How to help teens cope with depression, suicidal thinking

Help is available—and essential—for teenagers struggling with depression and suicidal thoughts.

In the wake of two recent teen suicides in Palo Alto, child and adolescent psychiatrist Frances Wren, MD, is working to raise community awareness of mental-health resources for young people. Wren, who directs the Child and Adolescent Depression Clinic at Lucile Packard Children's Hospital, hopes to clarify the warning signs of teen depression and counteract the stigma teens or families may feel about seeking treatment.

Recognizing the link between depression and suicidal thoughts is an important first step in preventing teen suicides. "A very large majority of people who die by suicide are suffering a psychiatric illness. About two-thirds are depressed, and often that depression has been present a year or longer," said Wren, who is also assistant professor of psychiatry and of pediatrics at the medical school. Teenage depression is common, she noted, with 15 percent of teens experiencing an episode of clinical depression before they reach adulthood. Although teen suicides are rare, attempts are more widespread, and all cases of depression should be taken seriously.

Parents of teens who notice depression warning signs—such as sustained changes in mood, deterioration in grades, withdrawal from friends or loss of interest in usual activities—should seek help, Wren said. "Depression is not just sadness," she said. "Patterns of irritability, anger and acting withdrawn can also signal depression."

The good news is that effective treatments for depression are available; the challenge is that, because depression sufferers feel hopeless, it's often necessary for another person to take the initiative in seeking treatment.

The first step in getting help is to talk to your child. "Many of us feel some discomfort about this, but it's important to ask, 'How are you doing?'" Wren said. "Don't be afraid to ask if they're feeling sad or down, and don't be afraid to ask if your child is having suicidal thoughts." Such a question does not increase the risk that a teen will attempt suicide, and will send the message that it's OK to talk about the problem.

"Then, if you believe your teen is depressed, it's very important that they have an evaluation, ideally by talking to a licensed mental health professional," Wren said. Some high school counseling centers have the right resources for such an evaluation. Parents can also approach their primary care physician or minister for guidance to a mental health professional. Even if the teen does not want to be evaluated, mental health professionals can meet with parents to discuss concerns about their children, added Wren, who has extensive experience treating teens for depression and suicidal thoughts.

It's also important for parents to play a supportive role when their children are part of a community where a suicide has occurred. "You can say, 'I find myself thinking about this,'" Wren said. "Knowing you want to talk to them opens the door for discussion." Friends can also provide important support in such circumstances, especially by getting help from an adult if they suspect a teen they know is contemplating suicide. "Young people may worry that seeking help from an adult would be disloyal to their friend, but it is vital to get depression sufferers effective help," Wren said.

Finally, Wren emphasized the importance of dispelling myths about teen suicide. "Every individual suicide is complicated," she said. "There is never a single event or a single thing said that fully explains a suicide."

Information about child and adolescent psychiatry services at Packard Children's is available at 723-5511 or online at In addition to seeking a mental health professional, parents and others concerned about a teen's mental state can get information and help from the resources at