Adolescents and suicidality
The term suicidal risk, or suicidality, refers to amental state in which a person's thoughts and behavior are directed toward causing his or her own death, i.e., committing suicide. This includes suicidal thoughts, suicidal plans, suicidal announcements, suicide pacts or suicide arrangements, and suicide attempts.
Suicidal thoughts or acts are not classified as a disease per se. However, they often represent the conclusion of a pathological development. In any case, they are an expression of external or internal distress and should be seen as a serious sign of an acute crisis .
This issue explains how young people can come across suicidal content on the Internet and provides tips for parents, educators and relatives of those affected.
Suicidal thoughts in adolescents do not always have to be the result of a mental illness. Thepreoccupation with the subject of death or the question of the meaning or meaninglessness of life is nothing out of the ordinary in adolescence, but rather a characteristic thought process marked by doubts during the difficult developmental phase of puberty. Young people are often insecure, overwhelmed or sometimes even dissatisfied with their lives. In addition, the general attractiveness of the topic of suicide or death for young people must be taken into account - among other things, because existing taboos can be broken here and boundaries can be crossed.
Thetrigger for serious suicidal thoughts or even a suicide (attempt) is often a crisis situation: Bullying at school, lovesickness, a conflict with the best friend, family problems, school failure or general fear of failure. In the adolescents' own assessment, these difficulties are usually seen in an unrealistically negative light. Those affected feel unable to continue living in the same way as before and have lost hope that the situation could turn around for the better. Suicide is seen as the seemingly only solution to a situation that can no longer be overcome.
However, the causes of suicidal tendencies usually lie deeper and are a complex interplay of previous life experiences, the social environment, the individual personality structure and psychological situation as well as the family and school experiences of those affected.
Basically, depression or depressive moods in children and adolescents play a major role in the risk of suicide; equally important are experiences of violence in the family, sexual abuse and/or negative experiences regarding one's own homosexuality. Other risk factors for suicidal acts are: Psychoses, addictive disorders, strongly pronounced aggressive behavioral disorders or impulse control disorders.
Suicidal children and adolescents usually send direct or indirect signals . They want someone to respond to them. Indications and alarm signs of danger may include:
- social withdrawal, breaking off social contacts,
- sad, depressed mood as well as mood swings,
- pronounced hopelessness, lack of future prospects,
- change in physical appearance and physical symptoms,
- written or verbal expressions, e.g. allusions such as "Soon I'll have it all behind me",
- giving away beloved things,
- specific actions in preparation for a suicidal act,
- suicide-related drawings and symbols,
- aggressively defensive behavior.
People also share their suicidal thoughts online. In particular, there is a lively exchange between people who are experiencing life crises in so-called suicide forums . Some offers provide constructive help, while others are problematic because they confirm suicidal intentions. In these prosuicidal forums, suicide is presented as the only solution with no alternative.
There is recurring web content that can have a particularly dangerous effect on young users and encourage them in their suicidal intentions. Particularly problematic are offers, profiles and posts thatone-sidedly trivialize or even glorify suicideand present it as a possible or the only logical way out of problems. This includes in particular detailed discussions of methods (for the most effective suicide method, for the procurement of suicide means and for the choice of location), descriptions of suicide attempts, but also suicide announcements, suicide partner searches and arrangements.
Furthermore, there is a trend toward posting prosuicidal posts, i.e., glorifying suicide pictures, videos, or accounts of experiences, especially in communities and video platforms popular among young people. When suicidal individuals view such content, memories of their own negative feelings and experiences can arise, which in turn can trigger the urge to endanger themselves again. This effect is known as Trigger (to trigger).
In social media offerings, one also repeatedly encounters profiles, videos, and images in which depictions of suicide are combined with content from the areas of self-harm and/or eating disorders . The use of multiple hashtags brings up a whole range of extreme content in the search function of the services (source: Ging & Garvey (2017)). The large overlap is particularly strikingfor suicide and self-harm content. Exposure to such content can trigger or reinforce risky behaviors in children and adolescents, if not encourage them to try out other types of risk.
