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Trigger Warning: Please note that this blog contains a discussion of suicide, self-injurious behavior, depression and/or references of other mental health disorders that may act as triggers. Continue your own discretion.
I have been very open talking about my own attempts at suicide and suicidal ideation as well as other difficulties with my own mental health. That has led me to many who work with children, reaching out seeking advice about what they should do both personally and professionally for children that they care about. This blog is a two-part series, this one addressing prevention and the second on processing grief after a suicide. These are difficult topics. However, I firmly believe that it is a critical component of the work of becoming trauma-informed. That while these articles specifically address suicide in teens, I know that many adults are also struggling with similar issues. This should not take the place of seeking immediate help.
The rise of student suicides
Over the course of the past several years, there has been an alarming increase in youth suicides across the nation, in our communities, and in our schools. And as the suicide rate increase, especially for young people attending middle and high schools, we cannot stand back as mere observers.
In 2020, suicide was the second leading cause of death for people between the ages of 10 and 14, according to the CDC. And the risk of suicide increases in certain populations, such as those who live in rural areas, identify as LGBTQ+ or are part of a racial minority.
Whenever a child dies, it’s an utter tragedy, and the sense of that loss is unmeasurable. When a child dies by their own hands, we can’t help but wonder what else we could have done.
Amidst this difficult topic, there is good news: over 90% of attempted suicides fail, and most people go on to live their lives.
Why have we seen an increase in teen suicides?
Although we’re not sure of the exact reasons behind the drastic increase in teen suicides within the last several years, there are several compelling theories.
More stress
It’s possible that increased stress on children, teens, and families, in general, is influencing rates of depression and other mood disorders. Of course, that is also complicated by the impacts of COVID-19, for which we do not have complete data, but many experts agree that the damage will be long-lasting.
Socio-economic struggles
From 2019 to 2020, poverty rates increased, and this could reflect a growing number of families that suffer from socio-economic issues. Coupled with more people to compare themselves to, thanks to the prevalence of social media, students could be facing a rise in suicides due to their economic status.
Bullying
Bullying isn’t new, but social media can make it nearly impossible for kids to escape bullying. Access to communication opens a lot of positive doors—but it opens negative doors, too.
How can you help prevent suicide?
Suicide prevention is the best thing you can do to help someone who’s struggling. Prevention consists of noticing certain behaviors, opening up a safe space for someone to talk, and providing non-judgmental, individualized support.
Watch out for signs of depression and mood disorders
First, you can keep an eye out. Whether it’s your friends and peers, students, children, or siblings, you can pay attention to see if your loved ones have any of the following symptoms that indicate they may be considering suicide.
They face difficulty regulating emotions and solving problems. When people with depression, anxiety, and other mood disorders encounter roadblocks, they often struggle with resilience. When things don’t go their way, do they face immense challenges coping with their emotions or finding solutions?
They commonly feel hopeless and numb or exhibit signs of hostility. Depression can make you feel empty, and it can also make you irritable. If you notice someone is frequently unpleasant to be around because they are overly aggressive or sad, it’s a sure sign that they could be suffering from depression.
They quit activities because they don’t enjoy them anymore. Although it’s normal for some people not to participate in extracurricular activities, if someone used to participate in activities and recently quit for no reason, you should wonder why.
They don’t sleep well. If someone is sleeping too much or too little, it can be a sign of depression. But poor sleep isn’t just a symptom. It can also worsen the condition, putting someone in a toxic cycle.
They’re facing interpersonal issues. Stress is a major contributing factor to mood disorders, and, like sleep, it can create a depressive cycle. When someone is on edge because of depression, their relationships often suffer. And as their relationships decline, their depression may worsen.
They often say self-deprecating jokes. This phenomenon is common in young age groups, and while it’s often brushed off as a joke, most people actually do believe the sentiments behind them.
If someone expresses feelings of hopelessness or depression to you, consider talking to them about how often they experience these feelings.
Provide access to mental health resources
Access to adequate mental health resources is one of the most important things you can do for someone who is at risk of attempting suicide.
This can look like:
· helping them make an appointment for therapy
· connecting them with a school counselor or specialist
· providing information on depression, anxiety, and other mood disorders
· showing them different self-care apps and techniques, like breathing exercises and journal prompts
Managing depression is extremely difficult, but when you have the right resources, it’s a little bit easier.
Work to eliminate the stigma around depression and suicide
Some teens may be afraid to express suicidal thoughts because they think it will land them in an in-patient facility—and if they have active suicidal thoughts, that may be the right option.
However, you are fully capable of creating a safe space where they can be vulnerable and speak about their thoughts and feeling. You create a safe space for students by providing them with the right words and distinguishing the differences between active and passive suicidal thoughts.
