Suicidal behavior in children and adolescents

Suicide: causes, symptoms, and diagnosis. Treatment and psychological assistance with the most modern methods at the EMC clinic, where patients can receive the full range from the best specialists.
Round-the-clock care in our own hospital.
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Treatment of suicidal behavior

Inpatient and outpatient treatment of adolescent suicidal behavior

Suicide is a deliberate suicide, a common cause of death in adolescence. The EMC Clinic of Psychiatry and Psychotherapy offers comprehensive treatment of suicidal behavior using advanced methods and in its own hospital.  

Over the past decade, there has been an increase in child and adolescent suicides by at least 35%. This applies to the number of child and adolescent suicide attempts, as well as to the number of suicides of minors. The highest frequency of child suicides is among adolescents, the most acute period is from 14 to 20 years. 

What kind of behavior is called suicidal

Suicidal behavior is a condition in which children intentionally harm themselves in all available ways, which often leads to suicide. A parent should be alerted if they regularly notice bruises on the child's body, burn marks, or other injuries.: This is a teenager's "cry for help," even though he may not talk about his real thoughts. Concomitant conditions and signs of suicidal behavior in adolescents include regularly low mood, increased emotionality, irritability, and a tendency to close oneself off from one's peers and relatives. The teenager's sleep is also disrupted. 

If you suspect a teenager is at risk of suicide, it is important to talk to him about his condition in time. If this is not possible, it is better to seek psychiatric help. 

Causes of child and adolescent suicides

 
First of all, the cause of suicide is a concomitant mental illness in a teenager. These can include depression, schizophrenic spectrum disorders, and dissociative identity disorders. A teenager, regularly experiencing many affective fluctuations, may attempt suicide in an attempt to get rid of mental anguish, so he needs psychiatric help. 

The reason may also be conflicting relationships with parents, which can push a teenager to commit suicide. During puberty, adolescents often become irritated, and parents use aggression and punishment as a method of parenting. Children do not always receive support from their loved ones and feel that they are not needed by anyone. 

Unrequited love, rejection in a team, difficulties in communicating with friends – all this can also give rise to feelings of guilt and uselessness in a child. As a rule, this is an additional factor to existing internal problems and as a result leads to thoughts of suicide.
Some children "romanticize" death and treat it unrealistically, not realizing that this decision is made once and for all. They do not realize what is happening to them and commit suicide. 

Puberty is a time when a child's body undergoes a powerful restructuring. It's not just about hormonal changes: the neurotransmitters of the brain are also being rebuilt, the emotional system is not coping. It is during adolescence that a person often has psychiatric problems, which can lead to suicide. 

Diagnosis of suicidal behavior

A parent will never be able to assess the child's condition and distinguish pampering and ways to attract attention from real intentions to commit suicide. Therefore, psychiatric help is necessary if suicidal behavior is suspected. First, the psychiatrist will have a conversation with the parent (most often without the child) and collect an anamnesis. During the conversation, the specialist learns how the children grew up from the moment of birth, how they developed, what happened to them, how emotional they were, how they adapted in kindergarten, at school, in social groups, and also finds out when and why the behavior and condition began to change, which specifically led to thoughts about suicide. 

Then a friendly conversation is held separately with the children – a one-on-one psychiatrist. In severe cases, several psychiatrists communicate with the child.: This is important in order to get a more comprehensive look at the clinical picture of the child's psychoemotional state. Then the doctors refer the children to a consultation with a psychologist. During the conversation, certain questions are asked, designed to identify the risk of suicide: their detection is a direct indication for hospitalization. Scales and tests are also filled in, which allows you to identify the depth of anxiety and depression, as well as thinking disorders.

At the EMC, each patient receives a fast and comprehensive comprehensive diagnosis. It is also important to rule out other concomitant brain diseases, so magnetic resonance imaging (MRI) and electroencephalogram (EEG) are performed. 

It is necessary to take laboratory tests, check the general biochemical parameters of the blood, thyroid hormones, prolactin, in order to understand the physiological characteristics of the patient. If the teenager's risk of suicide has not been identified, the patient can be treated on an outpatient basis.

Methods of treatment of suicidal behavior in children and adolescents

Suicidal behavior is always treated with medication. In addition to treatment, sessions with a psychologist are added, as well as biofeedback therapy (BOS therapy). If there is a high risk of suicide, it is important to treat a teenager in a hospital so that the patient is always under the supervision of specialists. 


A patient with suicidal thoughts is individually selected for drug therapy — as a rule, these are antipsychotic drugs and antidepressants, depending on his condition. The therapy is aimed at reducing tension and anxiety, and correcting mood. Without drug therapy, psychotherapy will be ineffective. It is extremely dangerous to refuse medications, because it is difficult for anyone to emotionally cope with these affective fluctuations. Drug therapy creates a platform for more harmonious work and stabilizes the patient's condition, freeing him from thoughts of suicide. Medical treatment, as a rule, takes place in a hospital. 

