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What every parent needs to know about depression and suicide in children

March 06, 2015

Written by Analise Vendittelli, Arnold Palmer Hospital resident

Depression and suicide in young children are topics that people are hesitant to discuss; however, it is crucial that we become more aware and more willing to talk about about these important issues. As a resident physician in pediatrics, childhood suicide has been one of the most difficult realities for me to digest. We need to be aware that younger and younger children are taking their own lives.

Sadly, suicide in childhood and adolescence is the 3rd leading cause of death. Suicide attempts are common, with approximately 50 to 100 attempts for every completed suicide.

Here are some important things you should know:

At what age are children at greatest risk for suicide? Are males or females more likely to attempt suicide?

Childhood suicide increases with age. Post-puberty females are more likely than males to attempt suicide. However, males are more likely to complete suicide. This may be because males often choose more lethal means.

What increases the risk of suicide in children?

There are many factors that place a child at higher risk for suicide. Importantly, psychiatric disorders, previous suicide attempts and a family history of mood disorders and/or suicidal behaviors all are associated with an increased risk of suicide. Exposure to violence in the home, bullying by peer groups and a history of physical or sexual abuse are also factors that increase a child’s risk of suicide.

Why should we be aware of childhood depression?

The majority of adolescents who attempt or complete suicide have a psychiatric disorder. The most common diagnosis is depression. Teens are more likely to have a psychiatric diagnosis than younger children. The truth of the matter is that childhood depression often goes undiagnosed and is under treated. With children committing suicide younger and younger, we need to be prepared to notice signs and symptoms of depression in younger children and prevent tragic outcomes.

What are risk factors for childhood depression?

There are many risk factors that predispose a child to depression including but not limited to family history of depression in close relatives, family dysfunction, psychosocial stressors, homosexuality, history of learning disabilities and chronic illness.

What are the symptoms of depression?

  1. Depressed or irritable mood: Child may feel sad and may believe life is “unfair.” Alternatively he or she may be annoyed and bothered by everything.
  1. Diminished interest or pleasure: Child may lose interest in spending time with friends or no longer want to participate in his or her favorite activities.
  1. Change in appetite or weight: Child may have either an increased or decreased appetite when depressed and consequently have unintentional weight loss or gain.
  1. Sleep disturbance: Child may have difficulty falling asleep or staying asleep. Alternatively, child may sleep excessively and never feel well-rested.
  1. Psychomotor agitation or retardation: Child may be unable to sit still. Child may talk and move more slowly.
  1. Fatigue or loss of energy: Child may feel exhausted and appear unmotivated.
  1. Feelings of worthlessness or guilt: Child may be excessively critical of himself or herself. Child may not engage in activities for fear of failure.
  1. Impaired concentration and decision-making: Child may appear indecisive and respond frequently with, “I don’t know.” Child may also develop difficulty with completing schoolwork due to problems with concentration.
  1. Recurring thoughts of death or suicide: Child may have preoccupation with music or literature about death and suicide. Furthermore, child may have passive or active suicidal ideation.
  1. Psychosis: Child may exhibit delusions or hallucinations during an acute depressive episode.

What does childhood depression look like?

Childhood depression may present with many of the symptoms above, similar to depression in adulthood. However, while an adult often appears sad and hopeless, a child may lack the insight to correctly identify their emotions. Instead a child suffering from depression may act irritable and have anger outbursts. You must have a high level of suspicion to notice depression in a child.

What do you do if a child is depressed or has suicidal thoughts?

If you suspect a child is suffering from depression, then talk to him or her. Look out for the signs mentioned above. Make an appointment with a doctor as soon as possible. If a child has thoughts of suicide, seek medical attention immediately.