Warning Signs of Depression and Suicide
By Matilda R. Cuomo & Margaret I. Cuomo Maier, M.D.

The three pillars of support for children are the home, the school and the community. When one of these supports is inadequate or even missing, the child suffers. The children who are at risk of dropping out of school are designated by their teachers to the Mentoring USA program. We recruit and provide trained volunteer mentors for each child, establishing a one-to-one relationship. The mentor is given training and many resources to help the relationship flourish and become meaningful. The mentor is a positive role model who can direct and counsel the child through many challenging situations in life.

During the bonding of the mentor and the mentee, the mentor is able to assist the child in solving his or her problems. Especially during the teenage years, the children can express their anxieties and fears. In a real sense, it is the mentor who can fill a void in the child’s life, listen to the child; realize the need for professional assistance and get the help the child needs. Mentoring USA’s concept is to help the child as early as possible, from grades K-12.

During the sensitive adolescent period, children can lose their self-esteem and can become depressed. When the mentor becomes aware of the child’s symptoms, which can be serious, the parents are informed. According to the National Institute of Mental Health (NIMH), up to 2.5 percent of children, and up to 8.3 percent of adolescents in the United States suffer from depression. In more recent decades, the onset of depression has been occurring earlier, and often recurs and continues into adulthood. In fact, once a young person has experienced an episode of major depression, she or he is at risk for yet another episode within the next five years.

At higher risk for depression are children who have an attention or learning disorder or who are under stress, or experience loss, such as the death of a parent. Other risk factors include abuse or neglect and the break-up of a romantic relationship.

Depression in children and adolescents is associated with an increased risk of suicidal behavior. Boys and girls are at equal risk for depressive disorders in childhood, but girls are twice as likely as boys to develop depression during adolescence.

The increase in the rate of adolescent suicide over the past decade has been widely attributed to changes in the social environment, and in particular, in the diminishing quality and cohesion of the family unit.

What are the symptoms of depression in children and adolescents? Here are several that have been reported by the American Psychiatric Association: inappropriate guilt, or feelings of worthlessness; persistent sad or irritable mood; loss of interest in activities once enjoyed; difficulty sleeping or oversleeping; psychomotor agitation or retardation; loss of energy; significant loss of change in appetite or body weight; difficulty concentrating; thoughts of death or suicide.

Another serious concern is a child who is contemplating suicide. Some of the warning signs of suicide as noted by the NIMH are: anger and rage; missed school or poor performance; difficulty with relationships; drug and/or alcohol abuse; reckless behavior. Herbert Hendin, M.D., author of Suicide in America, notes that the parents of suicidal children convey a sense of emotional detachment from the child. It has been suggested that when these children experience academic failure, they also risk the loss of parental love. Other possible causes of depression, as noted by the NIMH, are genetic vulnerability, hospitalization, especially for a chronic illness and rejection of the child by a caretaker. An increased rate of depression is found in children of parents with bipolar disorder.

Alan Lipschitz, M.D., author of College Student Suicide, reports that in contrast to the rebellious and aggressive behavior frequently observed in suicidal teenagers in high school, suicidal college students tend to be quiet and withdrawn, and are not usually drug and alcohol abusers. While there are many reasons why college students attempt suicide, hopelessness and the pressure to succeed appear to be key factors. How should parents, caregivers and friends relate to the suicidal young person? Above all, it is important to be a good listener, trustworthy and nonjudgmental. The young person at risk for suicide must believe that she/he is respected and accepted.

Awareness of mental health issues that affect children and adolescents is essential for parents, teachers, and mentors. By providing a caring, attentive, mature adult presence in a young person’s life, a mentor can serve as a significant support system for a young person at risk.#

Matilda R. Cuomo is the Founder and Chair of Mentoring USA, Margaret Cuomo Maier is a physician.

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