Learn about identifying and dealing with early signs of suicide in children and teenagers, and what you can do to help those in risk. Les Linet MD Psychiatry DrMDK

Video Transcription

Male: We have discussed some of the signs and some of the things that you can do if your concern is your child could possibly suicidal, Dr. Les Lanet, MD, Psychiatrist. Thank you, Dr. Lanet. Dr. Lanet: Suicide is a scary problem. Even psychiatrists cannot read the mind of a child or an adult who may be suicidal. The probably the most important thing is to recognize the depression so that if there is any suspicion about the diagnosis is to be made. Male: What are the signs that you should be looking for in your house if you have an adolescent that you thought could potentially be suicidal. What would you watch out for? Dr. Lanet: Aside from depression, hopelessness also previous acts or self-destructive, cutting oneself, sometimes people do this and they never commit suicide, but they do the suicidal gestures, but they are nonetheless to be taken seriously, there is a problem and sometimes it is an indication of potential future suicide. Male: If a parent thought that was the case, what should they do that minute? That second? Dr. Lanet: As in all cases, you need to have a good doctor. You need help with something like this. Do not ignore it. It is self injurious to us as parents to look at our child and say our child has some kind of mental or emotional problem, but it is more injurious to ignore it. Male1: If it is an immediate threat, many people will recommend that kid should be brought to the emergency room or to a psychiatrist immediately to evaluate if this is really a threat or just sort of just saying it and not meaning it. Dr. Lanet: If it is an immediate threat, definitely, it should be treated as an emergency, but also the gut feeling that the parent may have is one that I would recommend the parent act on. Have the child evaluated. Male: And that they do not put it off the next day because there may never be a next day, is that true? Dr. Lanet: That is correct. This can be a lethal illness. The lifetime suicide rate is something like 10% to 15% which is higher—it is a higher mortality than many illnesses that we take seriously, so-- Male: What is the current treatment for a person who could be that way? Dr. Lanet: Well, depression responds in general to psychotherapy and to antidepressants. There are depressions that are biological. I want to say something about depression that is not an illness. We are made so that we feel bad under certain circumstances and we feel good under certain circumstances, we are not robots. We are supposed to feel good and bad. This allows us to negotiate life and negotiate relationships with each other but there are people who feel bad or feel good and that is called mania. And you have these feelings because they have a disregulation of some mood regulating mechanism in the nervous system. We do not necessarily understand all of these things very well, but when it is a biological abnormality that may be very important to you—using antidepressants and there has been a lot in the news about antidepressants being associated with increase in suicidal thinking and suicidal behavior. There is what is called a black box which is simply a border around a paragraph in the package insert on this issue. This is something that we take seriously, but it is not clear how much the antidepressant is contributing to this and if you take ten thousand depressive children and you have them drink milk, some of them are going to hurt themselves. If you have them on antidepressant, some of them are going to hurt themselves. One of the things that happens is that if you are using a medicine, since it tends to make people uncomfortable and it does, to put children on medication, there is a tendency to conclude that the medicine may have contributed to it. I am not prepared to say and no one really is able to say that the medicine is not causing it, but we are also not sure that it does. There is sense, the SSRIs, the newer generation in antidepressants have been available, there actually is a lower teen suicide rate. If you just look at it globally, compared to the era before this medicines were available--