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A 9-year-old girl hung herself over bullying in Birmingham AL. How do you recognize the signs and what do you say?

Suicide is a difficult subject for parents to talk about, yet even think about And although suicide is rare between the ages 10 and 14, it is still the second leading cause of death for this age group. Research has found that 40 percent of children who have attempted suicide have done so at least once before high school, making suicide an important issue to address at these younger ages.

There is very little research on why this is happening, and more research is needed, both to understand the increase in suicide rate, particularly in black children (36.8%-double the rate versus 25 years ago), and to determine whether and how suicide prevention efforts should be tailored to pre-teens.

Developmentally, children may have difficulties processing trauma and the emotions that result from it. They are naturally impulsive human beings and their emotions can be difficult to control.

Therefore, they unintentionally, may respond impulsively, without thinking through their thoughts and fully understanding the potential consequences of their actions. Equally important to consider is their lack of knowledge and/or understanding of what it means to be suicidal.

Recognizing the signs/symptoms that a child may be suicidal can be challenging. The obvious typical warning signs may not have fully emerged and therefore, have not diagnosed. Children are not necessarily at the developmental age where they are likely to vocalize their feelings of helplessness, use substances or engage in self-harming behaviors, however, if parents and teachers notice a child’s CHANGE IN BEHAVIORS, this can be a red flag that often leads to mental health deterioration and places a child at risk.

Be on the lookout for CHANGES IN BEHAVIOR regarding their:

1)    Sleep patterns – sleeping longer or shorter durations, experiencing more frequent nightmares, sleep disturbances (difficulties with going and/or staying asleep), no longer wanting to sleep alone.

2)    Appetite – poor appetite or overeating that is becoming consistent

3)    Physical complaints- pain (i.e. headaches, stomachaches) and unable to identify what is really bothering them.

4)    Emotional concerns – undue sadness, anxiety/worry, depression, fear, grief, anger outbursts

5)    Changes in behavior- regressive signs (sucking thumb, clingy towards parent), less social, less patient, drugs, tobacco, and alcohol use, resist authority.

These reactions are natural and therefore, typically occur. However, if they are persistent or worsen for more than 2-4 weeks, and affect your child’s functioning, I strongly urge you to seek the help of a mental health professional. It is likely that your child may need additional help and better ways to cope.

When discussing suicide with your child, process your own emotions about the topic, decide on what you want your child to understand about the topic, use simple and direct wording (concrete), and ask open-ended questions (i.e. “Tell me more about how you feel,”) to ensure you answer their questions. Ensure them that they are “safe” to discuss their emotions with you. It is better to err on the side of caution if you believe or know your child is suicidal and seek professional help right away.

I have a daughter who at 17 is cutting herself. I want her to talk but she won’t talk to me and I don’t know how to get her to see someone.

I can imagine this being difficult and frustrating for you as a parent. In matters such as dealing with a teen (or child) who is intentionally self-harming (cutting or scratching the skin with objects that cause bleeding) and resistant to talk, it’s natural to be afraid, worried or even angry.

But it’s extremely important to avoid being judgmental toward her. Comments like “How could you harm yourself?” or “This must stop right now” are the last things you want to say when beginning a discussion about cutting.

Instead, it’s important to understand that your child is in pain. You don’t want to make her feel worse by making her feel ashamed. Tell her you’re there to listen and to get her help. Chances are she wants to stop and doesn’t know how.

Breaking the cycle of self-harm is not easy. Treatment can be an emotionally challenging time for your teenager while she’s going through it. It will help her if you let her know that you are there for her and provide her with empathy, understanding and unconditional love and acceptance.

I know a 12-year-old boy whose father had visitation privileges every other weekend but has not come to pick him up for visits for the past year and a half. I’m concerned about how this is impacting him. The father just stopped coming. He doesn’t pay child support either. How can you make sure the boy is OK?

When a parent is not involved in a child’s life, regardless of the reason, it is a loss. A loss for that child and those who love her/him. Society conditions us to know our biological parents. We innately yearn to know them so that we can better understand ourselves (we are half our fathers and half our mothers.)

And although we may resemble some of their physical and emotional characteristics and personality traits, we are still our “own person.” When a parent decides not to have a relationship with their child, the child often experiences this loss as pain, especially if his grief is ignored or belittled, creating shame.

1)    As a parent, it is important to understand that before you can help your child, you must address your own loss and grief.

2)    Acknowledge this as a “loss” and ensure them that it is not their fault. Encourage them to express their feelings/emotions, even if they cry or scream. It is important that they feel safe and comfortable of being able to outwardly express themselves while you are there to support and love them.

3)    Then, recognize that his father is human. When a parent abandons a child, that parent is deeply wounded. There is a reason they cannot fulfill their parental responsibilities. They do not recognize they are worthy of being needed, or can bring value to another person’s life.

4)    Recognizing this is part of the process of forgiveness.  It involves empathy and grace. This will likely take time for them to accept. Continue to support their journey.

5)    Talk to him. Say: “I’ve been thinking a lot about your dad. I imagine you do, too. How do you feel about the fact you don’t know him?”

6)    Ask him how he feels when he visits friends who live with their dads

7)    Have multiple conversations. Get into the habit of talking about him and their feelings/reactions.

8) Ensure that he is safe to discuss how he feels with you.

How can I convince my 22-year-old-daughter to love herself, when she sees she has no friends, no boyfriend, and she wants someone to love her besides her family. She wants someone to be there for her, especially when she sees her younger sister with best friends, good friends, and a boyfriend.

My oldest cries about this all the time. I’m trying to tell her she has to start loving and liking herself first, but she is not listening to me, because she thinks I’m just saying this as a mother. What can I do? 

Your daughter may be experiencing symptoms of depression. The signs of having no friends, crying spells, the possible interference of not having an intimate relationship, feeling like no one loves her, are common signs of depression.

How can I convince my 22-year-old-daughter to love herself, when she sees she has no friends, no boyfriend, and she wants someone to love her besides her family. She wants someone to be there for her, especially when she sees her younger sister with best friends, good friends, and a boyfriend. My oldest cries about this all the time. I’m trying to tell her she has to start loving and liking herself first, but she is not listening to me, because she thinks I’m just saying this as a mother. What can I do?

Your daughter may be experiencing symptoms of depression. The signs of having no friends, crying spells, the possible interference of not having an intimate relationship, feeling like no one loves her, are common signs of depression. If this is the case, individuals often feel “unloved and empty,” which can unintentionally, lead them to isolate themselves; it can create symptoms of low self-esteem, sadness, mood changes, and other worsening symptoms that interfere with their optimal functioning.

It can be difficult for a person who is depressed to accept that others love them or for them to love themselves when internally, they don’t feel these feelings due to being depressed. It is a good sign that your daughter desires intimate and casual relationships because this increases the likelihood of her wanting help to understand why these are concerns of hers and not currently happening for her. I highly recommend that she seeks a mental health professional to explore her interests further, allowing the professional to screen for underlying mental health disorders like depression and recommend a treatment plan to address these issues.

To stay in touch with Dawn Brown, MD (aka: Dr. Dawn Psych MD), go to DrDawnpsychmd.com. I offer online consultations and I look forward to meeting you and discussing how I can help prepare your next steps on your journey to live optimally.

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