A common mental health myth is that only adults and older adolescents can be depressed. In fact, kids and younger teens may experience depression too. In 2018-2019, 15% of adolescents reported experiencing a major depressive episode and 37% reported experiencing persistent feelings of sadness or hopelessness. Depression presents differently person to person and often is not just someone who seems really sad or down. In fact, for kids and teens, depression can look quite different. Depression spans a variety of symptom presentations including persistent tiredness, irritability, behavioral outbursts, isolation, and more.
Even though depression may look different for kids and adolescents, some young people will experience intense symptoms and be at high risk for suicide or self-harm. Depression is the most common risk factor for suicide for individuals of any age, and signs of suicidal ideation or intent to self-harm should be taken seriously.
The first step to helping is being able to recognize the symptoms of depression, and the second step is to identify potential risk for self-harm and suicide. Understanding why depression can lead to these behaviors and thought patterns is key to responding to risk in an appropriate manner and supporting your child through tough moments.
Some kids and teens who experience depression are at risk for non-suicidal self-injury (NSSI), which is intentional physical harm that is not intended to be fatal. Most commonly, this type of self-harm involves methods like skin cutting, banging their head, hitting themselves, or burning their skin.
People who engage in self-harm often say that it serves as a way for them to cope with anxiety and negative thoughts or feelings. The physical sensation of the injury can feel like a relief of stress or pressure, and the act of self-harming often feels like an assertion of control over their lives when it might be lacking in other areas. Scientifically, endorphins and adrenaline are produced in response to the injury, and this jolts the brain out of the negative depressive state it had been settled into.
Research studies tell us much of the same thing. Self-harm is a maladaptive coping strategy that occurs in response to overwhelming feelings of negative emotions or numbness and allows the individual to manage or change intolerable internal feelings or experience a sense of feeling when they’re numb. Because maladaptive coping has a true and effective physiological impact on the brain and the body, it is important to find healthy and safe coping strategies, as it makes sense to continue to use maladaptive coping if a person does not have other tools.
Depressed kids and teens may also experience suicidal ideation. Suicidal ideation, defined most plainly, is when you think about killing yourself. Suicidal ideation can manifest to different degrees in separate individuals, and these different degrees of intensity can communicate to us the level of risk the child is at for suicide.
Here are the levels of suicidal ideation:
-
Thoughts of death
Some kids and teens may have more abstract thoughts about death or may express the wish that they did not exist. For example, they might say, “I wish I were never born,” “I wish I didn’t ever have to wake up,” “I wish I were dead.” -
Thoughts of suicide
Explicit thoughts of suicide indicate the next level of risk. These kids and adolescents are actively thinking that they no longer want to be alive and are contemplating doing something to end their lives. -
Thoughts of method
Indications that a child or teen has thought about the specific way that they would end their life brings the risk to the next level. These individuals have taken a step further than just have thoughts of death and are beginning to envision the way that they would prefer to kill themselves. -
Presence of intent
Beyond thoughts of method, some kids and teens may begin to have conviction that they want to act on their thoughts of suicide. The inclusion of intent to follow through on their suicidal thoughts increases risk. -
Presence of a plan
At the extremely high-risk level, kids and teens will have started to work out an actionable plan to kill themselves. They will be formulating the method of suicide, where they will do it and when they will do it. When there is a plan in place, it is most often paired with an intent to carry it out. -
Taking action
The highest risk category of those with suicidal ideation and intent is taking steps to act on the plan that has been formulated. This could look like preparing the method of suicide, like collecting pills, or getting a gun. This could also look like writing a suicide note or giving away personal belongings.
Regardless of the level of risk that a child or teen is experiencing, it is highly important to take all signs of suicidal ideation seriously and take appropriate action to ensure the safety of the person. Now that we share a common language around non-suicidal self-harm and suicidal ideation, take a look at our next blog, Safety Planning with Your Child or Teen, to learn some ways you can take active steps to address the risks associated with depression for children and teens in your life.
Want to learn more?
Sources:
American Psychological Association. (n.d.). More than 20% of teens have seriously considered suicide. psychologists and communities can help tackle the problem. Monitor on Psychology. https://www.apa.org/monitor/2023/07/psychologists-preventing-teen-suicide
Mayo Foundation for Medical Education and Research. (2022, August 12). Teen depression. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985
Preventing youth suicide: Tips for parents & educators. National Association of School Psychologists (NASP). (n.d.). https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-safety-and-crisis/mental-health-resources/preventing-youth-suicide/preventing-youth-suicide-tips-for-parents-and-educators
Stanley-Brown Safety Plan. Stanley-Brown Safety Plan – Suicide Prevention Resource Center. (n.d.). https://sprc.org/online-library/stanley-brown-safety-plan/
Suicidal thoughts and suicide attempts. Suicidal Thoughts and Suicide Attempts – Suicide Prevention Resource Center. (n.d.). https://sprc.org/about-suicide/scope-of-the-problem/suicidal-thoughts-and-suicide-attempts/