Definition

Thinking about, considering, or planning to commit suicide is known as suicidal ideation.

Causes

Suicide is often the result of many factors which can vary from child to child. Many children thinking about suicide are having difficulty coping with stressful factors and feel very overwhelmed and hopeless.

The majority of children who consider suicide also have a mental illness like depression or substance abuse. These conditions may cause suicidal thoughts alone or simply make stressful situations worse.

Risk Factors

Factors that may increase the risk of suicidal ideation include mental health disorders such as:

• Depression
• Substance abuse
• Anxiety disorders
• Bipolar disorder
• Posttraumatic stress disorder
• Chronic medical illness

Other factors that may increase the risk of suicidal ideation include:

• Lack of a support system
• Poor coping skills
• Current traumatic or stressful life event, such as the loss of a relationship, social difficulties, or major problems at school
• History of trauma or abuse
• History of being bullied
• History of rash or violent behaviors
• Family history of suicide
• Exposure to others who have died by suicide
• Taking certain antidepressants that increase the risk of mood and behavior changes
• Prior suicide attempt
• Easy access to items that could be used for self-harm, such as guns

Symptoms

Children who are thinking about suicide may:

• Talk about wanting to die or commit suicide (it is crucial to take any talk about wanting to die seriously even in children)
• Talk about feelings of despair
• Plan for death, such as giving away favorite items
• Withdraw from family and friends

Other symptoms may include:

• Irritability
• Indifference
• Mood swings that range from irritability to a sudden sense of calm
• Difficulty focusing
• Poor performance in school
• Loss of interest in daily activities, such as school and hobbies
• Self-harm, such as cutting or burning
• Loss or gain in appetite
• Sleeping too little or too much
• Changes in appearance, such as lack of personal hygiene
• Increased use of alcohol or drugs

These symptoms can occur without suicidal ideations. However, if someone you know has these signs, try to talk to them to better learn what is happening. Asking about suicidal feelings will not encourage someone to commit suicide but may actually help prevent suicide.

If you or someone you know has thoughts of suicide or harming oneself, it is crucial to seek professional help right away. There are many suicide hotlines to help those considering suicide or to provide information for friends and family of someone considering suicide.

If the risk of suicide is severe, go to an emergency room or a call for emergency services. Risk is considered severe if the person has a well thought out plan to commit suicide or has access to items that can cause harm.

Diagnosis

The doctor will ask about your child’s symptoms and medical and psychiatric history. Other family members may also be interviewed.

A mental health specialist may complete a psychological assessment to look for any underlying issues.

Treatment

Immediate hospitalization may be needed if there is a severe threat of suicide.

Individual, family, and/or group therapy will be used to help manage suicidal thoughts.

Overall treatment goals include:

• Care for underlying mental, physical, and substance abuse disorders
• Limiting access to items that may be used for self harm
• Developing a support system that includes family members and friends
• Developing skills in problem solving, conflict resolution, and handling problems through non-violent means

Prevention

To help reduce your child’s risk of suicidal ideation, take these steps:

• Follow treatment plans for mental or physical health disorders that your child may have.
• Encourage your child to avoid drugs and alcohol.
• If your child has difficulty coping with a stressor, encourage your child to talk to you, a family member, friend, or therapist.
• Limit access to items that may be used for self-harm.

National Alliance on Mental Illness http://www.nami.org

Health Canada http://www.hc-sc.gc.ca

Klonsky ED, May AM, et al. The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples. J Abnorm Psychol. 2013 Feb;122(1):231-237.

Suicide—causes. NHS Choices website. Available at:
http://www.nhs.uk/Conditions/Suicide/Pages/Causes.aspx
Updated November 15, 2012. Accessed January 29, 2015.

Suicide risk factors. National Suicide Prevention Lifeline website. Available at:
http://www.suicidepreventionlifeline.org/learn/riskfactors.aspx
Accessed January 29, 2015.

Suicidal thoughts: American Association for Marriage and Family Therapy website. Available at:
http://www.aamft.org/iMIS15/AAMFT/Content/Consumer_Updates/Suicidal_Thoughts.aspx
Accessed January 29, 2015.

Symptoms and danger signs. Suicide Awareness Voices of Education site. Available at:
http://www.save.org/index.cfm?fuseaction=home.viewpage&page_id=705f4071-99a7-f3f5-e2a64a5a8beaadd8
Accessed January 29, 2015.

Teenage suicide. National Alliance on Mental Illness website. Available at:
http://www.nami.org/content/contentgroups/helpline1/teenage_suicide.htm
Accessed January 29, 2015.

Victor SE, Klonsky ED. Correlates of suicide attempts among self-injuries: a meta analysis. Clin Psychol Rev. 2014 Jun;34(4):282-297.