Inside this article: Many things can increase the risk of teenage suicide. One major risk factor is experiencing a mental health issue like depression, anxiety, or trauma.
I’m not sure when my sixteen-year-old daughter started dealing with depression.
I think it began in middle school when she started talking poorly about herself to fit in with a friend group. The girls would sit around and discuss what physical attributes they hated about themselves, whether it was a droopy eye, oily hair, or their big thighs.
It was during this time that my daughter started becoming acutely aware that she was different. Although we saw her as a beautiful soul with a quirky personality, her peer group did not appreciate these qualities. She was not a target of specific bullying, but she certainly wasn’t included in many social gatherings either.
She desperately wanted to be included.
When the pandemic rolled around when she was in ninth grade, at first I think the break from the hustle of a large high school was welcomed by her. She enjoyed her free time and seemed happy to do her own thing.
But as those days turned to weeks, and then months, we saw a dark change in her personality.
She started sequestering herself in her room for hours on end. We struggled to manage her screen time where she watched endless videos and scrolled aimlessly. Her normally pleasant demeanor turned flat. She did not engage with her sisters or me or her dad, and no matter the encouragement or incentive, she disconnected from the few friends she had.
I tried everything to get her to talk. I would take her for Starbucks and make casual conversation hoping she would open up. I pushed her with questions. I bought a journal so we could pass written communication back and forth.
But it just went from bad to worse. I knew I was out of my depth.
When to Seek Out a Therapist
One cold winter day when she lashed out because she did not want to come out of her room, I suggested that we find her a therapist to talk to. I stated that if she did not want to talk to me, she had to talk to someone.
It took about a week of arguing, but finally, she relented and said she would go.
When I first spoke to the therapist prior to her appointment, I told her that I thought the main problem with my daughter was she was just lonely. I explained that she was struggling a bit before the pandemic, and how I thought the crazy school year had exacerbated her feelings.
“I think she just needs someone to talk to,” I confidently stated.
I was wrong.
What You Should Know about Teen Suicide
It’s important to understand that there is a difference between passive suicidal ideation–having waxing and waning thoughts about suicide–and having specific suicidal thoughts, which would be considered active.
According to VeryWellMind.com:
Passive suicidal ideation occurs when you wish you were dead or that you could die, but you don’t actually have any plans to commit suicide.
Active suicidal ideation, on the other hand, is not only thinking about it but having the intent to commit suicide, including planning how to do it. This is when you need to take immediate action.
Threats of suicide are a cry for help. Always take such statements, thoughts, behaviors, or plans very seriously. Any teen who expresses thoughts of suicide should be evaluated right away. Talk with your teen’s healthcare provider.
Any teen who has tried to commit suicide needs a physical checkup first to rule out life-threatening health problems. He or she should then get a mental health evaluation and treatment until he or she is stable. This often will take place at an inpatient facility to make sure of the child’s safety.-According to Johns Hopkins
What are the risk factors for teen suicide?
A teen might feel suicidal due to certain life circumstances such as:
- Having a psychiatric disorder, such as depression, an anxiety disorder, bipolar disorder or oppositional defiant disorder
- Family history of mood disorder, suicide or suicidal behavior
- History of physical or sexual abuse or exposure to violence or bullying
- A substance use disorder
- Access to means, such as firearms or medications
- Exposure to the suicide of a family member or friend
- Loss of or conflict with close friends or family members
- Physical or medical issues, such as changes related to puberty or a chronic illness
- Being lesbian, gay, bisexual or any other sexual minority youth
- Being adopted
Parents Often Look at the Wrong Signs
After her first appointment, the therapist called me in for what I thought was a discussion regarding how their first session went. As I sat in the plaid wingback chair with my beautiful daughter sitting two feet away, I found out that she was having suicidal thoughts, and two weeks prior she thought about driving her car off of a parking garage.
What stopped her? There was a large group of kids up there hanging out on this beautiful Sunday afternoon and my sweet girl didn’t want to hurt anyone.
