Child Behavior



Teen Suicide, Mood Disorder, and Depression

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Thousands of teens commit suicide each year in the United States. In fact, suicide is the second leading cause of death for 15- to 24-year-olds. 

Suicide does not just happen. Studies show that at least 90% of teens who kill themselves have some type of ­mental health problem, such as depression, anxiety, drug or alcohol abuse, or a behavior problem. They may also have problems at school or with friends or family, or a combination of all these things. Some teens may have been victims of sexual or physical abuse, or bullied via social media. Others may struggle with issues related to gender and sexual identity. Usually they have had problems for some time. 

Most teens do not spend a long time planning to kill themselves. They may have thought about it but only decide to do it after an event that produces feelings of ­failure or loss, such as getting in trouble, having an ­argument, breaking up with a partner, or receiving a bad grade on a test. 

Why do most teens kill themselves?

Most teens who kill themselves have a mood disorder (bipolar disorder or depression). A mood disorder is an ­illness of the brain. It can come on suddenly or be present on and off for most of a teen’s life. A teen with a mood disorder may be in one mood for weeks or months or switch quickly from one feeling to another. 

Teens with bipolar disorder, also called manic depression, may change between mania (angry or very happy), depression (sad or crabby), and euthymia (normal mood). Some teens are more manic, some are more depressed, and some seem normal much of the time. Mania and depression can happen at the same time. This is called a mixed state.

Teens in a manic or a mixed state may

  • Strongly overreact when things do not go their way

  • Become hyper, agitated, or aggressive

  • Be overwhelmed with thoughts or feelings

  • Sleep less

  • Talk a lot more

  • Act in impulsive or dangerous ways

  • Feel they can do things they really can’t

  • Spend money they do not have or give things away

  • Insist on unrealistic plans for themselves or others

Teens with depression may

  • Feel sad, down, or irritable, or not feel like doing things

  • Have a change in sleeping or eating habits

  • Feel guilty, worthless, or hopeless

  • Have less energy, or more trouble paying attention

  • Feel lonely, get easily upset, or talk about wanting to die

  • Lose interest in things they used to enjoy

Mood disorders can be treated. Ask your teen’s doctor about treatment options. Recent declines in teen suicide may be due to an increase in early detection, evaluation, and effective treatment of mood disorders. 

What are the ­warning signs of depression, mood disorder, or ­suicide?

Signs of a mental health problem, such as a mood disorder, or suicidal thoughts or behavior may include 

Changes in activities, such as

  • A drop in grades or school performance

  • Neglecting personal appearance

  • Neglecting 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 or being rebellious, aggressive, or impulsive

  • Running away or threatening to run away

  • Withdrawing from friends or family or changing friends

  • Eating or sleeping less or more

  • Losing interest in activities

  • Using drugs or alcohol

  • Hurting oneself, such as cutting or severe dieting

  • Talking, writing, or posting information on social media about 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 good at hiding their problems. While depressed adults sometimes seem deeply sad and hopeless for quite a while, depressed teens may seem “OK” some of the time as they swing in and out of depression. Some teens don’t ever seem extremely depressed, but they are never OK—these teens are also at increased risk of suicide. 

Myth: People who talk about suicide or post messages on social media 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 more likely to kill themselves than those who do not. It’s important to respond right away, if your teen talks about suicide or death.

Myth: Low-lethality suicide attempts don’t need to be taken seriously.

Fact: A low-lethality attempt, such as taking a small number of pills or cutting the wrists, may be followed by behavior that is more lethal. It can be the first obvious sign of deep emotional problems. No suicide attempt should be dismissed, and steps should be taken to prevent future attempts.

Myth: Asking for or seeking help about suicidal thoughts increases the risk of suicide.

Fact: Research shows that asking about suicide and talking about it with a professional does not increase risk and likely reduces it.

Myth: Teens don’t really want to kill themselves; they just want attention.

Fact: Sometimes this may be true; however, the behavior can still be lethal. Teens not intending to die may still take too many pills or miscalculate when someone will rescue them. 

What you can do

  • Respond quickly if anyone is in danger. Bring your teen to a hospital emergency department if you are worried he or she may hurt himself or herself or others.

  • Listen to your teen. This is harder than it sounds. Focus on what your teen is saying and try not to suggest how to “fix” his or her problems. Here are questions you could ask: What is bothering you? Have you been sad or feeling down? Do you ever feel like you want to end it all or wish you could go to sleep and never wake up? Do you ever feel like hurting yourself, like cutting yourself?

  • Be understanding and supportive. It’s often easier to point out faults. Try to be understanding if your teen is “in trouble” or feels very negative about himself or herself. Let him know that however he feels now, you have an overall positive view of who he is and his future. Showing you care and saying “I love you” can go a long way.

  • Get professional help. 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 there 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.

Remember

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 disorders 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. 

The persons whose photographs are depicted in this publication are professional models. They have no relation to the issues discussed. Any characters they are portraying are fictional.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2016 American Academy of Pediatrics. All rights reserved.
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