Before starting drug therapy, a neurologist examines a patient at the EMC: this is important in order to understand the general physiological characteristics of a person and accurately select drugs that will not harm his health. The patient also visits an ophthalmologist who performs fundoscopy of the fundus: to select medications, it is important to examine intracranial pressure. If necessary, the patient is examined by a gynecologist, a cardiologist, and an endocrinologist: all this makes it possible to further exclude complications during drug treatment.

Psychiatric care

Working with a teenager, the specialist uses such advanced methods as DBT therapy (dialectical behavioral therapy) and cognitive behavioral therapy (KPD). These are scientifically proven methods used all over the world.

Dialectical behavioral therapy is used for affective fluctuations and dissociative identity disorders in adolescents, when the frequency of suicide attempts is highest. 

Cognitive behavioral therapy helps a teenager to better understand his emotional state and further correct it in a milder form.
Using these methods, the specialist develops the teenager's emotional regulation skills. Patients who have attempted suicide are taught SOS skills: if they get sick, they will always have emergency numbers on their phone. He warns his friends and parents about this so that they don't get scared by a sudden call at three in the morning.

With the help of a therapist, children also begin to analyze and recognize all the feelings and emotions they experience. They are also taught ways to improve interpersonal communication with adults, peers, and in society. All this helps to prevent repeated suicide attempts in the future. 

BOS therapy

In case of resistance to drug treatment, auxiliary methods can be used – for example, TMS (Transcranial Magnetic Stimulation) is prescribed when drug therapy is ineffective or insufficiently effective. 


During the session, the doctor places special sensors on the patient's head that monitor the bioelectric activity of the brain and its rhythms, and then transmit them to a computer. At this moment, the children are busy playing a video game, and the specialist, in turn, monitors the process and creates special conditions for improving brain activity through this game. BOS therapy is prescribed to patients to reduce anxiety levels. 

Psychological help in case of suicide attempt: treatment in the EMC hospital

If you catch a child trying to commit suicide, it is important to talk to them and tell them that they are dear, tell them about their emotions, try to support them, and ask for time to help them. On the same evening, it is important to contact a specialist: either call an ambulance, or, if the child is already engaged with a therapist, contact him. 

50% of patients under the age of 18 who come for treatment at the EMC are teenagers who have attempted suicide. For example, a child drank a handful of pills, his parents called an ambulance on time, he was taken to the city's toxicology center, rinsed, and his life was saved. After the physical condition has stabilized from the intensive care unit after a suicide attempt, such children are hospitalized in the EMS. It is extremely important that the child is under the round-the-clock supervision of doctors, because his emotional behavior is unstable, and parents do not know how to behave properly with him. Before returning to social life, the child begins a sharp leap: he may become aggressive, irritated, or on the contrary more calm and quiet. It is important to pay attention to this, and only a specialist in this case can choose the right treatment and prevent repeated suicide attempts. 

As long as there is a risk of a new suicide attempt and/or the teenager still has motives for such behavior, the patient is not alone in the room: the EMC clinic has specially trained medical staff with him, nurses who monitor his condition 24/7 and are always ready to provide the necessary help. 

Compared to treatment in other clinics, EMC has a short hospital stay. Specialists carry out comprehensive work that allows them to quickly stabilize the condition of patients after suicide attempts and gradually return them to a full-fledged social life. In the conditions of the EMC hospital, children can continue their studies, they do not get out of the social regime due to hospitalization. Neuropsychological assessment of the patient's condition is performed several times: at the beginning of hospitalization, in the middle and closer to discharge. This allows us to assess how well the patient can now learn the skills and school curriculum. Due to this, it is also possible to determine the effect of drug therapy on the condition and cognitive abilities of a teenager. 

During treatment at the EMC, the family actively participates in group therapy, and separate sessions with a psychologist are held for parents. Children do not feel disconnected from their family during treatment, which is also very important for their mental state. The concept of a "psychiatric hospital" scares many people: in the EMC, a teenager does not feel that he is in a psychiatric clinic and that he is "not like everyone else." He and his parents understand that the treatment takes place in a multidisciplinary hospital with comfortable conditions of stay.
During treatment, specialists assess the risks of suicide: if they are absent, trial discharges are carried out, and children are sent home for several hours. The change of environment is carried out gradually: an abrupt return to the home, where the child was visited by suicidal thoughts, can provoke a strong mood fluctuation and lead to new suicide attempts.  
Then the children are transferred to a day hospital: they stay there for about six hours a day, then spend the night at home. All this is combined with regular comprehensive diagnosis of patients' condition and psychotherapeutic work. If recovery from suicide attempts goes smoothly, the child is discharged and goes on outpatient treatment: first, he attends sessions with a psychologist and a psychotherapist 3-4 times a week, then the number of visits is reduced as needed.