Thoughts of Suicide in Pediatric Cancer Patients
Recognizing Signs of Suicidal Thoughts in Young People
Sadly, 2023 data on youth suicide shows that it is the second-leading cause of death among people aged 15 to 24 in the U.S. Almost 20% of high school students report severe thoughts of suicide, and 9% have attempted to take their lives, according to the National Alliance on Mental Illness (NAMI).
May is National Mental Health Awareness Month. Here we’ll focus on the critical and life-threatening issue of suicide among young people with cancer. Mental health issues are often stigmatized, and many young people may feel ashamed or embarrassed to seek help. National Mental Health Awareness Month for youth can help reduce this stigma and encourage young people to seek the support they need.
Dr.Carl Fleisher, who specializes in adolescent and child psychiatry at UCLA Health, explains that teenagers and young adults have rising rates of suicide compared to 10 or 15 years ago. He stresses that how young people feel about themselves in social standing and physical appearance plays a significant role in feelings of inadequacy that can lead to thoughts of suicide. He explains that developmentally, their judgment and decision-making abilities are still processing, which might make young people more impulsive with their feelings. Dr. Fleisher says: “They’re not going to weigh risks and consequences or values in quite the same way that older folks will.”
Now, imagine being a teenager or young adult with cancer. There is evidence to suggest that there is a correlation between cancer and suicide. The stress and emotional burden of cancer can increase the risk of suicide in cancer patients and survivors. The risk of suicide may be higher in younger cancer patients with more advanced cancer or a history of mental health issues. As parents and caregivers, it is imperative to stay vigilant and look for signs and symptoms that might start thoughts of suicide.
Psychological distress: Experiencing high levels of psychological distress, such as anxiety, depression, and post-traumatic stress disorder (PTSD).
Body image issues: Cancer treatment can cause physical changes to a teenager’s appearance, such as hair loss, weight changes, and scarring. These changes can lead to negative body image and self-esteem issues.
Physical symptoms: Cancer treatment can be physically grueling, causing pain, fatigue, and other symptoms impacting a child’s quality of life. Chronic pain and other physical symptoms can contribute to hopelessness and despair.
Substance use: Some teenagers with cancer may turn to drugs or alcohol to cope with cancer’s emotional and physical pain and its treatment.
Talking about suicide: If a young person is talking about suicide or making comments like “I wish I were dead” or “I want to kill myself,” it is a significant warning sign of suicide risk.
Withdrawal: Any significant changes in behavior or routine, such as withdrawing from friends and family, isolating themselves, or becoming more irritable or angry, can be a sign of suicidal ideation.
Mood changes: Mood changes such as increased sadness, hopelessness, or irritability may indicate that a young person struggles with depression or other mental health conditions that can increase the risk of suicide.
Reckless behavior: Engaging in reckless or impulsive behavior, such as driving under the influence or not adhering to rules meant to protect them through their cancer treatment, can indicate that a young person is struggling with mental health challenges and may be at risk of suicide.
Giving away prized possessions: pre-maturely giving away prized possessions or making final arrangements can signify that a young person is considering suicide.
If a parent or caregiver notices any of these warning signs, it is essential to seek help immediately. Talking to the young person about their feelings, seeking support from a mental health professional, contacting a crisis hotline, or taking them to the emergency department for evaluation are some ways parents can help. It is essential to take any warning signs of suicide seriously and seek help immediately.
The pre-cursor causes of suicide listed above are critical to look out for but what about an actual attempt? Suicide prevention is a crucial component of cancer care, and healthcare professionals work to minimize suicide risk among cancer patients when hospitalized. However, there may be some critical things that a caretaker at home needs to pay attention to. Here are some potential ways a cancer patient might attempt suicide:
Overdose: using pain medication or other medications to overdose.
Refusal of treatment: refuse treatment or stop taking medication, which could result in death.
Self-harm: engage in self-harm behaviors, such as cutting or burning themselves, to cope with emotional distress.
Access to weapons: access to firearms or other weapons may be at risk of suicide by firearm.
Suffocation: attempt suicide by suffocation, such as by hanging or drowning.
Whether a patient or a parent, you don’t need to tackle suicide alone. You are not alone and not the only person or family suffering from the thought of ending life. Because cancer can compound suicidal thoughts and feelings, it’s essential to look into the resources available to you. Early intervention can save lives. When youth suicide warning signs are identified early, it is possible to intervene and prevent suicide attempts or death.
Lastly, suicide has a profound impact on families and loved ones. Seeking resources for youth suicide not only helps prevent suicide but also provides support and resources for bereaved families. Resources for youth suicide include hotlines, counseling services, peer support groups, and education and awareness campaigns. It is important to seek help and support for anyone struggling with suicidal thoughts or behaviors or concerned about a young person’s mental health.
988 Suicide & Crisis Lifeline
The Lifeline provides 24/7, free and confidential support for distressed people, prevention and crisis resources for you or your loved ones, and best practices for professionals. If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the Lifeline network is available 24/7 across the United States. You can call or text 988 or chat at 988lifeline.org.
Crisis Text Line
Text Line is free, with 24/7 support for those in crisis. Text 741741 from anywhere in the U.S. to text a trained Crisis Counselor. Crisis Text Line trains volunteers to support people in crisis. With over 79 million messages processed to date, they are growing quickly, but so is the need.
#Chatsafe: A Young Person’s Guide for Communicating Safely Online About Suicide The #chatsafe guidelines have been developed in partnership with young people to provide support to those who might be responding to suicide-related content posted by others or for those who might want to share their feelings and experiences with suicidal thoughts, feelings, or behaviors.
Help a Friend in Need: A Facebook and Instagram Guide (PDF | 524 KB)
Facebook and Instagram are proud to work with The Jed Foundation and The Clinton Foundation, nonprofits that work to promote emotional well-being and to share potential warning signs that a friend might be in emotional distress and need your help.
Seize the Awkward
Nobody likes an awkward silence. But when it comes to mental health, awkward silences don’t have to be a bad thing. This campaign encourages teens and young adults to embrace the awkwardness and use this moment as an opportunity to reach out to a friend. The campaign focuses on that moment to break through the awkward silence to start a conversation about how they’re feeling.
What to Do if You’re Concerned About Your Teen’s Mental Health: A Conversation Guide (PDF | 617 KB)
A guide to help parents and families concerned about their teen’s mental health and emotional well-being have important conversations with their child. Although parents often pick up on concerning signs that their teen is struggling, not everyone feels well-equipped to approach their child to have a conversation about how they are feeling.
Youth Mental Health First Aid
Designed to teach parents, family members, caregivers, teachers, school staff, peers, neighbors, health and human services workers, and other caring citizens how to help an adolescent (age 12–18) who is experiencing a mental health or addiction challenge or is in crisis.
Here To Serve understands that cancer can be an extremely stressful experience for anyone, including teenagers and young adults. Adolescence is already a period of significant emotional and physical changes, and a cancer diagnosis can compound those challenges. Remember, we are here to support you during National Mental Health Awareness Month and year-round! Please contact us to get help as soon as possible.
By Sameera Rangwala, M.S., M.P.H
About the Author
Sameera Rangwala spent 15 years in the biotechnology industry and is currently a life science educator for children in grades 5-8. As a scientist and research professional, she uses her skills to blog and provides words of support to the cancer community.
All content in this blog is for informational and educational purposes only. Always consult a medical provider in your particular area of need before making significant changes in your medical decisions or lifestyle.