I had no idea it was this serious. No idea.
By law, my daughter’s therapist had to sit down with me and let me know that my daughter had the potential to hurt herself.
If I’m being honest, it was hard to take seriously at first. It did not seem possible that my beautiful, bright daughter who was so loved by her family, would want to end her life.
But as my therapist started handing me resources and numbers to call, and then started telling me action steps I needed to take immediately, it started to sink in.
This was no joke.
The therapist made my daughter sign a safety contract, and then released her into my care. It was terrifying.
Here are the immediate steps we took as a family when my teenager has specific suicidal thoughts.
Assume the worst. While my gut told me that my daughter was not at the point she would act on her suicidal thoughts, I was not going to take any chances. Additionally, I had to recognize that I honestly had no idea where she was in her thought process nor could I trust her to talk to me about when she felt like she was in danger.
I knew that my daughter was struggling to talk about her feelings with me, so we agreed on a number scale so she could identify how she was feeling without having to go into much detail. Zero to two meant she was feeling fine. Three or four meant we probably needed to seek help or ensure she was with someone. Five meant code red and the bad thoughts were consuming her. We would need to seek immediate help.
Important note: If you have any suspicion, ask your child if they are experiencing suicidal thoughts. This will not put the idea into their head or make them more likely to attempt suicide. Keep talking.
This number system was so useful for our family. It allowed my daughter to have a mechanism to assess herself and provide feedback to her family without it being intrusive.
Set Up a Family Plan. Our next course of action was to rally around my daughter as a family. We were taking steps to evaluate and develop a comprehensive plan, but in the interim, our number one goal was to keep her safe.
That meant, my daughter would not be left alone in the house, she would not have access to an automobile, and we needed to ensure our home was safe. We had a family meeting with our two other teenagers and made a plan to ensure someone would always be around and keeping an eye on the situation.
This was tricky because we did not want our daughter to feel like she was being punished for her feelings, so we had to talk with her about what was safe and what we felt was unsafe. It helped that the therapist also spoke with her about these concepts.
Each member of my family also had the National Suicide Prevention Lifeline at 800-273-8255 in their phone or knew to text CONNECT to 741741. We also knew that if the situation progressed outside of our control, we would call 911.
Secure Your Home. This was a big one. If you are going to take on the responsibility of monitoring your child at home, you need to make sure you take some precautions. Some legwork included:
- Putting the car keys in a safe place that she did not know about. Because her thoughts seemed to keep drifting to things with our vehicles, we made sure she did not have access to a car until we felt like she was stable.
- Disposed or hid pharmaceuticals. We did not make a big deal of this, but our therapist told us to reduce the temptation to act on her suicidal thoughts. “People who want to end their lives will always find a way, but we can make it harder for those who are struggling.” This meant I went through our old prescription drugs and went to a collection site at our local police station to get rid of anything expired or that we no longer used. I also hid away some pain killers and anything stronger in a safe spot where only my husband and I knew the location.
- Changing sleeping arrangements. For five straight days, my daughter shared a bed with me. This may seem extreme, but until my daughter could express she felt safe, we were not taking chances. Because we decided that we could monitor her at home in loving environment–but her thoughts were specific–we decided it was worth it to move her into our bedroom temporarily. She did not like this part at all, but we told her that it was this or a facility until we felt we were on better footing.
- Limited phone use. We told her that we needed to temporarily monitor her phone usage. We used timers and filtering software. This sucked, but we knew that moving her mindset from mindless scrolling and social media to other healthier coping mechanisms was critically important.
- Advice from our therapist included removing any guns or extreme weaponry from our home. In rash, dark moments, it’s important to limit access to things that romanticize or dramatize suicide. We did not have anything like this in our home, but it is recommended that a gun safe is even a risk with a smart, suicidal teen.
- In extreme situations, also consider locking up cleaning supplies, liquor, or anything else associated with harming oneself, such as ropes, cords, razor blades, etc. Purchasing a lock or separate container for these types of items can be useful and offer some peace of mind.
