About Depression and Suicide

All of us, including children and adolescents, have times during our lives when we feel sad or depressed and it is normal to feel that way sometimes. A depressed mood can be linked to specific events or it can be biologically based or it can be a combination of both.

You can tell when normal feelings have gone beyond “normal” when the feelings go on for an extended period of time; the feelings continue to get worse; things that have worked in the past to help relieve these feelings aren’t working; and/or the feelings interfere with day-to-day functioning.

These signs may indicate depression:

• Low self-esteem
• Anger management problems or preoccupation with violence
• Irritating, fighting with or withdrawing from friends, teachers and/or parents
• Refusing to go to school
• Behaving to get negative attention
• Doing poorly or dropping out of school
• Becoming pregnant early in life
• Increased physical health problems
• Becoming a smoker
• Abusing alcohol or drugs
• Threatening suicide or homicide

So what do you do if you recognize the signs? Talk with the child/youth about your concerns. Remove access to any lethal means and arrange for an evaluation by a mental health professional. The sooner depression is evaluated, the easier it is to treat.

Means Restriction and Means Reduction:

• Means restriction and means reduction refers to limiting access to the most deadly methods of dying by suicide. This could include:
  
  1. Removing guns from the homes of youth at-risk of suicide or storing guns locked and unloaded with the ammunition locked separately;
     
  2. Erecting barriers on bridges or other jump spots to prevent youth at-risk of suicide from jumping; and
     
  3. Dispensing fewer sleeping pills or other potentially-lethal medications to youth at-risk of suicide.

• Means Restriction is important because:
  
  1. Many suicides are impulsive
     
  2. Suicides often occur during temporary life crises
     
  3. Most people who attempt suicide do not go on to die by suicide

• Quick Quiz; what is the right answer???

 

1. In a case-controlled study conducted by US researchers, what percentage of suicide attempters - ages 13-34 - reported deciding to end their lives after thinking about it less than five minutes?  (answer: 25%)
   
2. In the National Violent Death Reporting System study, what percentage of young people, ages 17 or younger experienced a life crisis on their day of their death? (answer: 35%)
   
3. In a review of 90 studies of long-term outcomes of people who survived a suicide attempt, what percentage went on to die by suicide? (answer: 5-11%)

 

Recommendations for Families:

• Permanently remove guns, especially if children and teens live in the home AND/OR there is someone who is depressed and possibly suicidal in the home;
• Store guns safely -  locked and unload, with ammunition stored separately;
• Talk with neighbors and friends about guns in their homes before sending your child over to play;
• Limit prescriptions to non-lethal quantities; throw out unused prescriptions - check with Poison Control about what quantity of what medication would make it unsafe to store - [in Washington State call 1-800-222-1222];
• Given that alcohol mixed with Tylenol is very lethal, consider locking up alcohol in the home;
• Know the signs and symptoms for depression and do not be afraid to ask a child or teen if he/she is thinking about suicide; and
• Be willing to call for help - 1-800-273-TALK [8255] - if you are concerned about your child's behavior.

Recommendations for Clinicians:

• Routinely ask youth and their family about suicide risk factors and ALSO talk with them about restricting access to lethal means;
• Ask father AND mother (and/or all adults living in the house) if there is a firearm in the home;
• Ask about all firearms at all relevant homes;
• Advise about temporary and/or permanent safe storage of firearms and remain firm about this safest option;
• Discourage hiding guns;
• Advise families to remove lethal doses of medication from the home [this may require help from the clinician to educate the youth and family about the types and quantities of medications, including those that can be purchased over the counter];
• Sympathize, remain non-judgmental and avoid minimizing; and
• Keep the discussion focused on the youth at-risk of suicide.

References/Links: