Suicide is when a person causes their own death on purpose. Before trying to take their own life, a young person may have thoughts of wanting to die. This is called suicidal ideation. The young person may also have suicidal behavior. That's when a person is focused on doing things that cause their own death.

Suicide is the third leading cause of death in young people. For youth ages 10 to 14, suicide is the second leading cause of death. The CDC reports that:

• Youth and young adults ages 10 to 24 years are at risk.
• Boys are 4 times more likely to die from suicide than girls.
• Girls are more likely to attempt suicide than boys.
• Guns are used in more than half of all youth suicides.

The teen years are a stressful time. They are filled with major changes. These include body changes, changes in thoughts, and changes in feelings. Strong feelings of stress, confusion, fear, and doubt may affect a teen's problem-solving and decision-making. They may also feel pressure to succeed. Even preteen children can be affected.

For some preteens and teens, normal developmental changes can be very unsettling when combined with other events, such as:

• Changes in their families, such as divorce, siblings moving out, or moving to a new town
• Changes in friendships
• Stress from social media activities, including being a victim of cyberbullying
• Problems in school
• Other losses

These problems may seem too hard or embarrassing to overcome. For some, suicide may seem like a solution.

A young person's risk for suicide varies with age, gender, and cultural and social influences. Risk factors may change over time. They are:

• One or more mental or substance abuse problems
• Impulsive behaviors
• Stressful life events, such as being bullied or recent losses, such as the death of a parent
• Family history of mental or substance abuse problems
• Family history of suicide
• Family violence, including physical, sexual, or verbal or emotional abuse
• Past suicide attempt
• Easy access to guns or prescription medicines in the home
• Imprisonment
• Exposure to the suicidal behavior of others, such as from family or peers, in the news, or in fiction stories

Many of the warning signs of suicide are also symptoms of depression. They are:

• Changes in eating and sleeping habits
• Loss of interest in normal activities
• Withdrawal from friends and family members
• Acting-out behaviors and running away
• Alcohol or drug use
• Neglecting their personal appearance
• Unnecessary risk-taking
• Obsession with death and dying
• More physical complaints often linked to emotional distress, such as stomachaches, headaches, and extreme tiredness (fatigue)
• Loss of interest in school or schoolwork
• Feeling bored
• Problems focusing
• Feeling they want to die
• Lack of response to praise

Another warning sign is making plans or efforts toward committing suicide:

• Says “I want to kill myself,” or “I'm going to commit suicide.”
• Gives verbal hints, such as “I won't be a problem much longer,” or “If anything happens to me, I want you to know … ”
• Gives away favorite things or throws away important belongings
• Becomes suddenly cheerful after being depressed
• May express strange thoughts
• Writes one or more suicide notes

These warning signs may seem like other health problems. Set up an appointment with your child's doctor for a diagnosis.

Threats of suicide are a cry for help. Always take such statements, thoughts, behaviors, or plans very seriously. Any young person who expresses thoughts of suicide should not be left alone and should be assessed right away. Talk with your child's doctor about suicide and have a written emergency plan that you share with trusted others.

Many parents develop a written contract with their children. In it, the child agrees to alert parents if they are starting to have thoughts of self-harm. The parents agree to help the child interrupt the behavior in a nonjudgmental fashion. Examples of this could be as simple as taking them out to dinner and talking, or as intense as taking them to the emergency room for assessment and a possible inpatient stay. The important piece is the fact that your child knows you are approachable and nonjudgmental when help is critically needed.

Any child who has tried to commit suicide needs a physical checkup first to rule out life-threatening health problems. They should then get a mental health evaluation and treatment until they are stable. This often will take place at an inpatient facility to make sure of the child's safety.

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment starts with a detailed evaluation of events in your child's life during the 2 to 3 days before the suicidal behaviors. Treatment may include:

• One-on-one therapy
• Family therapy. Parents play a vital role in treatment.
• An extended hospital stay, if needed. This gives the child a supervised and safe environment.

Treatment doesn't end when your child is discharged from the inpatient facility. Ongoing follow-up care will help make sure they recover. Follow-up care may include individual therapy, family therapy, and medicines. Emergency plans should be in place. Your child needs to be an active participant in these plans. The more open communication can be about thoughts of suicide, the easier it can be for them to ask for help.

Learning the warning signs of youth suicide can prevent an attempt. Keeping open communication with your child and their friends gives you a chance to help when needed. Also take these steps:

• Keep medicines and guns locked and away from children and teens. Don't let the child know the combination to a safe or where the key is located.
• Get your child help for any mental or substance abuse problems.
• Listen to your child. Take the initiative. Something as simple as saying: "You seem sad. Would you like to talk? Maybe I can help." These simple statements will let them know you care and you are aware that something is not right. Just listen and try not to criticize.
• Help your child understand that asking for help is not showing weakness. It is the most brave thing a person can do.
• Show interest. Find out what's happening in their life. Ask about social media activity, what they enjoy and dislike, and what's important to them.
• Stay connected. Take the time to enjoy each other in a stress-free environment. A walk with you, even if much of it is in silence, can be comforting to your child.
• Become informed about youth suicide. Resources include the public library, local support groups, and the Internet.
• Know the warning signs for depression:
  • Feelings of sadness, hopelessness, or loneliness
  • Declining school performance
  • Loss of interest in social and sports activities
  • Sleeping too little or too much
  • Changes in weight or appetite
  • Nervousness, agitation, or grouchiness

Young people can take these steps to help prevent suicide if they see warning signs in a friend:

• Take their friend's behavior and talk of suicide seriously.
• Encourage their friend to seek expert help. Go with the friend, if needed.
• Don't leave your friend alone, not even for a moment, until a responsible adult is with them.
• Talk right away with an adult they trust about their friend.
• Call or text 988 if their friend has suicidal thoughts, a suicide plan, and the immediate means to carry out the plan. The Lifeline is available 24/7 to provide free and private support for people in crisis.

Contact your child's doctor right away if your child:

• Feels extreme depression, fear, anxiety, or anger toward themselves or others.
• Feels out of control.
• Hears voices that others don't hear.
• Sees things that others don't see.
• Can't sleep or eat for 3 days in a row.
• Shows behavior that concerns friends, family, or teachers. Or others in your child's life have expressed concerns or asked you to seek help.

Make sure your child has emergency numbers in their phone. These would include parents, other trusted adults, the doctor, and the 988 Suicide & Crisis Lifeline at 988 or 800-273-TALK (800-273-8255). You will be connected to trained counselors who are part of the 988 Suicide & Crisis Lifeline network. An online chat choice is also available. The Lifeline is free, confidential, and available 24/7. Help your child understand that reaching out for help is the most brave and important thing to do if they are considering self-harm.

Call 988 if your child is at immediate risk of harming themselves or others. This includes having a suicide plan and the means to carry out the plan. Don't leave your child alone, even for a moment.

• Suicide is when a person causes their own death on purpose.
• Suicidal ideation is when a person has thoughts of wanting to die.
• Suicidal behavior is when a person is focused on doing things that cause their own death.
• Normal developmental changes combined with stressful life events may cause a young person to think about suicide.
• Many of the warning signs of suicide are also symptoms of depression.
• Any child who expresses suicidal thoughts should not be left alone and should be evaluated right away. Call or text 988.
• After treatment starts, it will take a while for your child to feel better. Make sure they know this, and support them while their symptoms improve.

Tips to help you get the most from a visit to your child's doctor:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your doctor gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.
• Ask if your child's condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child's doctor after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.