Note: it’s easy to start seeing everything in your home as your threat. Try not to succumb to those fears and only address the obvious. Doing this with a partner helps.
Seek Medical Advice. We loved our therapist. While she was young, she connected with our daughter right away and made herself accessible with boundaries. She did check ins with us and then, at our request, set up additional therapy appointments for my daughter (she was talking to her therapist 2 to 3 times per week for several weeks.)
If you are unsure about your therapist, I urge you to get an immediate second opinion, but also give them the benefit of the doubt. While I wanted to think that the therapist didn’t know my daughter and was overreacting, the truth is, she had to work under the parameters of the law and the best interest of my child.
We also called our pediatrician who gave us a referral to a psychiatrist. We scheduled the earliest appointment possible for an assessment to see if a pharmaceutical regimen could help our daughter deal with her depression in the short-term or if there was an additional mental health condition that needed to be identified.
The majority of children and adolescents who attempt suicide have a significant mental health disorder, usually depression. I cannot underscore enough that you need to leave any preconceived notions you have behind when facing this situation, and develop a comprehensive plan. There is no shame in talking to doctors about a mental health condition just like you would talk to them about strep throat or a stress fracture.
Our family history included diagnoses of depression, anxiety and bipolar disorder, so we wanted to make sure we were looking at every angle possible. While we did not put our daughter on any medication during this time, we remained open to it.
My daughter’s therapist also encouraged me to get my own therapist to talk about the strain of the situation. You feel an awful lot of guilt when your child wants to take their own life, and it’s easy to make it about you. Having someone to talk through my own issues with regarding the situation enabled me to focus on my daughter’s needs.
Consider Outside Treatment Centers. The first thing the therapist told me was that when your teenager (or anyone) is having specific suicidal thoughts, you should take them to the Emergency Room or to a treatment center that takes immediate intakes or can perform an assessment. This can be difficult during a pandemic, so we made the decision as a family that we could keep her safe at home. Please note: our family is privileged that we had two parents working from home and we could keep a 24-hour watch on our daughter. If this is not your situation, please choose the safest option for your child.
We did consult a few treatment centers. Because of the pandemic, only a few were taking immediate intakes. Most recommended an outpatient facility where we would drop our daughter off at 7 a.m. and pick her up at 6 p.m. During that time she would have group counseling sessions, one-on-one therapy, activities, journaling, etc.
We were unsure of what to do. The intake coordinator said she definitely qualified, but she also felt we could try upping her therapy sessions and monitor her at home.
After several long conversations within our family, with our therapist and pediatrician, and with our daughter, we decided to give ourselves 10 days, and if we all didn’t agree we were making progress, we would pursue outpatient treatment.
Please let me reiterate, however, I only recommend this course if you have the capacity to monitor your child and you do not think they are an immediate harm to themselves. The next few months were a heavy burden on my family, and we were lucky to have the financial and time resources to accommodate my daughter’s needs.
You may want to read this article from a mom who needed to put her son in an in-patient psychiatric treatment facility.
Focus on Coping Mechanisms: I felt like I was a pretty involved parent, but to be honest, I missed the signs my daughter was struggling. I chalked it up to hormones or the pandemic or being out of our routine; but the truth–I was not helping my daughter come up with healthy coping mechanisms. I turned a blind eye, and it spiraled out of control.
Working in conjunction with our therapist, we developed a list of things my daughter could do to cope with her depression. Some of these she performed on her own, some had to become a part of her regular routine. These included:
- Walking the dog with me at least once per day for 15 minutes or more. I agreed that we did not have to talk, but we did need to get outside and move. Regular exercise is an important component of my daughter’s treatment plan.
- Purchasing some anxiety/stress relievers. This included some funny adult coloring books, a journal, and some fidget toys that my daughter could seek out when she was feeling depressed or anxious.
- Focusing on diet. This one was so hard, but we agreed that two meals a day had to be healthy, the third could be whatever she wanted. I do think over the pandemic we got out of control with sugar and junk food, so we would go to the grocery store together so she could pick out food she may want to eat throughout the week. I do believe this made a difference.
