What are the warning signs of depression or suicide?
The following may be signs of a mental health problem, such as a mood disorder, or they may relate directly to suicidal thoughts or behavior.
Changes in activities, such as:
- A drop in grades or school performance
- Neglect of personal appearance
- Neglect of responsibilities
Changes in emotions, such as:
- Appearing or talking about feeling sad, hopeless, bored, or overwhelmed
- Having outbursts, severe anger, or irritability
- Appearing or talking about feeling more anxious or worried
Changes in behavior, such as:
- Getting in trouble, being rebellious, aggressive, or impulsive
- Running away or threatening to run away
- Withdrawing from friends or family or having a change in friends
- Eating or sleeping less or more
- Losing interest in activities
- Using of drugs or alcohol
- Hurting oneself, such as cutting or severe dieting
- Talking or writing of suicide or death
- Any suicidal behavior, even if it could not have been lethal, such as taking a small amount of pills.
Myths and facts
- Myth: Teens who kill themselves are obviously depressed. Fact: It's not always obvious. Parents are sometimes "the last to know" their teens are so depressed and desperate. Teens are often very good at hiding their problems. While depressed adults sometimes seem deeply sad and hopeless for quite a while, depressed teens may seem "not unhappy" some of the time as they swing in and out of depression. Some teens don't ever seem extremely depressed, but they never are "not unhappy"—these teens are also at increased risk of suicide.
- Myth: People who talk about suicide do not do it. Fact: Teens who talk about suicide or wanting to "run away," "get away," "disappear," "end it," or "die" are much more likely to kill themselves than those who do not. Talk of suicide or death should be responded to right away. Asking about suicide thoughts will not cause a suicide.
- Myth: Low lethality suicide attempts may be dismissed as "a cry for help" or "if he really wanted to kill himself, he would have done something more lethal." Fact: A low lethality attempt, such as taking a small number of pills or making scratches on the wrist, may be followed by more lethal behavior at a later time. In addition, the low lethality attempt may indicate deep emotional problems not obvious otherwise. Suicide attempts, even those that could not have caused death, should be taken very seriously with prompt safeguarding and intervention.
- Myth: "She's just doing it to get attention." Fact: This is true at times, but the behavior can still be lethal. A teen not intending to die may still take too many pills or miscalculate when someone will rescue her.
What you can do
- Get help right away. Bring your teen to a hospital emergency department if you are worried he may hurt himself or others.
- Listen to your teen. This is harder than it sounds. Try not to offer suggestions on how to "fix" her problems. Ask your teen what is bothering her and whether she has been feeling sad or down. Ask whether she has ever thought of suicide or not wanting to live anymore. Use words other than suicide, such as "hurt yourself," "end it all," "escape," "get away forever," or "go to sleep and never wake up."
- Express understanding and support. While it's often easier to point out faults than to give praise, avoid being overly critical. Try to be understanding if your teen is "in trouble" or feels very negative about himself. Let him know that however he feels at the moment, you have an overall positive view of who he is and his future.
- Talk with your teen's doctor about treatment, including an evaluation by a child and adolescent psychiatrist or other mental health professional.
- Remove firearms from the home. Studies show that even when firearms in the home are locked up, teens are more likely to kill themselves than those in homes without firearms. A home is safest without firearms. If you must have a gun, make sure the gun is stored unloaded and locked in a safe or with a trigger lock, and bullets are locked in another place.
Family support and professional treatment can help teens who are at risk of suicide deal with their difficulties and feel better. Current treatments for mood dis¬orders and other mental health problems, such as individual and family counseling, medications, and other therapies, along with long-term follow-up, can be very helpful.