Suicide of Elementary School-Aged Children and Adolescents
Suicide in children and adolescents is a difficult topic to discuss. Suicide is the third leading cause of death among all children and adolescents in the U.S. As a mental health professional, my worst fear is a child prematurely ending his or her own life. As a mother, it is hard to comprehend the profound grief families must feel in the wake of a suicide.
My motivation for writing this piece is to help families identify children who may be struggling with thoughts of self-harm in hopes of preventing suicide.
Pediatrics, the journal of the American Academy of Pediatrics, recently published an article that compared death by suicide among elementary school-aged children (ages 5-11 years) and early adolescents (ages 12-14 years.)
They found that younger children who committed suicide were more likely to have experienced ADHD symptoms while early adolescents were more likely to have experienced depression symptoms. It seems that younger children who die from suicide are more likely to do so impulsively while early adolescents tend to struggle with depression for some time then plan and carry out suicide.
While this research is overwhelmingly sad, I think it is important because many of my patients have ADHD and depression. Does this study show that all children with ADHD or depression are going to kill themselves? Absolutely not.
What is important to realize is that in a young child, thoughts of suicide can occur without depression symptoms. I have to wonder if some of the elementary-school-aged children meant to end their life, or if they act impulsively not fully appreciating the consequences. Unfortunately, the result is the same regardless of the child’s intent. A child’s life has ended prematurely, and family and friends are left with immense grief and a lifetime of regret.
In childhood and adolescence, depression is more likely to present with irritability and angry outbursts than sadness. Young people are remarkably resilient and able to ‘compartmentalize,’ meaning they can feel deeply sad when alone but are able to socialize with their friends and appear happy on the surface.
Depression also manifests as changes in energy and sleep as well as social withdrawal, a drop in grades, or not engaging in activities they once enjoyed. If you see some of these signs and symptoms in your child, it may be time for an assessment. Starting with your pediatrician is a good first step because they can help assess for depression symptoms as well as rule out any medical problems that present similarly to depression.
It is important to know that 29 percent of children in both age groups disclosed their suicide intent to another person before death. I think it is vitally important to take children seriously when they say they want to die.
I think it is easy to dismiss a statement like this from a child because it is hard to imagine that they fully understand what they are saying, but I would sure hate to be wrong. I think it is important to believe our children and get help for them when they make suicidal statements. If you are concerned that a child may hurt him or herself or others, please seek professional help as quickly as possible. If you feel the threat is imminent, please take them to the Emergency Room for an assessment.
As parents, we care deeply about our children and want them to live happy and healthy lives that far exceed our own. When it comes to mental health, the most important thing we can do is listen to our children and be aware that they may not have the words to ask for help. Sometimes they show us they are struggling through their behavior. If you know a child who is struggling, please reach out for help. Pediatricians and mental health professionals are here and ready to lend a hand when needed.
About the author
Kristen Pyrc, M.D., isa board certified child and adolescent psychiatrist at Cook Children's. As a mother and physician, Dr. Pyrc has not time for hobbies, but someday hopes to squeeze in a yoga class. Cook Children's Behavioral Health services provides a broad range of care that focuses on children from ages 3 years through 17, and their families. As part of family-centered care all of our professionals are qualified both through education and experience to work with children who have behavioral and emotional challenges. Our psychiatrists are board certified in child and adolescent psychiatry and our psychologists and therapists are all licensed independently in Texas.