Risk Factors

Of course depression is not the only reason children attempt suicide, but when coupled with other risk factors, the risk for an attempt increases. Research estimates that if a family member has attempted or committed suicide, a child is two to three times as likely to do the same. There are several reasons for this. First, if a child has lost a parent through suicide, he may experience guilt that he somehow caused his parent to commit suicide. Also, he may think that if his parent used this behavior as a coping skill, then he can do it, too.

Second, a child experiences emotional loss when a parent dies. That loss can be even more profound if it was through suicide. This sort of loss makes a child vulnerable to depression, and left unresolved, he may resort to suicide just like his parent.

Third, some research claims that suicidal individuals have a chemical makeup that makes them more prone to suicidal behavior. Thus some experts postulate that the tendency toward suicidal behavior is genetic.

Emotional factors such as hopelessness, worthlessness, and feeling as if he has no control over his circumstances puts a child at greater risk. Included here is the child who has attempted suicide before. Eating disorders and substance abuse can intensify feelings of depression and put a child a greater risk for harming himself. In addition, substance use lowers the ability to control impulsive behavior.

Alert!

Children who are psychotic have trouble distinguishing between reality and fantasy. Often their auditory hallucinations include voices telling them to harm themselves or others, and they have trouble controlling the impulse to obey the voices. If your child is psychotic, make sure you get a clear explanation from her as to what she is hearing and get help immediately.

School Performance

Believe it or not, poor grades or performance in school is a risk factor. The more failures a child experiences, the lower his self-esteem will drop. When this happens, a child believes he is a disappointment, a failure, and that there is no way he can improve. Dying is seen as a way to avoid having to deal with what he perceives is a hopeless situation.

In addition to these problems at school, many teens feel pressure from parents and others to meet expectations. When they do not or cannot measure up, their concerns that they are disappointing others further contributes to their feelings of being “less than” or “not good enough.”

No One Likes Me

Everyone experiences the feeling of not fitting in or that someone doesn't like you. For a child, this can be devastating because they don't know how to handle this sort of rejection. Again, poor self-esteem creeps in, and depression often follows. Likewise, in families where there is a lot of conflict and tension, a child can quickly become overwhelmed by the chaos and discord. He will often report that if he were “better” somehow, things would improve at home. Of course, this isn't true, but for a child, this is his reality and one that sets him up for depression and possible suicidal behavior.

Essential

Handguns in the home, especially when loaded, are another risk factor for suicide. If a child is impulsive, and the thought of suicide pops into his head, heading for the gun is the first place he is likely to go. If the gun is loaded, he doesn't even have to think any further than pulling the trigger.

Loss

You may have a child who has recently lost a friend, a boyfriend, or a girlfriend. Too often, adults say that they remember how that felt and a child “will get over it.” For the most part, this is true. Yet there are some children who have suffered multiple losses, and as these pile up, his resistance to depression weakens. As well, some kids just don't know how to cope with these losses. They can become overwhelmed by feelings of loneliness, despair, and worthlessness. Once again, they may be at greater risk for doing harm to themselves.

Abuse

Children who have been physically or sexually abused are at risk for suicide. Again, while you can rationalize that what happened to them is not their fault, a child simply does not see it that way initially. They feel as if they somehow caused the abuse to happen, that they deserved it somehow because they are bad. Left unaddressed, the self-blame often carries with it a good amount of anger, and as the anger fuels the negative esteem that is developing, the combination can lead to dangerous behavior.

Alert!

Children who are unsure about their sexuality are two to three times more likely to attempt suicide. The reason for this seems to be the problem a child faces in coming to terms with his sexuality. In addition, the response from loved ones and the child's community has a tremendous impact on how he adapts.

Sharing the Secret

Parents often want to know if it is healthy for a child to know about another child's suicide or attempt. Generally, the answer is yes. The reason for this is because open communication, the ability to ask questions, and the willingness to address suicidal feelings will reduce the likelihood that your child attempts suicide. If a child knows he has a safe, confidential place to turn when he is feeling like he wants to hurt himself, he may be more willing to open up about his feelings.

Is suicidal behavior contagious?

You may have heard of instances where one teen commits suicide and others follow with gestures or attempts. What a teen sees is that suicide is now a real option, not just one he has in his head. It is a real phenomenon and one that must be watched carefully.

However, there is other evidence to suggest that if your child is depressed, hearing about another's suicide will increase his thoughts that dying is an option for him, too. Then there is the fact that in the immediate weeks following a child's suicide, the number of attempts by other children increases.

Antidepressants and Suicide

A lot has been made of the link between antidepressants and suicide. Do antidepressants increase the risk? The research is still out on a definitive answer. Obviously a child with depression is at greater risk for suicide.

Fact

One study conducted by a Seattle health-care system found that the incidence of suicide is, in fact, greater in the month before beginning a medication regimen than while on it. This is largely because many people don't get the treatment they need until they are at their worst.

Whether a child is at greater risk for suicide while taking an antidepressant should not be the first question a parent needs to ask. Instead, ask the doctor prescribing the medication about the possible side effects and if suicidal thoughts are among them. Also ask how your child will be monitored and how often. A physician who is well-educated in these medications will choose to be slow and deliberate in his prescription of antidepressants and will want to keep a very close watch on your child.

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