Attention-Deficit/Hyperactivity Disorder (ADHD) is a developmental disorder that involves delays in how well a person is able to control, or regulate attention, behavior and emotion. Symptoms of ADHD can affect a child’s functioning in the home, at school and with friends.
Teachers and parents often focus heavily on managing the behavioral and academic challenges experienced by youth with ADHD while paying far less attention to the emotional and social effects ADHD can have. Unfortunately, children with ADHD are at an increased risk of experiencing depression and suicidal thoughts or behaviors throughout their lifetime, which suggests emotional and social factors should be a focus of care for these children.
How Does ADHD Increase the Risk of Suicide Among Youth?
In an effort to gain a better understanding of the relationship between ADHD and suicide, researchers have been paying more attention to this question in recent years. While the mechanisms through which ADHD increases the risk of suicide are not yet fully understood, here is what is known about how ADHD may increase risk for youth suicide.
Youth with ADHD are at an increased risk of developing depression and anxiety symptoms during adolescent years which may increase the likelihood of having suicidal thoughts, suicidal behaviors and self-harm. Girls with ADHD seem to be more vulnerable to developing depression, anxiety and self-harm behaviors compared to boys with ADHD.
Youth with ADHD are at an increased risk of suicide due to higher levels of impulsivity (a prominent symptom of ADHD). Impulsivity can drive ADHD youth to move rapidly from thoughts about suicide to suicidal behaviors during times of distress. Youth with ADHD are more likely to act in risky or dangerous ways and spend less time considering the impact and permanence of a suicide attempt.
Youth with ADHD often have difficulties paying attention to social cues and following instructions which can contribute to academic and social struggles. Many of the core symptoms of ADHD, when untreated, can increase stress and conflict with others. Youth may experience increased feelings of failure, rejection, loneliness and hopelessness about the future which can increase risk for depression and thoughts of suicide.
Finally, there is evidence that youth with untreated ADHD are at greater risk of abusing drugs and alcohol. Substance use can significantly increase the risk of acting on suicide thoughts through decreasing inhibition and fear the youth might have about attempting suicide.
What Are the Warning Signs?
Not every child diagnosed with ADHD struggles with depression or is at high risk for suicide. However, the increased risk of suicidal behaviors among those with ADHD warrants increased awareness, rapid recognition of key warning signs for suicide risk and depression,and knowledge about how and where to get help. The following behaviors require immediate response:
Talking or posting on social media about death or suicide
Increased sense of hopelessness, sadness, or feeling of being a burden on others
Talking about a plan to die, researching plans to die on the internet, and/or looking for items to kill oneself (e.g., medications, firearms, sharp objects, rope)
Giving away prized possessions
Visiting, calling, or texting others to say “goodbye”
What Can Parents Do to Increase Safety and Support?
Help your child label their emotions and check in regularly with them about how they are feeling. Let them know all of their feelings are valid and that they have choice over how they express them. If changes in mood occur, consult with a primary care physician or mental health provider.
Make sure all things that could be deemed unsafe (e.g., firearms, medications/poisons, sharp objects) are locked appropriately at all times and out of reach of children. This also includes the proper storage of medication, checking the home environment regularly for poisons and objects that can cause suffocation or hanging and being more watchful when a crisis does occur.
When a youth with ADHD is displaying warning signs of suicide, take it seriously, make sure a safety plan that is easily understandable to the child is in place and consider being more watchful of children during the crisis.
Make sure you, as a parent, are taking care of yourself and building a support team. Raising a child with ADHD and managing a suicidal crisis is quite challenging. It can be a draining experience and requires a team of support.
Use local and national crisis supports whenever needed. It is never a sign of weakness or limitation as a parent to use crisis resources.
If your child reports thoughts of suicide, there are resources to help. For more information on how to talk to your child about suicidal thoughts, click here.
If you or your child need immediate help due to having suicidal thoughts, call or text the 988 Suicide & Crisis Lifeline at 988. If there is an immediate safety concern, call 911 or go the nearest emergency room.
For more information on Big Lots Behavioral Health Services at Nationwide Children’s Hospital, click here.
John Ackerman, PhD, is a clinical psychologist in Behavioral Health and Suicide Prevention Coordinator for the Center for Suicide Prevention and Research (CSPR) at Nationwide Children's Hospital. He directs community, school, and hospital efforts to educate others about the risks and warning signs of pediatric suicide.
Samanta Boddapati, PhD
Psychology
Samanta Boddapati, PhD is a psychologist and PAX coordinator at Nationwide Children's Hospital.
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