DEAR MAYO CLINIC: My daughter has struggled with depression as a teen, and sometimes I worry she may consider suicide. I don't want to make things worse by bringing it up, though. What are the signs that a teen may be thinking about suicide? Should I talk to her about my concerns?
ANSWER: You should definitely talk to your daughter about your concerns. Many parents share your fear that bringing up the topic of suicide may put it into a child's mind when they were not considering it before. But it does not hurt to ask. It helps.
Suicide is the third-leading cause of death among those ages 10-24. Suicide is highly associated with psychiatric illness, such as depression, and often follows stressful life events. Problems with school or in personal relationships may seem insurmountable in the moment. A history of psychological trauma and current problems with alcohol or drugs may underlie, or facilitate, someone's thoughts of suicide and suicidal actions.
Specific suicide warning signs to watch for include talking about wanting to die or to commit suicide, or looking for a way to commit suicide. Also, pay attention to what your teen says. Talking about feeling hopeless or having no reason to live; talking about feeling trapped; being in unbearable pain or feeling isolated; and talking about being a burden to others are all signs a teen may be thinking about suicide.
In addition, the following behaviors are suicide warning signs: acting anxious or agitated; sleeping too little or too much; behaving recklessly; increasing use of drugs or alcohol; withdrawing from friends, family or activities; showing rage or talking about seeking revenge; and having extreme mood swings. These signs may mean a teen is at risk for suicide. The risk is greater if a behavior is new or has increased and if it seems related to a painful event, loss or change.
If your teen has any of these signs or if you're worried for any reason that your child may have suicidal thoughts, it's no time to tiptoe around the question. Ask directly: "Are you thinking of killing yourself?"
If the answer is "yes," "sometimes," or "maybe," do not try to downplay or dismiss your daughter's feelings. Don't use phrases like: "That's crazy." "You're such a drama queen." "You're making too much of it." Instead, say: "I'm sorry you're feeling so bad." "How can I help?" "We'll get through this together." "Let's keep you safe."
Take her seriously and seek professional assistance immediately. If you're not sure where to turn, call her doctor and ask for recommendations of counselors or therapists in your area who specialize in preventing teen suicide.
In addition, sit down with your daughter and make a list together of people she can trust. Reassure her that she has people who are always there to talk with her and who care about her. Include on that list the number of the National Suicide Prevention Lifeline: 1-800-273-TALK. Encourage her to carry it with her, so she has it anytime she needs it.
Finally, make sure your home is safe. If you have pills your daughter could use to hurt herself, lock them up. If you have a gun, don't just lock it up but get it out of the house. Taking these steps will help keep your daughter safe.
It can be hard to talk to teens about suicide. But as difficult as these conversations may be, as her parent, you play a central role in helping your daughter feel safe enough to talk about her painful feelings. Many suicides are preventable when people get the help they need. For more information, visit the National Suicide Prevention Lifeline website at www.suicidepreventionlifeline.org. -- Timothy Lineberry, M.D., Psychiatry and Psychology, Mayo Clinic, Rochester, Minn.
(Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. E-mail a question to firstname.lastname@example.org. For more information, visit www.mayoclinic.org.)