By Debra Cohen-Melamed, LCSW, CCTP, TF-CBT, CPDTP
Suicide Prevention Awareness Month – September 2025
“I don’t actually want to die. I just don’t know how to keep living like this.”
That’s what a 14-year-old client once whispered to me during session, and it’s something I’ve heard echoed in different ways from kids much younger than you’d expect.
As a therapist who works with children and teens, I wish I could tell you suicidal thoughts only show up when things have gotten extreme. But in truth, I’ve had 9-year-olds express a desire to disappear. I’ve had high-achieving teens say they feel numb, stuck, and emotionally exhausted. When a young person talks about wanting to die, it doesn’t always mean they truly want to end their life. More often, it means they feel overwhelmed, alone, ashamed, or afraid—and they don’t know how to ask for help without disappointing someone or being misunderstood.
Suicide prevention isn’t just about responding to a crisis. It’s about what happens before the crisis—when a child stops showing interest in things they used to love (sometimes called anhedonia, or loss of joy), or when a teen starts sleeping too much and pulling away from friends. It’s when a kid who used to be expressive starts saying “I don’t care” about everything.
These aren’t always “warning signs” in the clinical sense, but they are emotional signals. They’re often quiet ways of asking, “Do I still matter if I’m not okay?” or “Can I fall apart without being punished, fixed, or dismissed?”
One of the biggest barriers I see in therapy is kids keeping these feelings inside—not because they’re manipulative or dramatic, but because they’re terrified of how the adults in their life will respond. They worry about being hospitalized, yelled at, or told to “toughen up.”
They worry they’ll make their parents sad. And in that worry, they say nothing.
Instead of “I want to die,” they’ll say things like “I’m just tired,” or “I don’t care anymore,” or “What’s the point?” Some won’t say anything at all—they’ll just get quieter. More irritable. More withdrawn. Sometimes they’ll seem suddenly calmer after a stretch of depression, which can actually be a dangerous sign that they’ve made a plan and feel relieved by it.
This is why suicide prevention has to be relational. It has to be built into the way we create emotional safety with our kids long before they’re in acute distress. That safety comes from the way we respond to hard feelings in daily life—when our child slams a door, shuts down, or says something scary. Do we freeze? Do we punish? Do we rush to problem-solve? Or do we say, “I can tell you’re hurting. I’m here, and I’m not going anywhere.”
If you’re concerned about your child, you don’t need a perfect script. You can simply say:
“I’ve noticed you’ve been quieter lately, and I’m worried. Sometimes when people feel that way, they have thoughts like, ‘I don’t want to be here anymore,’ or even thoughts of suicide. Has anything like that been happening for you?”
It’s okay to use the word “suicide.” It doesn’t plant the idea—it shows you’re not afraid of hearing the truth. If your child says yes, thank them for trusting you. Stay calm. Listen more than you talk. Get support from a therapist or doctor. And if the risk is immediate, take it seriously: remove dangerous items, make sure they’re not alone, and go to the ER if necessary.
What hurting kids need most isn’t perfection—they need presence. They need permission to feel sad without being rushed into gratitude. They need to know they’re still lovable when they’re messy, when they’re angry, or when they’re not okay. They need to know someone sees them, stays with them, and won’t look away—even when the feelings are big. The core of suicide prevention is emotional safety. Not just in emergencies, but every day.
Suicide remains tragically prevalent across age groups: in 2022, it was the second leading cause of death for people ages 10–34 in the U.S.—including children ages 10–14 and young adults ages 20–34 (Centers for Disease Control and Prevention [CDC], 2023). Meanwhile, up to 22% of high school students reported seriously considering suicide in the past year (CDC, 2023).
If you or your child is in emotional distress, call or text 988 for the Suicide & Crisis Lifeline, or visit 988lifeline.org to chat with a trained counselor, 24/7. No one should have to hurt in silence. Let’s talk about it—before it’s too late.
P.S. Looking for a more structured guide to warning signs and what to do if you’re concerned? You can read our 2024 post here
References:
Centers for Disease Control and Prevention. (2023). Suicide data and statistics. U.S. Department of Health and Human Services. https://www.cdc.gov/suicide/facts/index.html
