Suicide, which is almost unheard of in younger children, is the third leading cause of death among tweens and teens ages 10-14. According to the American Foundation for Suicide Prevention (AFSP), suicide rarely occurs without warning signs, and can be prevented when the warning signs are recognized, taken seriously and addressed.

As parents of tweens and teens, we’re constantly challenged by how to protect our kids while still giving them more freedom and independence. Are they old enough to go to the movies without an adult? What is an appropriate curfew? What in the world are they doing after school, and should I be checking on them more often?

In contrast to these general questions, there is another frightening and confusing question that plagues many parents and yet is often never asked: how can I protect my child from self harm, including suicide?

In the prologue to her book Will’s Choice (HarperCollins), about her son’s suicide attempt, Gail Griffith writes: “How do you explain the suicidal impulses of a child? We give our children life; we think we know everything about them. And why shouldn’t we? We tell them what to think and do from the moment they are born. So it comes as a shock to learn that our children have secret lives— and that their secrets may be deadly.”

Asking the general questions as well as talking about children’s secrets are the keys to suicide prevention. By becoming educated about what signs to look for and how to respond, we as parents become the most effective people to address suicidal behavior and prevent suicide attempts by our children and their friends.

Suicide and Depression in Young People
AFSP estimates that 90 percent of all people who die by suicide have a diagnosable psychiatric disorder at the time of their death, and that most are suffering from clinical depression, an extremely treatable disorder. The most effective way to prevent suicide in tweens and teens is to recognize the warning signs of depression and other psychiatric disorders and get kids the appropriate treatment.
Warning signs of depression include:
• frequent sadness, tearfulness or crying
• persistent feelings of hopelessness
• decreased interest in activities or inability to enjoy activities once favored
• persistent boredom or low energy
• social isolation or difficulty relating to friends or family
• low self-esteem and feelings of guilt
• extreme sensitivity to rejection or failure
• increased irritability, anger or hostility
• frequent complaints of physical illnesses, such as headaches and stomachaches
• frequent absences from school or poor performance in school
• poor concentration
• a major change in eating and/or sleeping patterns
• talk of or efforts to run away from home  
• thoughts or expressions of suicide or self-destructive behavior
• alcohol or drug abuse
• intentional self-injury, such as cutting

Any parent of a tween or teen has surely seen some of these warning signs in their child. Often parents feel frustrated or confused by how closely some of these warning signs mirror behavior they consider as “just being a teenager.” The key to distinguishing normal teenaged “moodiness” from depression is persistence. Normal moodiness is fleeting, whereas a child who displays a number of these symptoms for a few weeks could be suffering from depression and should be evaluated by a mental health professional. If you are unsure, it is better to have your child evaluated. Nearly eight out of ten people with depression can be helped with treatment, but only one in three people ever seek help.

Suicide Warning Signs
The signs of depression and other psychiatric disorders in tweens and teens can be subtle and easy to miss. It’s also important to keep in mind that most depressed adolescents are not suicidal, and there are complex and widely varied causes behind suicide attempts. In other words, screening for depression and mental illness will not detect every suicidal teen. Even the most outgoing and seemingly gregarious young person could be feeling suicidal impulses.
According to the American Academy of Children and Adolescent Psychiatry, signs that a teenager may be planning to commit suicide include:
• complaining of being a bad person or feeling “rotten inside”
• giving verbal hints with statements such as “I won’t be a problem for you much longer,” “Nothing matters,” “It’s no use,” or “I won’t see you again”
• putting his or her affairs in order, such as giving away favorite possessions, cleaning his or her room, throwing away important belongings
• becoming suddenly cheerful after a period of depression
• showing signs of psychosis (hallucination or bizarre thoughts)
Although there is no hard and fast test that can tell you without a doubt that a child is suicidal, these warning signs, especially suicide threats, should be taken very seriously. As a parent, you know your child better than anyone else. Trust your judgment. If you suspect that your child is experiencing suicidal impulses, seek professional help.

An adolescent contemplating suicide may believe that they cannot be helped, so you may need to be persistent to make sure that your child gets the help he needs. If your tween or teen is reluctant to see a mental health professional, offer to accompany him or suggest that he brings a friend or sibling with him to the appointment.
In an acute crisis, such as with a child who is threatening suicide or has made a suicide attempt, you must act immediately. Remove from the vicinity all firearms, medications, poisons or sharp objects that could be used in a suicide attempt. Do not leave them alone until help is available. Take your child to the emergency room or walk-in clinic at a psychiatric hospital, as hospitalization may be necessary until the crisis is over. If you cannot safely get your child to an emergency facility, call your local emergency number.

When Suicide Happens
When another child dies by suicide in your child’s school or your community, it can spark feelings in your tween or teen— ranging from shock to sadness to anger. A suicide of another child, or an adult well known to your child, can even spark thoughts of suicide in a child who is depressed. It’s important to talk to your child about the loss and let them know that you’re there if they want to talk more. It can be an uncomfortable discussion to have with your youngster, but a reassuring parent-child conversation will do wonders to help your tween or teen grieve.
Find resources on talking to your child about suicide and suicide prevention at www.afsp.org.

Sam Ritchie works for a national education organization and is walking in his local Out of the Darkness Community Walk to raise money for the American Foundation for Suicide Prevention. To find out how you can walk in your area, visit www.outofthedarkness.org or call (888)333-AFSP.