If your child is suicidal, it’s crucial to understand that he cannot just “snap out of it” or will himself to feel better. A depressed child feels a constant sense of discouragement, a loss of self-worth and an inability to imagine a better future. Treatment from a licensed mental health professional, in conjunction with loving support at home and at school, is critical to a full recovery.Your Children’s clinician will work with you and your child to determine the best approach to care during an immediate crisis, as well as over the long term.
The mainstay of treatment for suicidal thoughts and behaviors—and for depression in general—is psychotherapy, or “talk therapy.” Here at Children’s, our clinicians use therapy to help your child understand and cope with her feelings. Coping strategies taught in psychotherapy can include:
- identifying and talking about feelings, worries and relationships
- stopping automatic negative thoughts (“Nothing I do will ever turn out right”)
- relaxing the mind and body
- identifying activities that are engaging and comforting
- recognizing and appreciating positive self-attributes and achievements
- building hope for the future
Using these strategies, your child will be able to:
- focus on changing her distorted views of herself and the environment around her
- work through difficult experiences and relationships
- identify stressors in her life and ways to avoid them
- improve their general problem solving ability
When a child is suicidal, the entire family is affected. Family therapy can be an invaluable resource in building a support system for the child and addressing the concerns and issues faced by other family members.
If environmental circumstances in your child’s life—for example, being bullied at school or coping with a parent’s alcoholism—are triggering his suicidal feelings, it is critical to change these circumstances as much and as quickly as possible. Your Children’s clinician can advise you on managing issues at your child’s school, with peers and at home.
Many children and teens who contemplate or attempt suicide are so depressed that therapy alone is not enough. In these cases, antidepressant medications may be recommended to help the child feel less depressed and subsequently relaxed, motivated and comfortable while working on coping skills in therapy.
Medication is not a “standalone” treatment; Children’s always considers it part of a two-prong approach, with psychotherapy as a necessary component. Our Psychopharmacology Clinic is devoted to helping children, families and clinicians decide whether medication might be a useful part of treatment.
Commonly prescribed antidepressant medications include:
SSRIs (selective serotonin reuptake inhibitors, which adjust the levels ofserotonin—a chemical that regulates mood—in the brain)
Atypical antidepressants (drugs that impact both serotonin and other chemical messengers in the brain)
No single medication is effective in all children. Families should expect a trial-and-error process that can last weeks, or even months, as doctors find the drug regimen that works best.
Since 2004, the U.S. Food and Drug Administration has placed a black warning label on antidepressant medications. The warning label states, in part:
“Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with Major Depressive Disorder (MDD) and other psychiatric disorders. Anyone considering the use of [Drug Name] or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior.”
If your child is prescribed any medication, your clinician will carefully go over the specifics of the drug, as well as any potential side effects you should watch for. Our team has years of experience in managing the use of psychiatric medications in children of all ages and with a wide variety of conditions. We will closely monitor your child for any sign of a negative response to the medication, and are always here to address any concerns you may have.
It is important to note that every study has shown that the combination of medication and psychotherapy reduces the risk of suicide.
Learn more about psychiatric medications.
A child who has attempted suicide—or is severely distraught and on the verge of an attempt—may require a period of intensive, inpatient treatment.
Children’s Inpatient Psychiatry Service is a 16-bed psychiatric unit. The service provides comprehensive medical and psychiatric care for children, ages 8 to 18, who are experiencing a mental health crisis that calls for immediate treatment in a hospital environment. We offer:
- family-centered assessments and customized treatment plans
- medication consultations and management
- referrals to other hospital and community mental health services
- coordination of follow-up with primary care physicians and treating mental health clinicians after the child is discharged