Childhood suicide: Bullying, ADHD and relationships

Suicide is the third-leading cause of death for young people ages 10 to 14. More than 1 in every 10 high school students have attempted suicide and almost 20 percent of high school students think about suicide, according to the American Psychological Association.

The stories behind the problem are as horrifying as the statistic themselves: an 8-year-old boy who was bullied at school, a 12-year-old girl bullied online and a 16-year-old boy who said he could no longer handle the pressure of his highly competitive high school are recent examples.

“I see so much more of it recently than when I started 20 years ago,” said Danae Lund, Ph.D., Licensed Psychologist at the Sanford Health Department of Pediatrics in Bemidji, Minnesota. “There’s a lot of pressure on kids that’s not good for their emotional development.”

Growing up is not always easy — especially as a teen. Between the mood swings, emotions and drama, the teenage years are a very vulnerable time for many. And sometimes it’s hard for young kids to see the bigger picture, especially when things go wrong or something bad or unexpected happens.

“Children and teens sometimes can’t see their way through it,” Lund said. “They can’t imagine a time when they’ll feel better or things will be better.”

Impulsive decisions

While some youth think about suicide for a long time before attempting, others are more susceptible to impulsive decisions.

Generally, the majority of teens who attempt suicide experience a mental health disorder, usually depression, according to the American Academy of Child & Adolescent Psychiatry. However, it’s important to note that children don’t have to be depressed to have suicidal thoughts, and not all depressed children will have suicidal thoughts. Among older children, suicide attempts may be linked to feelings of stress, self-doubt, pressure to succeed, financial worries, disappointment, and loss, where they feel that suicide is the only solution, according to the academy.

Attention Deficit Hyperactivity Disorder (ADHD) also increases risk for suicide attempts, especially among younger children whose actions are often impulsive responses to feelings of sadness, confusion, anger, or problems with hyperactivity and inattention. A TIME article highlighting a case study that looked at 693 childhood suicide cases across the United States found that 60 percent of children ages 5 to 11 who died by suicide had ADD or ADHD.

The smartphone generation

With the rise of smartphones and social media in recent years, cyberbullying is starting to be seen as a possible cause of the rising teen suicide rate.

“Everything is so much more public than it used to be,” Lund said. “Among the kids I work with, every week I’m so struck by the sheer amount of time kids spend online socially interacting with their friends and how that becomes their world.”

Drama and conflict can escalate quickly online, and Lund said a lot of children don’t know how to deal with it. When they’re stressed or overwhelmed, they’re much more likely to impulsively respond.

Kids who are bullied on or offline are more than twice as likely to have issues with suicidal thoughts or actions, according to Lund. Even the kids doing the bullying are at an increased risk for having suicidal thoughts or attempts.

Lund said it can be hard for parents to know what their kids are doing online, but that they should make good efforts to monitor their children’s online use, or better yet, get them away from their phones.

“It’s important for us to put in the time to do stuff with our kids so there’s more in their world than being online,” she said.

Relationships with parents

Having a relationship with an adult is a really protective factor against suicide for kids.

“As a parent it’s important to prioritize that relationship and show the child they’re important to you,” she said. “Interact in positive ways, take time to do fun things and talk to them about things they’re interested in.”

In today’s busy world, it’s easy for even the best of parents to get caught up in their own distractions or spend too much time on the phone, sometimes causing them to miss warning signs that their children are struggling.

“A lot of parents don’t do it on purpose, but we can get into this time crunch in our busy lives and we don’t take time to enjoy each other’s company with our kids,” Lund said.

A strong connection with family and friends is key for children with depression or suicidal thoughts. Lund said it’s helpful when kids know they have someone who cares and won’t judge them if they’re having those thoughts. It’s also crucial to reassure them that a time will come when they’ll feel better, because often times kids can’t see that.

“It’s not enough at the time just to tell your child, ‘I love you, I care about you.’ You have to show it,” Lund said. “Participate in the bigger world, not the narrow view that they’re having.”

Communication

Proper communication with young children experiencing suicidal thoughts could be the difference between a saved life and a lost one. It’s important for parents and anyone who talks to kids about suicide to take it seriously and avoid judgment.

“A lot of people will say ‘You’re just trying to get attention,’ and that’s really hurtful,” Lund said. “Just listen and let them know you’re there.“

When parents are worried, they can come across as stressed, angry, or not open to talking about the situation. Instead of telling your child they shouldn’t think or feel that way, show empathy and validate their feelings. Focus the conversation on your concern for the child’s well-being and tell them you will arrange to get help, either through a clinic-based professional or a school counselor.

Lund also adds that it’s helpful for parents to involve themselves in the therapy. Rather than simply dropping the child off, attend the sessions with them and participate to whatever degree the clinician requests.

Recognize the problem

Identifying the risk factors and warning signs of children thinking about suicide can help parents address the problem before it gets worse. It’s important to take these signs seriously and not see them as ways of children trying to get attention. Besides Lund’s own firsthand experience, she said these organizations also are great resources.

Risk factors (American Psychological Association):

• Recent or serious loss (death, family divorce, health problems, economic problems)
• Prior suicide attempt(s)
• Depression, hopelessness, guilt, worthlessness, shame, helplessness, anxiety or extreme mood swings
• High risk behaviors
• Increased alcohol or drug use
• Bullying by peers or being a bully
• Child abuse or neglect
• Witnessing violence in the home
• Mental illness, including suicide, in the family

Other environmental or community risk factors:

• Access to lethal means (firearms, pills)
• Stigma associated with asking for help
• Lack of access to services

Serious warning signs (American Psychological Association):

• Talking about suicide, wishing they were dead or being preoccupied with death
• Trouble eating or sleeping
• Drastic changes in behavior, eating or sleeping habits
• Mood swings
• Loss of interest in school, work or hobbies
• Serious conflicts with peers
• Engaging in careless, high risk behaviors
• Increased or unusual alcohol or drug use
• Being bullied or bullying others
• Prior suicide attempts

Prevention

Parents and adults can take the following actions to prevent suicide attempts among children (American Psychological Association):

• Foster strong connections to family, friends and community
• Prioritize interacting with your child in positive ways
• Monitor your child’s activities and social interactions, especially online
• Be aware and try to prevent and protect against cyberbullying
• Teach and model for your child effective skills in problem-solving and conflict resolution, identifying and managing emotions and impulses and effective communication, especially if your child has ADHD, anxiety or depression
• Limit access to highly lethal means of suicide
• Encourage children with suicidal thoughts to seek professional help with therapy or medication

Additional resources for children include:

• Society for the Prevention of Teen Suicide
• American Society for Suicide Prevention
• SAMHSA National Helpline: (800) 662-HELP (4357)
• Suicide & Crisis Lifeline: 988 or (800) 273-TALK (8255)
• Crisis Text Line: Text HOME to 741741
• SAMHSA Disaster Distress Helpline: (800) 985-5990

Visit sanfordhealth.org to find resources, risk factors, warning signs and steps you can take to help a loved one.

Learn more

• Podcast: Pediatric mental health
• When media changes adolescent moods & anxiety
• High-profile suicide can trigger emotions in anyone

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Posted In Back to School, Behavioral Health, Children's, Health Information

Hannah Nieman