None of us wants our child to suffer from depression. No one wants their child to experience suicidal ideation, but unfortunately, some do.
Since 2011, the number of children, teens and young adults committing suicide has doubled. According to the Centers for Disease Control and Prevention, suicide is the third leading cause of death in young people between the ages of 10 and 24, resulting in about 4,600 lives lost in the U.S. each year.
We cannot ignore these statistics. Suicide among girls is on the rise. Girls are more likely to turn isolation, pain, shame and unexpressed fears against themselves, engaging in self-injurious behaviors. Boys are more likely to express intolerable pain with anger or rage. For both girls and boys, shame may prevent a young person from admitting pain. Eventually, such unexpressed emotion becomes unbearable, and violence against the self or others may be the consequence.
Recognizing risk and taking action
Common risk factors include family alcoholism, substance abuse and pervasive emotional, psychological, physical neglect or abuse — either within the home or in school settings — leading to emotional and psychological isolation. Less commonly recognized factors include divorce, single parenting, adoption and foster care. Some children respond by becoming over- or underachievers. Others become co-dependent protectors of their caregivers or parents. Many leave home prematurely, or turn to drugs or other addictive behaviors to mask the anger and sadness unnoticed by their primary caregivers.
Over time, depression becomes progressively debilitating. It may manifest in hyperactivity, agitation or psychological paralyses, immobilizing the capacity to think, feel or be creatively productive and relationally connected. It is time to support families in developing greater awareness and mindful attention to signs, symptoms and behaviors that may signal depression, and to provide basic skills and tools to enable intervention.
Cause and impact
A contemporary cause of depression is excessive dependence on social media for self-acceptance. From an early age, children contort themselves into an orchestrated, self-critical version of the self to comply with fast-moving social norms. Children who cannot keep up may be more at risk for depression.
Parents with heavy work schedules and personal demands may fall short in offering crucial support to their children. This is typically not due to lack of desire, but more often attributable to their own lack of strong relational skills.
The good news is that today, we understand more about attachment, what creates strong emotional bonds and what essential building blocks can support young people in weathering early childhood losses. These building blocks, however, are not sufficiently implemented or taught. These are relational parenting skills that must be applied and sustained for positive outcomes. Where a child’s pursuit of achievements trumps establishing strong emotional connections at home, the child is left vulnerable. A fundamental fracturing between the authentic self and an increasingly idealized persona may occur.
What children fundamentally require
In addition to custodial care, food, and shelter, children fundamentally require a place where pain, losses, fears, anger, shame and longings may be expressed and sorted through and valued in order to make contextual meaning of life’s difficult experiences.
Emotional sheltering, nurturing normal feelings, providing wise perspectives and validating the strengths of the child all serve to develop a strong emotional core during formative years. Without these fundamental assurances, children may experience varying degrees of depression.
Conversely, when a family member, friend or community member notices a child’s distress, and has been taught the importance of empathic engagement, a critical intervention is possible. With time and appropriate care, there is hope for building a loving, compassionate and productive life.
The most difficult task for a family can be to recognize a problem and admit to its seriousness. Only in the past decade has the lasting emotional and psychological impact of trauma become broadly recognized. Many families are at risk in ways they do not recognize or understand. Parents and caregivers must become particularly mindful of the child’s usual behavior, and become keenly attuned to signs or symptoms that digress from normal relational behaviors.
Fortunately, some distinctive behavioral clues exist that warrant parents taking a closer look at the emotional and psychological well-being of their child. This is especially true for a child who does not otherwise communicate loneliness or distress.
Warning signs
The following behaviors may indicate depression or anxiety:
Isolation within the home. Spending more time outside the home or at a friend’s home.
Communicating less, if the child previously engaged with family.
Excessive engagement with social media, video games, cell phones.
Obsessions with guns and other weapons.
Mood swings, aggressive to mild-mannered or profusely apologetic. Easily irritated. Possible depression/anxiety combined with drug use.
Odd postings on social media. Repetitive negative or dark rantings. Threats about others or property. Self-harm subject matter.
Suicidal ideation. If a child expresses a desire to die, address immediately.
Change in eating habits. Excessive sweets (possible marijuana intake) or greatly reduced food intake (anorexia).
Hyperactivity or dulled responses. Slurred speech.
Sleeping later than usual. Difficulty getting up in the morning.
Repetitive grandiose statements; expressions of feeling invincible.
Repetitive magical thinking.
Hiding the backpack at the end of the day (drugs, paraphernalia).
Family interventions
Have the most trusted adult family member open a dialogue with the child in a supportive, non-judgmental way. Inquire if there are issues at school or in the community. Reassure the child that what he says will be held in confidence, outside of immediate danger.
Create a ritual of sitting down with the child and talking about daily activities. Remind the child that sharing and enjoying company is important. Practice active listening.
Restrict access to social media. Know children’s passwords, and ensure that online areas they frequent are age-appropriate.
Check their threads on social media sites. Look for threats or mentions of violence either from the child or directed at the child. Notify authorities if you spot clear and present danger. If you sense a threat but do not know specifics, share your information with a school official, family member or another trusted adult. Together assess the severity of the potential threat. Do not act alone. There is both safety and support in numbers.
Steps to take if interventions are ineffective
Confide in a trusted family member, friend or neighbor about a child’s troubling behaviors. If you feel guilt about bringing changes to a child’s life that were not received well, address this with a trusted adult. Do not share your guilt with the child.
Do not underestimate losses your child has experienced, such as the death of a grandparent, the absence of a close friend who moves away, bullying in school or moving away and leaving core friends and teachers. Ask questions, validate losses and listen to your child’s feelings. Engage in drawing, coloring, making cards or journal writing to address the loss. Conversations over time make a difference. The child will begin to feel heard, seen and valued.
Healthful confrontations represent our strongest chance for positive change. With older teens, it may be valuable to share that we have all experienced some degree of trauma.
The key is to closely observe the child: to see, hear, inquire more deeply; to consider both the parents’ and child’s history; and to be attuned to subtle changes in behavior and responses.