Active suicidal ideation. Active suicidal ideation is dangerous. This means that someone has thoughts of suicide and has developed a plan to carry it out. If someone is experiencing active suicidal ideation, then they need help very soon, especially if they’re considering when to do it or have begun preparing to do it.
Passive suicidal ideation. Passive suicidal ideation isn’t dangerous unless it develops into active suicidal ideation. A lot of times, students keep their passive suicidal ideation to themselves out of fear.
So, it’s important that you talk about what passive suicidal thoughts look like and why we should talk about them.
Passive suicidal ideation includes scenarios like:
· Wishing to not exist or be alive but not wanting to kill yourself
· Thinking about killing yourself but not forming a plan to do it
· Considering different ways that you could commit suicide but not choosing one
Of course, you’ll need to build relationships with students before they’ll feel comfortable opening up to you. It’s awkward being vulnerable around a stranger, so you should never pressure or intimidate people into sharing their personal thoughts.
Help someone create a safety plan
So, we’ve talked about how you can identify the symptoms, connect people to resources, and start a conversation around suicide. Once you start the conversation around depression, you can work directly with students to develop safety plans.
A safety plan identifies triggers, behaviors, and coping mechanisms. You can think of it as a sort of handbook for life that includes tools for someone to use when they feel depressed.
A section of your safety plan could look like this:
Trigger
Behaviors
Coping Skills
Fear that something bad will happen
Mind races with worrying
Heart rate increases
Pacing around the room
Can’t stop crying
Panic attack
5-4-3-2-1 exercise
Box breathing
Cuddling in a fuzzy blanket
Talking to a friend
Or it could outline a less severe situation like this:
Trigger
Behavior
Coping Skills
Struggling with homework and feeling like I can’t do it
Getting angry
Quitting
Throwing away what I’ve already done
Avoiding homework
Taking a 10-minute walk or break from work when I start to feel upset
Skipping hard questions and coming back to them later
Celebrating every time I finish a step
The purpose of a safety plan is to help the individual notice the signs of distress in themselves and turn to healthy coping mechanisms that can help them regulate their emotions during times of stress.
There’s no one-size-fits-all template for creating a safety plan. It’s truly dependent on the individual, what they struggle with, and what helps them. It might also take some time for someone to figure out what coping skills work best for them.
Notice the red flags
We talked about how to notice the signs of depression, and now it’s time to discuss the red flags. These are signs that someone is experiencing active suicidal ideation and may attempt suicide soon.
Watch out for these behavioral symptoms that could be red flags:
· Talking of the future as if they won’t be there
· Frequently discussing death or dying
· Saying things like “if I killed myself” or “when I’m gone”
· Giving away their possessions
· Saying goodbye or sorry to friends and loved ones at strange times
· Withdrawing socially
· Engaging in dangerous behaviors (bridge jumping, drunk driving, excessive drug use, mixing drugs and alcohol that could be potentially fatal
· Showing the belief that death is the only end to emotional pain
· Self-harming through sex, drug use, relationships, or activities
· Sudden changes in sleeping patterns
· Drastic changes to eating habits
· Declining grades or poor performance
· Sudden poor attendance at school
Some physical symptoms could also indicate active suicidal ideation, including:
· Chronic illness
· Scars or other evidence of self-harm
It may be easy to overlook these red flags of suicidal thoughts, especially if you attribute these things to their age or personality—but these warning signs could mean the difference between life and death.
It’s also common for kids to be punished when displaying some of these symptoms. That’s why it’s essential to follow a connection over correction model when approaching children and teens who may be struggling with depression.
What to do if you know someone is actively suicidal
If you believe that someone you know is actively suicidal, then there are steps you can take to help them.
Talk to them about it. That doesn’t mean mention it once and then agree that they’re probably fine. It also doesn’t mean badgering them to get an answer.
Talking to someone about depressive thoughts is an ongoing conversation. It involves building a relationship with them and supporting them in a way that makes them feel valued, heard, cared for, and appreciated.
Give them options. Depression doesn’t get better on its own. Give them options, like setting up weekly check-ins with you or seeing a licensed therapist. There are in-patient and out-patient programs that can help. They may also be interested in trying medication. Encourage them to speak to a doctor about their depression.
Refer them to an in-patient facility. If someone is a risk to themselves or others, an in-patient facility may be best for them. You may be able to convince them to try an in-patient program voluntarily.
Some states have laws that allow involuntary commitment under certain circumstances, usually if the person presents an immediate danger. Keep in mind that if you go against someone’s will and choose involuntary commitment, it could damage your relationship with them.
At the end of the day, the best thing you can do to help someone who’s struggling with depression is to strengthen your relationship with them.
Are you suffering from depression or suicidal thoughts?
If you’re struggling with feelings of depression, loneliness, or hopelessness, consider reaching out to your doctor to talk about your symptoms or using learning more about living with depression on The National Suicide Prevention Lifeline Website.