by Eric J. Sigel, MD, FAAP and Maria H. Rahmandar, MD, FAAP, American Academy of Pediatrics

Credit: CC0 Public Domain

As children grow and become more independent, it can be more challenging for parents to know what they are thinking and feeling. When do the normal ups and downs of adolescence become something to worry about?

Parents and family members can help teens cope when life feels too difficult to bear. If you see signs that your child's mental health is under threat, tune in. Maybe your child is just having a bad day. When signs of mental health troubles last for weeks, though, don't assume it's just a passing mood.

Studies show that nine of 10 teens who died by suicide were struggling with mental health conditions such as depression. But keep in mind that teens who haven't been diagnosed with any mental health condition may still be at risk. In part, this is because it can be hard to pinpoint mental health issues at early ages. Occasionally teens who attempt suicide do not have underlying mental health issues. But they may give signs that they're considering ending their own lives.

Your goal should be to remain calm, alert and ready to speak with your teen. Don't wait for them to come to you. You might start by saying, "You seem sad. I'm open to talking about this, because I love you and I care what happens to you."

Don't be surprised if your teen turns away when you first raise the subject of mental health or suicide. Keep in mind that, even if your child is silent at first, actions may speak even more loudly than words.

Watch for major changes in your child's sleep patterns, appetite and social activities. Self-isolation, especially for kids who usually enjoy hanging out with friends or participating in activities, can signal serious difficulties.

If your child is struggling more than usual with schoolwork, chores and other responsibilities, these are additional signs you shouldn't ignore.

Some suicide risk factors include: loss of a loved one to death, divorce, deployment, deportation or incarceration; bullying in person or online; discrimination, rejection or hostility due to gender identity or sexual orientation; racism; stigma—the belief that it's wrong or shameful to talk about mental health or suicide; or witnessing or suffering violence or domestic abuse.

Additional risk factors include financial instability; suicide in their school or friend group; major life-changing events, such as a breakup with a dating partner or academic disappointment; and self-harming behavior.

Do not dismiss what you're seeing as "teenage drama" or assume your child is exaggerating or playing games if they say or write things like "I want to die or I don't care anymore."

Many adolescents who attempt suicide will tell their parents ahead of time (though others do not). These words indicate an urgent need for help.

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