Asking about Suicide and Fostering Resilience
Lisa M. Horowitz, PhD, MPH
Understatement alert: anyone who has ever raised a child will tell you, it isn’t easy to be apparent. I remember a dear friend telling me when I was pregnant, “This is going to be the hardest job you will ever love.” While parenting at baseline is difficult, it is exponentially harder during times of great adversity. How do parents foster resilience and strength while keeping their own sanity during times of uncertainty and instability?
Certainly, there is no magic answer and no “one size fits all” advice during this pandemic. Kids are constantly growing and changing and hit development milestones at their own pace. This variation makes it hard to know what is “normal” and what requires intervention. Since half of all mental illness begins in childhood, it is important to intervene when something doesn’t feel “right.” And in these times, nothing feels “right.” So how does a parent manage?
There is nothing “normal” about having families in quarantine and isolation and not being able to leave the home. Yet because of variations in development and personality types, it is important not to compare the behavior of your kids to their peers. More importantly, compare your child to their baseline. As a parent or guardian, you know your child better than anyone else. If they are not acting like themselves, intervene.
As a suicide prevention researcher, I’m writing about the uncomfortable topic of youth suicide. Suicide is the second leading cause of death for young people all over the world. This is not meant to scare you; it is reported to raise awareness. In 2018, over 6,700 kids took their own lives. Out of all deaths of 10–24 years olds, over a quarter of them (27%) were from suicide, a condition that is preventable. Our young people are struggling, and we do not yet know how the pandemic will affect the ever-increasing suicide rate.
What can parents do? First, learn the warning signs of suicide. The first one is talking of wanting to die or be dead. This seems obvious, but people often ignore talk of suicide. Other warning signs include acting reckless, excessive use of drugs and alcohol, as well as signs of depression—withdrawal, sleeping too little or too much, loss of appetite, not finding pleasure in things they used to enjoy, isolating themselves.
There is a widespread myth that asking someone if they are having thoughts of suicide will put the idea into their head. It’s actually the opposite; the best way to keep a young person from killing themselves is to ask directly, “Are you thinking of killing yourself?” And then listen, really listen, to their answer. What if they say “yes” or “maybe” or anything other than “no”? Be prepared for a non-no answer. You do not have to be a mental health professional to handle the answer. You won’t be able to quickly “fix it”; instead, get them help, and allow them to be heard. A person who thinks about killing themselves is in a tremendous amount of pain. They want someone to care, and they need someone to listen, without judgment, without criticism—they need your best listening skills. You can be prepared to respond with something that is connecting and caring: “I’m sorry you are feeling so bad.” “How can I help?” “We can get through this together.”
Learning to use coping strategies is a critical part of suicide prevention. During this pandemic, everyone is coping with loss of some sort, in this new non-normal way to live. There is a great loss of some basic human needs, on a grand scale. For parents to help their children through this crisis, first, they need to take care of their own mental health. Studies show that when you treat the depression in parents, it helps depressed children get better. Next, parents can help their children build resilience. Normalizing feelings of stress, worry, and sadness for our children is an important step in helping them cope. Resiliency, or the ability to recover from adversity and thrive, requires learning and practice, like all other skills. Every one of us has the capacity for resiliency, but it needs to be fostered. We need to teach children how to handle the ups and downs of life and how to feel their feelings, but still use their good thinking to cope with stress. It’s good to remind young people that their greatest coping skill is thinking. Resiliency does not mean that someone is immediately “okay.” Resiliency is messy. Help your child identify and address their problems, but also encourage them to let some things go.
In addition, all kids need to be seen and feel heard. While connecting with kids, especially the eternally ear-budded teenagers, sometimes seems nearly impossible, connection with parents is important. They need to feel like they are a priority, and they matter. Family dinners are important no matter how short they may be. It may be a few minutes of a child revealing something they are worried about in a car ride or just asking you to play a video game with them. These are all opportunities to listen and be present and curious with them. After they tell you something, pause and think before responding; afterward, tell them how proud you are that they shared their feelings with you.
As parents, we can and will make a million mistakes; luckily, we have a million and one chances to correct them. Look for the signs that your child might be struggling—are they acting like themselves? If you are concerned, find them mental health care or call your pediatrician. Most importantly, if you are worried that your child is thinking of suicide, ask them directly about it, and then listen to the answer. And equally important, take good care of yourself during this crisis. Take a tip from the airlines—in the event of change in pressure, put your oxygen mask on first, before calmly assisting others.
Lisa M. Horowitz is funded by the Intramural Research Program of the National Institute of Mental Health (ZIAMH002922). The views expressed in this work do not necessarily represent the views of the National Institutes of Health (NIH), Department of Health and Human Services Secretaries (DHHS), or any other government agency or official.