high-profile news items, such as:
- Mass shootings
- Climate change
- Rise in suicide rates
- Separation and deportation of immigrant families
- Sexual harassment and assault
"It's hard to identify any one reason or factor," says Children's Hospital Colorado child and adolescent psychologist Laura Anthony, PhD. "But the warning signs of suicide are pretty consistent."
Whatever the cause, says Dr. Anthony, there's a direct correlation between rising rates of suicide and depression, and it affects teens regardless of race, class or background. For parents, prevention starts with knowing the signs.
Depression vs. normal teen angst
A certain amount of stress is normal in the teenage years, but teens today report more stress than ever. So how do you know when a teen is depressed? It can be hard to tell, Dr. Anthony admits, because moodiness is frequently a built-in feature of the adolescent years. The big differences are length and intensity of symptoms.
Mood changes and feelings of sadness are normal, but they don't generally last for more than a few days. Depression involves feelings of hopelessness, irritability, anger and frustration that last much longer — and get in the way of daily life. Changes in eating or sleeping habits, a drop in performance in school or sports, statements of self-harm, loss of interest in friends or social withdrawal, or quitting activities they used to enjoy — all are indicators of potential depression.
Signs of depression
- Prolonged anger, frustration or tearfulness
- Withdrawal from activities of previous enjoyment (sports, clubs, etc.)
- Loss of relationships or lack of interest in them (peer friendships, romantic relationships)
- Trouble sleeping or sleeping excessively
- Change in appetite: not eating or eating too much, which may even effect weight
- Feeling less energetic, like everything takes too much effort
- Moving or speaking slowly (or too quickly if expressing signs of mania)
- Difficulty concentrating or remembering information, which can include a drop in academic performance
- Increased thoughts or references to death or suicide including self-harm behaviors
A higher risk of suicide for depressed teens
Adolescents and young adults are still developing in the limbic system of the brain, which regulates their emotions, as well as their prefrontal cortex, which is in charge of impulse control and future-oriented thinking. The combination of depression, intense emotional triggers, impulsive thoughts of escape and an inability to see current difficulty as temporary puts adolescents and young adults at higher risk of making a potentially fatal decision.
Depression is far and away the greatest risk factor in suicide, but it's treatable with help. The key is to catch it. In fact, the American Academy of Pediatrics recommends annual depression screening for teens.
What to do for a teen with depression
Parents don't have to wait for a depression screening if they notice something off with their teen. A conversation is a great place to start. Depression is isolating, and just the process of bringing it into the open can be therapeutic in itself.
If parents do suspect their child may have depression, their best first resource is probably their primary care provider, who can refer to other resources if needed. Generally, the treatment includes talk therapy and sometimes medication.
One big benefit to therapy: Parents aren't necessarily trained to see the signs of suicide, but a therapist is. By developing a trusting relationship with the teen and family, a therapist can spot signs of trouble and treat them before they get worse.
How to talk to teens about suicide
Even if a teen isn't showing signs of depression, Dr. Anthony says, the most important thing parents can do to prevent suicide is to talk to their kids about it. Like sex, drugs, bullying or any other topic facing teens, suicide is fraught with discomfort and stigma. Misinformation abounds — which makes it that much more crucial to discuss. And an honest conversation about suicide lets teens know they can come to you with issues if they need to.
Of course, suicide isn't the easiest subject to broach. Dr. Anthony offers a few tips for getting the conversation started (and keeping it positive):
Do bring it up naturally
Leverage TV shows and media coverage of the topic to start a conversation. Dr. Anthony recommends an indirect approach: "Something like, 'Hey, I read an article about this. What do you think?'"
If your child or teen asks you why someone commits suicide, try to respond in a proactive way: "I don’t know why they didn’t try to get help. Plenty of help is available, and the first step is always to reach out to an adult you trust. I hope if you or anyone you know is having thoughts of suicide, you will talk to me about it."
Don't worry about "putting ideas in their heads"
"A conversation is not going to make a kid depressed or suicidal," says Dr. Anthony. In fact, openly discussing suicide with teens can mitigate the effects of a suicide in a community, since "copycat" suicides are often fueled by glamorization and misconception.
Do counter the stigma
Anything a child interprets as judgment or stigma could cause them to shut down and not want to talk about it again. "If a kid does express those thoughts, stay calm," says Dr. Anthony. "Take it seriously and listen, but as much as possible, contain your own emotional reaction. Kids are going to be hypersensitive to your perception of it, and a lot of kids will perceive a parent's fearful reaction as anger — which enhances the secrecy around it."
Don't try to fix it
Instead, hear teens out, be supportive and seek professional help. Don't argue with them or tell them they shouldn't feel the way they do, and be very careful not to say anything that could make them feel shame. Stay vigilant of any patterns, mood changes, loss of hope about the future, or shifts in grades or sports performance.
Do "listen, listen, listen"
Dr. Anthony encourages parents to trust their instincts if their teen seems different. Call the suicide prevention hotline, a pediatrician or Children's Colorado; professionals can direct you to the appropriate help. If you think there's an imminent danger, call 911 or go to the ER. Emergency departments can provide psychiatric evaluations.
Suicide prevention resources
If you or someone you love are currently experiencing thoughts of self-harm, please call one of the crisis lines below. You are not alone.
Learn more about our Pediatric Mental Health Institute.