Parents should always talk openly with their children about their Internet behavior and, if necessary, also about the topic of suicide. As a general rule: If you notice websites, profiles or groups on social media platforms with trivializing or even glorifying depictions of suicide, please always report them first to the platform's supportteam at (e.g. using the report function). The platform operators bear a great responsibility as providers of storage space for third-party content. They can contribute most quickly and effectively to making it difficult for children and young people to access this content.
If you suspect suicidal behavior in your or a child, you shouldnot assault him or her with appeals, demands or even coercion. First of all: It is quite normal to feel helpless and overwhelmed in such a situation. Keep calm and do not react with panic, accusations or threats.
Try to address the person directly. In doing so, adopt as neutral and non-judgmental an attitude as possible. Communicate your own worries and fears very clearly. Address the fear of suicide in a concrete and very direct way (without paraphrasing or trivializing!). Signal that you are available as a contact person. If there is a willingness to talk, you can ask what is so stressful in life and what you can do to help address and work through the problems. Ask how serious the suicidal intentions are. Make an effort to point out alternatives to suicide.
If the person is not willing to talk, you do not have to remain inactive. Share your observations with another person or colleague you trust. Think together about who could support you in this situation or who you should inform next.
Getprofessional support if possible . Adults in particular who are unsure how to assess the behavior of affected children or adolescents should, if possible, seek advice and help on how best to address the situation from appropriate counseling centers.
Professional help in acute crisis situations can be found, for example, at school psychological counseling centers, educational counseling centers or girls' and women's clubs.
If there are clear indications, that a suicidal act is imminent, contact the local police directly or call an ambulance. The rule is that the more specific the suicidal thoughts, the greater the danger and the more action is needed.
If the suicidal threat is already very pronounced, you should immediately seek inpatient treatment or, again, call an ambulance. For this, you do not need an admission or referral from a doctor, but can have the affected person admitted directly to the nearest child and adolescent psychiatric clinic. Cooperation with experienced specialists is essential for accurate diagnosis. In outpatient and inpatient child and adolescent psychiatry and psychotherapy, you will find specialists for diagnosis, therapy, prevention and rehabilitation in cases of suicide risk.
If you have any doubts about whether there is an acute suicide risk, do not take any risks. Introduce the individual or individuals to professionals in the fields of child and adolescent psychotherapy or else child and adolescent psychiatry. Then let the professionals decide whether inpatient treatment seems reasonable and necessary. At www.bptk.de or at www.bundesaerztekammer.de you will find the appropriate specialists.
- Establish a good and trusting contact and listen patiently and attentively.
- Accepting that, especially during adolescence, other adults are more likely to be taken into the young person's confidence
- Take indications and alarm signs of danger seriously and talk about them openly, also talk about their own problems and fears in connection with suicidal thoughts
- Avoiding reproaches or blame, but giving support
- Offer physical closeness - pay attention to voluntariness and do not force closeness,
- Do not issue prohibitions or punishments
- Ask specifically about suicidal thoughts - the concern that this will stimulate suicidal impulses is unfounded.
- convey confidence that help is available, even if the person concerned initially reacts defensively
- Inform yourself comprehensively about suicidal behavior and professional help (books, Internet, exchange with those affected).
- Be aware of the limits of your own efforts to help, i.e. offer limited, reliable help rather than making promises that lead to disappointment.
- Seek help yourself if you notice that you feel bad or feel increasingly paralyzed in your normal activities
- ignore, deny,
- fearful avoidance of the topic - this reinforces the already existing feelings of shame and guilt in young people,
- giving an ultimatum,
- making promises that cannot be kept ("I'm always there for you, day and night"),
- disregarding one's own boundaries.
Children and young people have a right to digital participation in society. Young users should be able to use online services in a self-determined, critical and creative way, but above all without worry. This requires a contemporary protection of minors with regulatory, technical and educational components. While younger children need more protection, greater freedoms and competencies for self-protection become more important as they grow older. In addition, parents and educational professionals need tips and practical assistance for media education.
It is important that parents actively accompany their children on the Internet, know where their child is communicating with whom, which topics, services and apps are currently in vogue, and have an open ear in case of problems. In this way, parents can counteract at an early stage if their child ends up in an unsuitable online environment. If parents strengthen the child's self-confidence and media skills, it can more easily distance itself from dangerous content and people. In general, it is advisable for parents to advise their teenage child to carefully check web offers, forums, but also profiles of groups and individual users as well as friend requests.