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How to help a teen who may be suicidal
Various experts talked about practices to help parents of teens who are suicidal, and cited family vacations as one possible practice. Mental health counselors say that family memories that can be savored and anticipated make a huge difference. - photo by Lois M. Collins
It started when Ryan was 14 and continued for several years, a kind of hyper angst that was sad and desperate and nearly deadly. He was so depressed he tried several times to kill himself.

Now 20, employed, happy and 180 degrees from where he was back then, that yesterday sorrow puzzles him. Through therapy inpatient and outpatient medication and hard work, hes no longer suicidal, but if you ask him what made him want to die, he cant point to a particular event or trigger. Although he had friends, he felt socially isolated and disconnected. A friend had died (not from suicide). He started dreading school. A combination of factors sent him spiraling, which experts say is not uncommon.

While Ryan cant say clearly why he wanted to die, he can tell you how happy he is that he lived. Hes glad his mom who bothered and bugged and near-smothered him with attention and dad got him through it. They put him in therapy, they arranged home schooling, they stripped the house of anything he could use to harm himself and they watched him closely.

Ryan, who asked that his last name not be used because he doesnt want to be defined by the lowest point in his life, is proof to youths that things change if you hold on. Life looks and feels better.

Last month, we sat down with Ryans family, as well as separately with Jackie Peacock and her son Coby the mom and brother of a boy who killed himself in Gunnison, Utah, in 2015 and various experts to talk about practices to help parents of pain-filled kids increase the chances a youth with suicide ideation does not die.

We learned:

Trust your gut if you think somethings wrong. Dont skirt the topic. Ask: Are you thinking of killing yourself? Being direct is more likely to elicit an honest answer.

Know typical warning signs, which include individuals withdrawing from family and friends, losing interest in activities they once enjoyed or commenting that they feel helpless, hopeless or worthless. But also know different people display different signs and the only real hint may be a drastic change in behavior, including apparent improvement. The day Peacocks son Anthony died, he was cheerful and joking after months of being distressed.

Positive distraction can work. Ambivalence about suicide is common.

Don't back off. Ryans mom stuck close to him. She worked with school counselors to pull him out of classes and home-school him with help from a district staffer. Peacock, too, suggests hypervigilance: Until you are 100 percent sure, dont leave them unattended at all. And dont ever just back off.

As a family, plan something to look forward to, like a vacation that can be savored and anticipated. Mental health counselors say that makes a huge difference. No matter how chaotic things got, Ryans family planned fun activities and dragged him along. They cultivated laughter.

Work on relationships and communication within the family. The Utah Health Department notes positive family interaction saves lives. Youths who feel they have input in family decisions, the family cares about them and they can ask their parents for help with a personal problem are more likely to be OK.

Encourage kids to participate in extracurricular activities that foster friendship, such as church youth groups, clubs or sports teams, so they dont fill their free time with screens, which can be very isolating. Connectedness tends to deter suicide while isolation creates significant risk.

Dont make certain topics taboo, even if they make you uncomfortable. Youths are desperate to know how to talk about suicide, substance abuse and other challenges that are all around them, even if they arent experiencing them. Establish yourself as a safe place to come for counsel. Start talking and keep talking. Your child may be someone elses childs glimmer of hope.

Things that calm are helpful, and parents can practice them alongside the teen, says Nancy Marshall, a Pennsylvania psychotherapist who wrote Getting Through It: A Workbook for Suicide Survivors. Meditation, massage and exercise slow things down and relieve stress.

Create a family culture where kids can check in at the earliest signs of trouble. Take it seriously. Too many parents try to find excuses for problems Its just hormones when issues should be addressed directly, says Vickie Anderson, president of the National Alliance for the Mentally Ills Sanpete chapter. Seek professional counseling.

If your child is suicidal, remove anything that might provide a means, from substances to guns or sharp objects. Dr. Craig Bryan, University of Utah suicidologist, says having a firearm at home increases the likelihood a teen will die by suicide threefold, mostly due to accessibility. One of the common assumptions is that the best predictor of whether or not someone kills themselves is how badly they want to kill themselves. Thats actually a very weak predictor of suicide. A much stronger predictor is availability of highly lethal means.

Medication and talk therapy together are more effective than either alone. Be aware an especially dangerous period in recovery is when one begins medication and starts to feel better. Suicide risk goes up in that transition phase.

Eliminate every risk you can by creating a stable home environment and seek help yourself if you need it.

Call the 24-hour National Suicide Prevention Lifeline: 800-273-TALK (8255).