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The Dark Side: ADHD and Suicide

Posted Feb 17 2012 10:06pm
Welcome to your worst nightmare: Your child says he or she wants to die, or even worse, attempts suicide. I get asked a lot about suicide, and given that it's a timely topic on the " A Mom's View of ADHD" Facebook page , I thought I would share some information that you may find helpful if you find yourself in a situation where suicidality is involved (or where you suspect it is involved).

It should come as no surprise to most of you that children with ADHD are at risk for depression. A recent study headed up by Benjamin Lahey, Ph.D., of the University of Chicago, found that children with ADHD are up to four times as likely to become depressed than their peers without ADHD. The study also showed that children with early ADHD were five times as likely to have considered suicide, and twice as likely to have made an attempt. Ugh.

Unfortunately, I don't find the figures surprising. When you think of all the stress and pressure kids are under these days, it's extremely tough for them to make their way in this crazy world. Add ADHD into the mix, and it's downright overwhelming.

So, what do you do if your child says they want to die?

First, look at med changes - just a small increase can wreak havoc on a kiddo's brain. Call your doctor and let her know what you are hearing and seeing. Don't be afraid to call - that's what they are there for! And don't let the doctor blow you off. If your doctor tells you not to worry, it's time to look for a new doctor.

If meds don't seem to be a factor, start formulating a safety plan for how you can help your child, while keeping your own emotions in check. I always encourage people to err on the side of overreacting, while staying calm. I like the way Michael Bradley handles the question of suicide in his book, "Yes, Your Teen Is Crazy." He came up with some "Critical Do's" and "Critical Don'ts" that may be helpful to you:

Michael Bradley's Critical Do's:

1. Take any signs seriously. Signs that a child may be planning or thinking about suicide may include:
  • Openly talking about suicide
  • Use of drugs or alcohol
  • Giving away prized possessions
  • Sudden contacts with all friends or family (interactions that could sound like goodbye)
  • Talking, writing, listening to music with death themes
2. Monitor your kid. It may annoy your child to have you watching them like a hawk, but at least you are showing them that you heard what they said and that you care. To me, safety always comes first, and it always trumps privacy.

3. Talk directly about suicide concerns. I encourage people to use the language "Are you thinking of killing yourself?" If a child says anything from, "I want to die," to "I want to stab myself with 1,000,000 knives," you can calmly respond something that sounds like, "Wow, so you are saying that you want to kill yourself? That's scary, and you must be hurting really badly." Saying "kill yourself" makes it real and tangible, and not watered down. If you already have a clear picture of your child's thoughts, and they say that they do want to kill themselves, ask about their plan. How would they do it? When would they do it? If they don't have a plan, you can probably breathe a little easier, but still stay aware of what they are saying and doing. If your child has a clear plan, assess whether or not your child has access to the things needed to carry out their plan. For example, if he says that he wants to stab himself, remove knives, scissors and sharp objects until you feel like the threat has passed (same with guns...I don't want to start a gun argument, but the CDC released information that people who live with guns in their houses for protection are FIVE times more likely to have suicide happen). Even though it's difficult, do your best to stay calm and empathize. Your child is giving you a message about how they are feeling - so listen. How you handle your emotions in this situation may be as critical as what steps you take. If your child senses that they need to hide or protect you from freaking out, it's not likely that they'll share that information with you again.

4. Get help. Even if you don't think it's a real threat, go ahead and get the opinion of a professional so they can do a full assessment of your child and so they can give you more in-depth tools to support your child through this difficult time. My feelings about this are the same as the statement above about doctors: if your therapist blows you off, it's time to find a new therapist. You can also call the National Suicide Hotline at 1-800-273-8255 (National Suicide Prevention Lifeline).

Michael Bradley's Critical Don'ts:

1. Don't guess about or ignore a risk sign (see above). If you see it, take it seriously.

2. Don't think that this won't happen to you. It can. It just can. I don't know how else to share this with you.

3. Don't think you'll put ideas into his or her head by talking about suicide. Talking about suicide can only show that you care, that you're aware of what they're going through and that you have the emotional space to deal with what they're throwing at you. Assume they've already thought about it. If they haven't already thought about it, you have simply created more awareness and opened the door for future conversations.

4. Don't hope that it will just blow over. Don't let your own uncomfortable feelings about this topic keep you from being there for your child. It's okay to talk about this stuff!! Even if it all was just a "plea for attention" or a "cry for help," taking it seriously and handling it well shows your child that you will be there for them when things are at their darkest.

What do you do if you have had the talks with your child, and you truly believe they're in immediate danger? Get them to an emergency room or call 911. Sure, it's extreme. It also may be the smartest decision you ever make.

And if (I hope this always stays an "if" for you) your child attempts suicide, please know that it's not your fault. All anyone can do is the best they can with the information they have. The fact that you're reading this website proves that you are going above and beyond to help your child.

I wish you all peace tonight. Go hug your sweet kids...

Kara Thompson is a Marriage and Family Therapist in Lenexa, Kansas. This post is intended for information purposes only, and not to be considered therapeutic direction. If you find yourself in a situation where suicide is involved, please don't hesitate to contact a mental health professional in your area. You can find Kara on her website at www.karathompson.com , on Facebook at www.facebook.com/karatherapy , or follow her on Twitter at www.twitter.com/karagthompson .
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