Dr. Bob: I am worried about my teenage son. His school performance is dropping off, and he is less interested in being with his friends. He says things that make me worry about possible self-harm. When I try to bring things up, he immediately shuts down. Any suggestions?
Answer: This is such a difficult time for adults – to see their children struggling. We often don’t know the cause of the struggles and want to help. I will discuss some of the warning signs below but first let me emphasize one very important thing.
It is ok to ask your son if he has thought about suicide. Asking about suicide does not put the idea in his head. As a matter of fact, it often opens the possibility of a forthright discussion of the issues that are present.
Now, we all know that teen mental health problems are on the rise. Social media has undoubtedly been a factor, but multiple problems contribute to the rise and the increased risk of suicide. A short list of some of things to be on the lookout for –
- Family issues that can affect the teen – separation, divorce, severe illness, unstable housing, foster care, parental mental health issues.
- Concerns about sexual orientation – many teens are facing issues regarding sexual orientation (LGBTQ+) and gender identity. Remember as a parent, our role is to help and support our children through the tumultuous teen years, not to condemn them. Teens facing these types of concerns are at high risk of self-harm or suicide (up to 4-fold increased risk) and worthy of our help, not our scorn.
- Alcohol and/or drug use – early use of alcohol and other recreational drugs are certainly risk factors for deterioration in mental health. They are a signal of a need for further help.
- Racism and discrimination affect mental health – as a health professional, I need to be cognizant of this issue and urge parents of children from different ethnicities to be aware and on the lookout.
- Bullying and cyberbullying problems – we know that in-person bullying and bullying via social media can have a dramatic negative effect on teens and can lead to suicide. Be aware of your child’s school environment and his relationship with his peers.
- Co-existing behavior problems – expressions of extreme behavior (for example, rage, aggression, or withdrawal) are calls for help and speak to the need for intervention before they get worse.
The list for warning signs far exceeds the list above. But I want to spend the rest of the time discussing things that you should be doing given your concerns.
- Again, remember that it is ok to ask your son if he has thought about suicide. You will not be putting the idea into his head. By asking the question, he might see your concern for his well-being and open up about his worries.
- Have an open environment at home about mental health. Just like you want your children to let you know if they have a physical ailment, please let them know that you are open to a discussion of their mental health. Be calm and non-judgmental.
- Seek professional help right away. Reach out to your pediatrician or a mental health professional.
- In the event of an emergency, remember to use resources that are now available. The 988 Lifeline is available 24 hours a day, 7 days a week, 365 days a year. This suicide and crisis hotline can be a lifeline. Use it.
Listen to the signs from your son. Don’t be afraid to be forthright and reach out for help as needed.
Dr. Saul is Professor of Pediatrics (Emeritus) at Prisma Health and his website is www.mychildrenschildren.com. Contact Dr. Bob at askdrbobsaul@gmail.com with more questions.