The human brain is quite literally wired from birth to avoid self-harm or risks that may cost us our lives. But for some teens, those wires seem to cross. Instead of avoiding the topic or finding it frightening, they begin to see suicide as an option to help them deal with intense, intractable physical or emotional pain.

Suicidal ideation rarely occurs in a vacuum. Instead, it is the result of a complex mixture of influences, including genetics, mental illness, stress, and a general lack of coping skills. The good news is that it is not only possible to identify suicidal ideation, but also to intervene and help teens recover before it turns into action.

What Does Teen Suicidal Ideation Look Like?

  • Suicidal ideation is defined as thinking about or planning suicide. Rather than being an official diagnosis, suicidal ideation is a side effect of other mental health conditions, such as Depression or Schizophrenia.
  • Thoughts of suicide typically occur when the delicate balance between coping skills and negative emotions or experiences falters. When negative experiences become so common and so severe that they begin to take over the teen’s life, it can feel like the only solution to end the suffering.
  • Suicidal ideation rarely occurs out of the blue, but it can feel like it presents out of nowhere because warning signs are often extremely subtle. Symptoms may go largely overlooked until the teen is so unwell they can no longer be ignored.
  • Listening to your teen, encouraging them to talk about their feelings, and encouraging them to reach out is vital to helping them find an alternative to suicide. It is also one of the best ways to maintain that connection when they need support most.
  • As a parent, reaching out to your child about suicide can be very scary. You may feel as if you are making assumptions or assume it is an overreach, especially if you aren’t sure what they’re feeling. Seeking professional intervention gives you the power to identify critical red flags that justify further intervention.

Signs of Teen Suicidal Ideation

Joking or casually mentioning dying

Withdrawing and isolating from society

Constantly shifting moods

Self-destructiveness or self-harm

Over and under eating and sleeping

Preoccupation or obsession with death

It can be very difficult to determine if your teen is just joking around, being dramatic, or is really experiencing suicidal ideation. This makes it extremely hard to identify important warning signs. Remember that you are your teen’s best resource; you’ve raised them and know their personality, and how they joke, well. Chances are, if you are worried about their behavior or the thoughts they are sharing, an issue probably exists. A professional can help you, as a parent, navigate your child’s thoughts and actions and get the right help.

Note that joking about suicide can in fact be a symptom. Teens sometimes “test the waters” before coming right out and asking for help by making light of suicide with seemingly flippant comments. Threats of suicide should always be taken seriously, no matter how off-handed or light-hearted they feel.

What Are the Causes of Teen Suicidal Ideation?

Suicidal ideation is caused by many different factors, nearly all of which are closely tied to deep emotional or physical suffering. Research tells us that there may also be a genetic tie; a teen who is closely related to someone with a mental illness, or someone with a history of suicide attempts, may be more likely to make an attempt. However, environmental factors can significantly change how likely teens are to think about suicide as an option.

Studies show that women are more likely to commit suicide than men. However, the numbers skew in the other direction in outcomes. Men who attempt suicide are much more likely to succeed because they frequently choose more lethal methods.

It is also important to note that stigmatized people and minorities are more likely to experience suicidal ideation. This includes people who are transgender,  people who are gender-fluid, and people who identify as lesbian, gay, bisexual, or asexual.

Some of the environmental factors that lead to suicidal ideation include:

  • Drug or alcohol use and abuse
  • Experiencing trauma (abuse or violence)
  • Severe, protracted stress, including loss
  • Despair and hopelessness
  • Self-isolating from socialization
  • Chronic physical pain or illness
  • Dysfunction within the home or school

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Teen Suicidal Ideation Treatment | Paradigm San Francisco

The Different Types of Teen Suicidal Ideation Treatment

Suicidal ideation is extremely serious and can escalate very quickly. For this reason, the first goal of any treatment path is always to ensure physical safety. This often includes inpatient treatment. During these initial efforts, counselors will use specific techniques to help teens cope with feelings of isolation, hopelessness, and shame.

Professional intervention is extremely important. Whether suicidal ideation stems from Anxiety, Depression, Bipolar Disorder, Personality Disorders, or even a physical health condition, treatment and recovery is always about getting to the root cause. Medication may help teens gain temporary relief from overwhelming feelings of despair, allowing them to feel more emotionally stable and able to engage in therapy. From there, a continued and regular combination of therapy and interventional medications help teens refocus on what matters and find hope in the future once again.

Remember that suicidal ideation is a reaction to extreme stress. This can and often does include Depression itself as well as a variety of maladaptive behaviors and experiences, such as bullying, losing a parent, losing a pet, or even just ending a relationship. Ideation occurs on a spectrum ranging from fleeing thoughts the teen has no desire to act on to compulsive, impossible-to-ignore, often-obsessive thought patterns that never cease. If teens have reached the point that they have a defined plan for how and when they will do it, you should consider it a medical crisis and seek assistance immediately.

Many Americans experience suicidal thoughts from time to time. The vast majority of us do not act on these thoughts, but for those who do, nearly all have another mental health condition. Substance abuse, which is in and of itself a negative coping skill, changes brain processing and may exacerbate ideation. If your teen is experiencing suicidal ideation now, it does not mean they will struggle with mental health issues for life. Teaching teens that the future can be different with the right help is an important part of restoring hope for the future.


