Question: 

How can I know if my teenager is developing suicidal tendencies or a self-destructive mindset? I’m asking because I’m afraid that my teenager may be moving in this direction. Are there any warning signs to be aware of? Does depression always include a risk of suicide?

Answer: Though depression doesn’t always lead to suicide, it is one of the major contributing causes of a suicidal state of mind, and it should be taken seriously on its own account. If you have reason to suspect that your child might be clinically depressed you’ll want to be aware of and on the lookout for some common signs and indicators. You should look for behaviours such as painful introspection, negative self-concept, dramatic mood swings, episodes of moping and crying, withdrawal and isolation, fatigue and other unexplained physical ailments, poor school performance, and outbursts of anger and overt acting out. If these symptoms are present and persist for more than two weeks then you should seek appropriate help immediately. You may want to contact your physician for advice or a referral. Even if a present threat of suicide doesn’t seem to be part of the picture, you should still take definite steps to deal with the depression.

You didn’t tell us exactly why you believe that your teen may be suicidal, but even without more information about the specifics of your situation we can tell you this much: it’s always better to err on the side of caution. In particular, any talk about suicide on the part of your child – statements such as, “I’d be better off dead,” or “Maybe life would be easier for you if I wasn’t around” – should be taken seriously and given full attention.

Identifiable risk factors for suicide among young people include the following: mood disorders, substance abuse, certain personality disorders, low socio-economic status, childhood abuse, parental separation or divorce, and interpersonal conflicts or losses. You should be especially vigilant if any of the following predictors of suicide are present:

• A previous suicide attempt.
• A family history of suicide.
• The presence of chronic pain, degenerative disease, or some serious psychiatric condition such as bipolar disorder.
• Expressions of intense guilt or hopelessness.
• Threatening, talking or joking about suicide.
• A teen who has been struggling with depression, stress, anxiety or deep disappointment suddenly seems happier and calmer. This may be a sign that he has made up his mind to end his life.
• “Cleaning house” – i.e., a sudden impulse to give away personal possessions.
• Suicide among other adolescents in your community.
• A sudden, major loss or humiliation. Parents should be on the alert to ensure that their child is not the victim of either physical or social bullying. A dramatic boyfriend-girlfriend “breakup” is another situation that should be regarded very seriously. Resist the temptation to minimise a teen’s feelings. It’s not important that the problem seems trivial or easily solved to you. What counts is how he sees it.

You can evaluate the level of risk and the imminence of the danger by remembering the following acrostic: S-L-A-P:

• S = Specific plan. Is your teen considering a specific course of action for taking his own life (either communicated to you directly or brought to light in some other fashion)? If the answer is yes, go on to the next question.
• L = Lethality of the plan. Is this specific plan really deadly? If so, he’s now running a fifty percent risk. Continue to “A.”
• A = Availability of plan. Can the plan be enacted? Does he have access to the means and/or materials needed to carry out his intentions? For example, would it be easy for him to lay his hands on large amounts of prescription medications? If so, he is in considerable danger, and you should take immediate action. Be sure to read the final question.
• P = Proximity of help. Are there people close enough to keep him from following through with this specific, lethal, and available plan? He probably won’t try anything while friends, family, or others whom he respects are around. Most suicides happen when the depressed individual is alone or in the company of another suicidal person. If there is no help close by, get your son to a place where he can be kept safe. If you can’t put him under family supervision, call 999 or take him directly to a local Emergency Room.

If you’re not sure about the answers to these questions, it would be a good idea to sit down and have a heart-to-heart talk with your teen. Don’t be afraid to get pushy. Press him with some direct questions. You might begin with something like, “Where are these negative feelings coming from?” or “What is it that’s causing you to talk so much about ending your life?” It could be especially helpful and revealing to ask, “Exactly what would have to change for you to feel better?” You may also want to get an official psychiatric diagnosis in order to ascertain more clearly what’s behind the depression and the allusions to suicide. Your child could be struggling with an anxiety disorder, a bipolar condition, or some kind of substance abuse.

Call us at 03-3310 0792 or email us at support@family.org.my. Our caring counsellors would be happy to discuss your situation with you. They’re also in a position to provide you with a list of referrals to professional counsellors in your local area.

© 1999, 2010 Focus on the Family. All rights reserved. Used with permission. Originally published at focusonthefamily.com.