As a parent, it can be difficult working out if something is just a phase or a more serious issue, particularly in these challenging times. But, with depression in young people on the rise, it’s as critical as ever to get attuned to the state of our children’s mental health. Here, a clinical psychologist in Singapore shares what every parent should know about depression in children, signs to look for and what to do if you think your child could be suffering from thoughts of self-harm or suicide.
Depression is often thought of as an adult condition rather than one that impacts children. But, while it can seem unimaginable for an eight-year-old to think about ending their own life, it’s an unfortunate reality that very much exists beyond the realm of adults and teens.
DR SANVEEN KANG is a clinical psychologist and founder of Psych Connect. She helps families manage all kinds of mental health issues, and provides comprehensive psychological testing and therapy for infants up to early adult years.
She says thoughts of self-harm or suicide are more common in kids than many of us might think. Research from the US suggests that more children as young as kindergarten age are in dire need of support, and the number of children aged six to 12 who visited hospitals for suicidal thoughts or self-harm has more than doubled since 2016.
In Singapore, suicide is actually the leading cause of death for people aged 10 to 29.
Spotting the signs – and taking them seriously
Often, children and adolescents thinking about suicide may make openly suicidal statements or comments such as, “I wish I was dead”, “I won’t be a problem for you much longer” or “I don’t want to live anymore”.
But, how can you determine whether or not your child is actually going to inflict self-harm?
“Research shows that suicidal thoughts and behaviours are the greatest predictors of suicide,” says Dr Kang. “These include passive thoughts of wanting to be dead, recurrent thoughts about ending one’s life, plans and behaviours that ‘rehearse’ killing oneself, and suicide attempts.”
There are many factors that determine whether a child would act on these thoughts. What’s more, the motivation and desperation to act on them can change day to day – even, moment to moment, she says.
“I urge parents to take these comments seriously. Every year there are tragedies in which children and teenagers take their own lives after making these threats – and everyone asks themselves, ‘How could this happen?’ and ‘Why didn’t we take the threat seriously?’”
While many of these threats are not carried out, they are still cries for help that need to be addressed – not dismissed as “overly dramatic”, “just acting out” or “attempts to get their way”.
“These threats can be a reaction to a perceived hurt, disappointment or rejection. But, they are not likely to be motivated by attention-seeking behaviour or manipulation. In fact, the attention that one gets after verbalising these thoughts can be more negative than positive,” says Dr Kang.
“So, when a child makes such threats, it should not be dismissed as just idle talk. Parents, teachers or other adults should immediately talk with the child. If it’s determined that the child is at risk, or the child refuses to talk, is argumentative, responds defensively or continues to express violent or dangerous thoughts or plans, arrangements should be made for an immediate assessment by a mental health professional with experience evaluating children and adolescents.”
In addition to verbal threats, there are many other indicators to be aware of. Warning signs to look for include:
- changes in eating or sleeping habits;
- frequent or pervasive sadness;
- withdrawal from friends, family and regular activities;
- frequent complaints about physical symptoms, often related to emotions, such as stomach aches, headaches and fatigue;
- a decline in energy levels and in the quality of schoolwork;
- an inability to think clearly or concentrate;
- preoccupation with death and dying;
- not caring about activities or things that previously mattered;
- engagement in risky behaviours and being careless with one’s safety;
- increased irritability; and
- substance abuse.
“Also, young people who are thinking about suicide may stop planning for or talking about the future,” says Dr Kang. “They may even begin giving away important possessions.”
How to talk to your child about suicide
As uncomfortable as it may be about talking about death – especially, suicide – don’t avoid the conversation because it’s difficult, says Dr Kang. And don’t fall for the misconception that talking about it will plant the idea in your child’s head. On the contrary, talking about suicide is actually helpful and important for many reasons. It helps dispel misinformation and provide solutions, creates a safe environment where they can ask for help and gives assurance that somebody cares. When approaching your child about this hard-to-discuss topic, Dr Kang suggests using clear, straightforward language such as “I’m worried about you”, then following with questions.
Examples of questions to ask might include:
- “Are you feeling sad or depressed?”
- “Are you thinking about hurting or killing yourself?”
- “Have you ever thought about hurting or killing yourself?”
“Be present and available to listen, and empathetic to their struggle,” says Dr Kang. “Let them know you are worried about them, that you love them and that they are precious to you. Also, seek professional help.”
“Hearing that your child is having suicidal thoughts is distressing and it’s likely to have a big impact on you. You’re not expected to be their psychologist or to know exactly what to do to help them through the troubling situation. Reaching out for professional support is important for your wellbeing and the wellbeing of your child,” says Dr Kang.
“When parents accept their child’s reality and seek help, they can steer them toward a healthier place, which can help prevent dark feelings from bubbling up later on.”
Psychotherapy (also known as talk based therapy), she says, can prove invaluable. It helps in the development of new skills to cope with problems, and identify or prevent future episodes of depression.
So, how does “just talking” help? “Research over the past 20 years has shown time and time again that psychotherapy is indeed correlated with changes in brain activity and connectivity,” she says. And, the visibility of these changes is very real. “This means that any change in our psychological processes is reflected by changes in the functions or structures of the brain.”
At Psych Connect, the team of psychotherapists, psychologists and counsellors employ a range of psychotherapies, including Cognitive Behavioural Therapy (CBT) , Acceptance Commitment Therapy (ACT), Solutions Focused Therapy and Art Psychotherapy, among others.
“Psychotherapies attempt to enhance one’s problem-solving capacities, self-representation and emotional regulation,” says Dr Kang. “The eventual goal is for our clients to be psychologically healthy and lead meaningful lives.”
This article first appeared in the March 2022 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
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