Most common cause of death in teens is suicide


American teenagers attempt suicide every day


Suicidal teens show “red flags” before they attempt

How Can I Help with Teen Suicidal Ideation?

The fear that your child may harm themselves is paramount and overwhelming among parents. At Paradigm San Francisco, we recognize that having a teenager who experiences suicidal thoughts and ideation can make you feel hopeless, out of control, frightened, and as if you don’t know how to help. It is often difficult for parents to know where to begin.

If you believe your teen is at risk of harming themselves, we strongly recommend that you get immediate assistance from professional therapists or psychiatrists. Proper diagnostics, testing, and support are paramount to protecting your teen’s physical safety.

Seeking urgent assistance is especially important if your teen reveals to you that they are considering suicide or have a plan to commit suicide, whether or not they appear extremely upset. This may include seeing a local doctor, a therapist, or even visiting your local hospital emergency room. These talented professionals can help you keep your teen safe from immediate harm while also identifying opportunities for support. If Paradigm is the best place for your teen to stay, we can help you find your way to us – even during or after inpatient hospital treatment.

Suicidal Ideation Treatment At Paradigm San Francisco

Paradigm San Francisco works carefully and closely with teenagers who are dealing with suicidal thoughts. We use a diverse range of approaches and treatments, including solo therapy, group therapy, medication, and more. Addressing suicidal ideation becomes just one part of a holistic treatment plan addressing the needs of the entire teen. These treatments also address underlying causes and symptoms of suicidal ideation, such as comorbid diagnoses, which lead teens to have harmful suicidal thoughts in the first place.

At Paradigm, our unique structure and location allows us to better address what teens are going through through a very personal lens. Instead of cookie cutter treatments, we spend time really getting to know teens and what they have experienced to help them address destructive behaviors and thought patterns on a deeper level. This is especially helpful for ensuring that teens who are suicidal or have suicidal ideation remain safe and protected, no matter what the thoughts associated with their illness tell them. Once immediate safety is secured, we can begin working with them one on one to root out and remove destructive belief systems.

Paradigm also specializes in addressing comorbid diagnoses, such as Depression, Personality Disorders, and even interpersonal struggles. By focusing on the whole patient, we can help teens acknowledge relationship struggles and improve social skills that help them reach out and connect in a healthy, sustainable manner. Therapy often includes identifying and working on triggers, which may lead to suicidal thoughts, helping teens gain important coping skills.

Paradigm’s experts know that medication isn’t a quick fix, nor is it the only way or the right way for every patient. By teaching healthy mechanisms, such as breathing exercises, meditation, yoga, artistic expression, and more, we help teens live healthier, more enjoyable lives that don’t cave in under pressure or the influence of old habits.

As a parent of a teen having suicidal thoughts, you should know that help – and hope – is available. With the right support, your teen can overcome these feelings and grow into a healthy, happy, well-adjusted adult who is successful in everything they do.

 I can't say enough about the team of therapists whose expertise, kindness, compassion and dedication drew my son out of his dark depression, challenged him to challenge himself, re-instilled in him the will to live, and brought the beautiful smile back to his face.

– Chantal C.

Frequently Asked Questions About Teen Suicidal Ideation

Could my teen be faking suicidal ideation for attention?

Threats of suicide or claims of suicidal feelings are almost never a simple cry for attention. It is critical to take even off-handed mentions of suicide seriously. Assume your teen is telling the truth at all times, even if their attitude doesn’t necessarily seem despairing. Remember that cries for attention are usually a sign of struggle all on their own.

That said, it is important to note that jokes about suicide are all too common in our culture. Teens may react to a bad test score or fight with a friend dramatically, saying things like, “I can’t believe I failed! I’m going to kill myself!” A once-off mention should prompt a conversation, but may just be a bad joke depending on comedic context. If “jokes” appear over and over again, or with any regularity, your teen may be using the cover of humor to hide how they are really feeling about suicide. Consider it a cry for help.

Why is my teen suicidal, yet their friends seem to cope fine?

Every teen is an individual with their own lives, their own experiences, and their own environmental influences. Socioeconomic disadvantage, extreme stress at home or at school, comorbid mental health conditions, and even genetics can make teens predisposed to suicidal ideation. Situational pressures, like rejection, trouble at school, emotional pain, and severe bullying, also play a role, as can past traumas like childhood abuse. The tipping point occurs when teens experience so many risk factors or influences that they are no longer able to use coping mechanisms (healthy or unhealthy) to achieve relief and cope.

Is talking about suicide okay?

Absolutely. Talking about suicidal thoughts and suicide decreases the stigma surrounding the issue and gives teens the message that it’s okay to share their feelings, even if they are scary. However, it is extremely important to approach the topic with sensitivity, curiosity, and concern. Always approach from a place of openness and be prepared for what you might hear when talking to your teen – and never accuse or shame them for revealing suicidal ideation.

Regarding suicide in the media, parents have an important role to play in helping teens understand and parse the information they see. It’s okay to talk about or discuss suicide in the news, in movies, or even in video games as long as you aren’t glorifying suicidal ideation or the act of suicide itself. In fact, this can be a good way to get a conversation started.

One in every 25 suicide attempts on American soil is successful. By talking about the issue and providing teens with the right support, you can help decrease the stigma and ensure they get help if and when they need it.

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