Suicide Prevention: Tips for Parents

International Awareness Day for Suicide Prevention is marked every year on September 10th. Experts at Schneider Children’s emphasize that undiagnosed and untreated depression in children can lead to recurrent and lifelong chronic illness.

Dr. Silvana Fennig, Director of the Department of Psychological Medicine at Schneider, notes that “about 250 cases connected to suicide attempts arrive in the ER each year. It is essential to raise awareness among parents about the importance of early identification of depression in children and youth. The earlier depression is identified, the greater the chances of recovery and the prevention of related complications. ”

Depression is described as an emotional state characterized by feelings of sadness, helplessness and despair. Most people suffer from temporary periods of depression at some time in their lives. Depression doesn’t only affect adults but also children and adolescents. However, childhood depression is not a passing phase or symptomatic of normal mood swings as in adulthood, but a serious and fatal illness that is identifiable and affects millions of children under 18 in Israel and abroad.

About 2%-3% of children (one per class) and some 8% of adolescents (2-3 per class) in the general population suffer from depression. Incidence is the same among both boys and girls up till age 13. Thereafter, the rate rises in girls to three times higher than in boys. Depression, like anxiety, is an emotional disorder defined as an introverted problem. In childhood depression and anxiety, the child suffers alone without necessarily exhibiting any outward signs or telling his parents. This is in contrast to extroverted disorders such as hyperactivity or behavior difficulties that are noticeable and impact upon society and therefore easily and quickly identified and treated.

Prof. Alan Apter, world-renowned expert on depression and suicide in children and adolescents, and head of the Child Research Institute at Schneider Children’s, notes that “complications that can result from untreated depression at a young age include deterioration of studies and school dropout, alcohol and drug use, eating and behavioral disorders, anxiety, social isolation and even the danger of suicide. About 80% of cases where help is sought show improvement in a number of weeks, but left untreated, the signs of depression can be prolonged and worsen leading to suicide attempts. Effective therapy can prevent the recurrence of depression.”

Both psychiatrists and psychologists staff the Mood Clinic at Schneider Children’s, where Cognitive Behavioral Therapy (CBT) integrates psychological, social and medicinal approaches. This method does not focus on the reasons for depression or seek to understand the child’s deep emotional state. Rather it deals with the symptoms of depression and provides the child with tools to cope with depression and its related issues. Children suffering from depression are treated individually at Schneider Children’s to cope with mood swings. Therapy allows longer time lapses between attacks and identifying early signs in order to prevent the next attack. On the behavioral level, the child is encouraged to gradually return to activities he enjoyed before the crisis and return to normalcy both in school and socially. He is similarly encouraged to participate in sport on a regular basis as this leads to the secretion of opioids in the brain which improve mood.

Work with the child sometimes includes teaching different skills such as social skills and time management which allow the child to better cope in the future with situations that cause him distress. During therapy, the child receives tasks to carry out at home: keeping a follow-up diary of events that affected his mood including identifying thoughts and feelings that arose; an attempt to consider better positive alternative thoughts; and practicing skills learnt in therapy.

Concomitantly and as an integral part of treatment, parents are key partners in their child’s therapy. They are provided with tools to cope for the entire family and receive guidance about involving a wider circle such as school to help create a supportive environment adapted to the individual needs of each child.