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A Call For Help: Good Parenting with Dr. Debbie

Dear Dr. Debbie,

Is it normal for a four-year-old to talk about suicide? More than once my little nephew has said he wants to kill himself.

His parents are divorced, and not friendly to each other to say the least, and I don’t have kids of my own.

Just Asking

Dear JA,

Suicide talk is not a typical topic of conversation for a four-year-old, but it does happen.  According to a review of research reported by the National Library of Medicine, it “warrants proper assessment and timely intervention.”  Fortunately, according to the researchers, “death by suicide before 10 years of age is rare” despite an estimated 4 to 13% of preschoolers expressing suicidal thoughts and behaviors.

Feeling Helpless, Hopeless, and or Worthless

Try to get your nephew to expand on this thought – that his life isn’t worth living. This might be easier for him to do when his feelings aren’t so raw, so choose a moment when things are going well with him. “The other day you said you wanted to kill yourself. Can you talk a little more about that?” 

Help him to identify the situations, words, and or actions that make him feel sad, scared, angry, etc. Depression can be described as feeling unable to make things better and believing that things will never get better. You want to know what these things are.

Suicidal thoughts also occur with low self-esteem, or worthlessness, as in “No one would even care if I weren’t around anymore.” Ask him to relate experiences that have made him feel this way. It could be words spoken by an overwhelmed single parent in a moment of extreme frustration. It could be a misunderstanding about being less loved than a younger sibling. Or jealousy over the attention a parent is giving to a new romantic relationship. Or a threat of being expelled from his school or child care center due to behavior outbursts.

Talk of suicide may be a way to draw attention to himself. The goal is to get his beloved parents (or other significant family members) to stop the continuing battles between them. This is a good strategy so long as it effectively creates a more amicable family structure with a lasting peace between the divorced couple.

Coping Skills

It is possible to build up a child’s ability to handle stressful/painful situations. Encourage your nephew to keep talking to you. When you acknowledge his feelings, as in “You get angry when . . .”, or “It scared you when . . .”, you are relieving some of the pressure of the negative thoughts bouncing around in his head. A listening ear is a good place for his feelings to go.

In addition to your being a good listener and an ally, help him to identify other resources he has such as those that are within himself.

Does he show courage? Remind him of times that he approached a challenge head-on. Does he exhibit sensitivity? Point out when he recognized that someone else (maybe a parent) was in a bad mood.

Are there interests and activities that you enjoy with him that take his mind off of his negative thoughts? If the source of his depression is out of his control (warring parents, for starters) it’s good to tip the balance of his life experiences toward wonderful times he has with you.

You can also help him to develop patience. Suicide is often an impulsive, and permanent, solution to an almost always temporary situation. Teach patience with such tactics as keeping all your promises to your nephew, minimizing the duress of waiting times with him with songs, I Spy, or conversation, and by modeling patience yourself.

Adult Problems to Solve

Suicidal thoughts are tough to bear at any age, but a child, especially one so young, needs for his grown-ups to step up and make some positive changes on his behalf.

Among the possible causes for a young child’s talk of killing himself are “parental psychopathology and family instability.” Until and unless the adults address their own discord and mental health needs, your nephew is living in an impossible situation.

There is a correlation between youth suicide and Attention Deficit/Hyperactivity Disorder: Has this been investigated for your nephew? The behaviors associated with ADHD are often challenging for parents and other caregivers which could lead to his having low self-esteem. Also, children with ADHD are often impulsive which adds to the risk of suicide. Treatment for a child with ADHD includes accommodations to help him to re-focus as needed and allowance for frequent movement throughout the day.

Reach Out

A new national hotline provides immediate, free, and confidential support to prevent suicide. The recently opened 9-8-8 Lifeline provides immediate connection to trained crisis workers across the country. In addition to listening, they will direct callers to local resources to help manage the specifics of the situation. Concerned family members and friends can call.

Your nephew’s call for help should not go unanswered.

Dr. Debbie

Deborah Wood, Ph.D. is a child development specialist and founding director of Chesapeake Children’s Museum.  

The museum is open with online reservations or call: 410-990-1993.

Dr. Wood is presenting a parenting series on guiding the behavior of young children on Monday evenings, July 18 and 25, 7-9 pm, on Zoom. Childcare professionals can earn MSDE-approved certificates for participating.

Read more of Dr. Wood’s Good Parenting columns by clicking here.

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