My recent column pertaining to a 12-year-old who told his parents he’d thought about suicide several times over the past six months stirred a fair number of folks to respond. Feelings toward the column ranged from “many thanks” to “how interesting” to fear and loathing.
Said pre-teen was obviously well-adjusted. He enjoys several good friendships, displays no signs of depression or anxiety and is not “problematic” in any way. A child who shares with his parents that he’s thought about suicide is likely to tell his parents if suicidal thoughts worsen. In my experienced estimation and using guidelines published online by the likes of the Mayo Clinic, the boy is not at any significant risk of taking his life. He simply thought about suicide.
Most if not all of today’s pre-teens and teens have thought about suicide. Beginning in middle school, kids attend talks on suicide; before high school graduation, most kids know the name of a peer who has taken his or her own life. In and of themselves, such thoughts are not necessarily cause for alarm. Thinking about what it would be like to commit suicide is not the same as seriously considering suicide. In other words, not all suicidal thoughts are equal. They are certainly worth assessing and addressing, which is what said youngster’s parents were asking help with.
Some respondents chided me for not recommending that the boy see a therapist. According to an article from Stanford Children’s Health, the strongest risk factors for teen suicide are depression, drug abuse and persistent aggressive or disruptive behaviors. The child in question did not come close to exhibiting any significant risk factor, so I disagree that he should see a professional.
Besides, therapy with a young person is a dicey proposition. The first question to be asked is, “Which therapist?” Lots of parents have reported to me that their kids’ emotional and behavioral states worsened considerably after they began seeing therapists. Not all therapists are equal. Besides, many kids who commit or attempt suicide are seeing mental health professionals. It would be nice to think that therapy is a one-size-fits-all solution for kids with suicidal ideation, but it’s not. Indeed, certain forms of therapy have been found to be helpful on average, but again, mere “thoughts” of suicide in an otherwise well-adjusted youngster are not reason enough to take said child to a therapist. They are reason to keep a sharp eye open, but not to jump to apocalyptic conclusions.
Most of my respondents — the upset ones — said I should have recommended that the boy begin taking anti-depressant medication. Unfortunately, a young person who begins seeing a therapist for thoughts of suicide is likely to end up taking one or more of several psychiatric medications; the problem being that several studies have shown that the medications in question may actually increase the risk of suicide, especially in children and teens.
Some respondents were very appreciative of my advice. One heartbroken father whose teenage son committed suicide while seeing a therapist and taking medication asked me to warn my readers of the medication-therapy-suicide relationship. The mom of a pre-teen put on medication told me she is convinced that the medication caused her son’s depression and suicidal ideation. When she stopped giving him drugs, he stopped thinking about committing suicide. At this point, I’d say the medication-suicide relationship is not conclusive but nonetheless strong enough to warrant significant caution — precisely what the FDA pointed out several years ago.
Correlations don’t prove cause, but worth pondering is the fact that as the rate of teens seeing therapists and taking psychiatric medications has increased exponentially, so has the child and teen suicide rate.