- Coming up with a list of things she could do when she started to go to the dark place. This was a technique she developed with her therapist, but it included a list of activities she could do when she felt depressed. It included a range of items like drink a big glass of water, work out, or watch a certain show on Netflix to writing down what is stressing me out and reading off a set of mantras. She kept the list on a sticky note in her room, and I know that she used it on the regular.
- Limiting bedroom time. She had to be out in the open for a good portion of the day, or if she was in her room, her door needed to be open. This was challenging, but effective. The goal was to keep her around people without being too intrusive.
- Regular check-ins. I set an alarm for every three hours for the first three weeks. My husband or I would then either check in with my daughter in person or send her a text that said, “How are you feeling?” She would respond with a corresponding number to our rating scale or a message like, “I started feeling like a 3, but then I wrote a gratitude list and now I’m at like a 1.8.” Knowing that our daughter was taking this seriously and doing self-assessments was a relief, and truly the only reason we felt we could keep her at home.
- Focus on building self-esteem. Low self-esteem and negative self-talk was a major problem for my daughter. These issues do not correct themselves overnight and progress is slow and unsteady. Because my daughter is a musician, we tried to highlight her love for her instrument and encouraged her to play every day, even recording herself to see her progress. We also talked a lot about social media and the impact it had on her psyche. This was critical to her progress.
- Sleep: We started waking her up by a certain time each day to get her body on a better routine (9:30 a.m. seemed reasonable to us.) Regulating her sleep was a huge help in stabilizing her mood.
Slowly Getting Back to Normal. It seems ridiculous to say, but the first time I let my daughter take the dog for a walk by herself, I was sick to my stomach. I didn’t sleep for the first few nights my daughter moved back to her room. The first time I let her take the car by herself again, I wanted to chase after her.
But she was ready.
It’s important that people facing mental health issues have some safe ways to keep their independence, but it is a process built on trust. Take baby steps and make sure you’re being honest with each other.
My daughter still faces an uphill battle with depression, but using a wide variety of resources, integrating some coping mechanisms, and instituting regular check ins, we were able to keep my daughter safe. We’re still working on getting her to a place where she feels happy and confident, but I know we’ll get there.
My best advice. Keep an open mind. Utilize mental health therapists who know what they’re doing. Keep talking to your kids.
And give yourself some grace. You are not alone.
We’re all just doing the best we can with what we’ve got.
You may also want to read: Know the signs of teenage suicide. What to do if my child is suicidal: 8 tips for parents (choc.org)
The National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week.
Need additional resources? Here are some books and workbooks for you and your teen that may help.
Dead Serious: Breaking the Cycle of Teen SuicideTeen Grief: Caring for the Grieving Teenage Heart (Good Grief)Real Life Teens: Deep Depression & SuicideTeen Suicide & Self-Harm Prevention Workbook; A Clinician’s Guide to Assist Teen ClientsWhat Made Maddy Run: The Secret Struggles and Tragic Death of an All-American TeenFeeling Better: CBT Workbook for Teens: Essential Skills and Activities to Help You Manage Moods, Boost Self-Esteem, and Conquer Anxiety (Health and Wellness Workbooks for Teens)The Ultimate Self-Esteem Workbook for Teens: Overcome Insecurity, Defeat Your Inner Critic, and Live ConfidentlyThe Anxiety Workbook for Teens: The Complete Guide to Help Teens and Young Adults Boost Their Confidence and Self-Esteem (Overcome Worry, Stress, Depression, Shyness, and Fear)Life Sucks – But It Can Get Better: A Workbook for Beating Teen Depression & AnxietyArt Therapy for Anxiety and DepressionDepression: A Teen’s Guide to Survive and ThriveMindfulness for Teen Depression: A Workbook for Improving Your MoodLet That Sh*t Go: Find Peace of Mind and Happiness in Your Everyday
Parenting teens and tweens is no joke. Here are other articles you may find useful.
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