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How To Talk To Your College-Age Kids About Depression And Suicide

(Cynthia del Río /Unsplash)MoreCloseclosemore
(Cynthia del Río /Unsplash)

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School’s back in session, and parents ushering kids to college for the first time will undoubtedly deliver some emotional nuggets of advice. But they should also have a potentially life-saving talk with their kids in the first semester of college to avert a possible tragedy — suicide.

In my experience as a child and adolescent psychiatrist, parents can be naïve about both the academic and social pressures kids face in college. While we’re confident that our children will flourish and excel, it’s also important to equip them with information on the mental health challenges some college students encounter. Per the American College Health Association, one-third of college-aged students report being depressed to the point of being unable to function. In his book, "College of the Overwhelmed," Harvard psychiatrist Richard Kadison says that 1 in 10 students will seriously consider suicide.

Talking to teenagers about emotional turmoil is like talking about sex: it’s not a one-time effort, but about setting the tone and creating an environment for openness. Parents, have your elevator speech ready. Here are some tips:

Set up a minimum expectation for communication on a regular basis. Sometimes parents feel their job is done, only to find out too late that their child is floundering or depressed. Freshmen especially will be undergoing huge transitions at college — anything from academic challenges, identity changes, to social frustrations — and it’s important to maintain support from home. While it’s necessary to give your child the space to grow and develop into their own person, letting your child know that you love them unconditionally is most important. And remember to be flexible about using their favored form of communication (i.e. email, texting, calling).

In this Feb. 1, 2016 photo, Massachusetts Institute of Technology student Andy Trattner displays a wrist band that features the acronym TMAYD for "Tell Me About Your Day," a campaign to encourage students to talk to one another in an effort to defuse to the stress of campus life before it leads to a crisis. (Steven Senne/AP)
In this Feb. 1, 2016 photo, Massachusetts Institute of Technology student Andy Trattner displays a wrist band that features the acronym TMAYD for "Tell Me About Your Day," a campaign to encourage students to talk to one another in an effort to defuse to the stress of campus life before it leads to a crisis. (Steven Senne/AP)

Model talking about the tough topics. Sometimes failing students worry that they’re going to burden parents if they share what’s going on, especially if they’re used to being successful. Accomplished high schoolers often enter college only to find out that they’re a small fish in a big pond. This change can feel remarkably alarming if a student is also experiencing their first episode of depression. If you’ve had some personal or professional setbacks, talk about what helped — particularly around mental illness. It’s not over-dramatic to go over depression symptoms, or to reinforce that asking for help as early as possible is key to getting over it faster. I’ve seen students worry they might disappoint their parents as they slip into depression, delaying care and turning toward suicide as a permanent answer to a temporary problem.

Utilize on-campus resources. Many students who’ve dealt with an eating disorder or self-harming in high school want to enter college with a clean slate. But unexpected happenings, such as a tough roommate, feelings of isolation or anxiety about eating in the cafeteria, can trigger old patterns of coping. I always encourage high school students and the families I’ve treated to be aware of the counseling services at the university health center and to discuss confidentiality. Often it is helpful to have vulnerable teenagers set up a “get to know” appointment with a counselor at college so it is easier to go back if they run into trouble later. It is also helpful to give your child a 24-hour helpline number. While it’s true that students over the age of 18 have protected rights, vulnerable students should be encouraged to sign a release to allow for parental intervention — particularly during psychiatric emergencies or when a psychotropic medication may be warranted. In my experience, families are often the best medicine when their child is struggling.

Cornell University students cross the college's Thurston Avenue Bridge in Ithaca, N.Y. on Tuesday, March 16, 2010. In that same month, three students jumped from campus bridges. (Heather Ainsworth/AP)
Cornell University students cross the college's Thurston Avenue Bridge in Ithaca, N.Y. on Tuesday, March 16, 2010. In that same month, three students jumped from campus bridges. (Heather Ainsworth/AP)

Talk about heartbreak. Sometimes a depressed college student can feel even more isolated, vulnerable or even suicidal after a breakup. I’ve often heard freshmen talk about “the turkey drop” — when students return home for Thanksgiving and break up with their high school romantic partner. Without being intrusive, it’s important to check-in with your child if they think that losing this person means they can’t live without him/her.

Ask the probing questions. During my freshman seminar, I plan a college mental health week where we discuss ways to be self-protective. This doesn’t mean selfish. The first few weeks of college are often an adrenaline rush of late nights, changed eating patterns, and sometimes binge drinking propelled by the new freedom of no parental supervision. Parents should be curious and inquire how their child is managing the pressure in a healthy way and finding a balance.

For more resources, visit the American College Health Association and the American Foundation for Suicide Prevention.

National Suicide Prevention Lifeline: 1-800-273-TALK (8255), available 24/7

The Trevor Project has help and information for GLBTQ youth. Phone, chat and text services available: 1-866-488-7386

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Nancy Rappaport Twitter Cognoscenti contributor
Nancy Rappaport is a part-time associate professor of psychiatry at Harvard Medical School and a child psychiatrist at the Cambridge Health Alliance.

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