Special to Iredell Free News

Many parents would agree that they know their child well. They believe they can easily read their child’s expressions and emotions and would immediately know if something was seriously bothering them.

However, it’s important to recognize that even in close relationships, there can still be moments when a child conceals their emotions or internal struggles.

Dr. Rachel DiSanto

In fact, many parents often have no idea that their children may be considering or thinking about suicide. According to a study published by the American Academy of Pediatrics, half of parents don’t know their child has had thoughts about suicide, and three in four parents are unaware of their child’s thoughts about death and dying.

There can be several reasons for this disconnect, including lack of communication, the stigma around mental health issues, developmental factors, and online and peer influence, to name a few.

“As mental health issues continue to rise in children and teenagers, it’s so important for parents to stay involved in their child’s mental health. Parents are typically the first to spot any signs of depression or other risk factors for suicide, and they should never just assume that their kid looks okay,” said Dr. Rachel B. DiSanto, a physician at Statesville Family Practice.

In observance of National Suicide Prevention Month, take the time to start a conversation with your children and learn how to help them if they begin to feel depressed or suicidal.

Below, DiSanto answers a few questions about the disconnect between parents and teens, warning signs of depression and suicide, and how parents can help.

Q: Why do you believe parents are sometimes unaware that their teen is having suicidal thoughts?

DiSanto: Kids are very good at hiding things, and parents themselves are distracted. Parents are often doing the same sort of online behaviors as kids, but they assume if they are okay online, then their kids are okay. But the problem is kids’ brains are not fully developed. Parents are much better equipped to handle the negative aspects of social media and may not realize how harmful it is to their kids. For instance, if someone says something negative to a parent on Facebook, an adult will usually just unadd them and go on with their day. But for a kid, that’s much more of a traumatic experience.

I don’t think many parents have a clue how much life is being lived online through TikTok, Snapchat, and other social media outlets. Parents often do not realize how much communication and interaction is happening that helps form their child’s thoughts. Parents may never know what their child sees or interacts with on their phones, and that’s a reason as to why it’s so easy for kids to hide things.

Q: Why do you believe there is a disconnect between children and parents?

DiSanto: Part of it is just the age-old saying, “Parents just don’t get it.” But that is especially acute in the digital age because most of us, as parents, haven’t lived the digital age. We did not have social media as kids, so we never had to face these problems and may not really understand the draw of social media.

I speak to kids in my practice, and being connected on social media is their world. If someone says something mean about them online, they’re devastated. As parents, you may think, “That’s not real life,” but to kids, it is their reality. I think there’s a disconnect because parents do not understand the level of emotional attachment that kids have to this.

Addiction has always been an issue with young people in particular, but we don’t yet understand the nature of social media and device addiction. However, it is addiction behavior. Kids now may be addicted to digital devices from the age of two. Whereas for many parents, those things were not options when they were young, so parents don’t even know how to help their children navigate this.

Q: What do parents sometimes discount their child’s emotions as “teen drama?”

DiSanto: I think it’s easy to discount their child’s emotions as being dramatic because parents are thinking back to their lives and high school years and thinking, “That was bad, but I lived through it.” But there is so much more influence online now to hurt yourself. We didn’t have kids at school writing self-harming statements on all the walls but that is what’s happening to these kids online in comment sections. The bullying is 24/7, and you can’t escape it when you get home from school.

I was listening to a podcast during the pandemic, and they were talking about grief in the teenage population throughout lockdown. As a parent, you could look at missing prom and graduation and believe that’s not that big of a deal. It’s not like losing a spouse or a parent. But, to that child, that was the biggest event in their life, and it could have been the biggest loss they’ve ever faced.

Loss to a child is all relative. It’s a big loss or a big deal to them to lose their phone or have that friend “ghost” or ignore them.

Q: How can a parent start to have those tough conversations about mental health and suicide?

DiSanto: A lot of kids do not want to sit down and have face-to-face conversations about mental health, so sometimes it helps if you are doing something. In the car is a place where kids may open up. You can also talk while you do an activity, like walking the dog. Every family and every child is different. Some children may do better with scheduled talks than spontaneous talks, but you need to make sure to have these conversations often. If they said they were feeling fine six months ago, you should not assume that’s how they feel now.

It’s also important to be non-judgmental. For instance, try not to say judgmental statements like, “I don’t like your friends,” or “I think your friends are a bad influence.”

With teenagers, it’s important to ask questions like, “How do you feel about that?”, “How does it make you feel when someone says that to you?”, or “Are there ways you can better communicate your feelings?”

Asking questions is a more non-threatening and non-judgmental way to approach topics with kids. If you say something that is perceived as judgmental, they may shut down, so you have to circle back and just try to see things from their perspective. Remember, you’re trying to check in and see where they’re at, not tell them what you think is best.

It’s also important to normalize mental health issues. I often say this to kids and parents in my office, “If you see someone else struggling, say something.” This teaches kids how to help a struggling friend, but they can also internalize that as advice for themselves to get help if they need it. Make sure they know to get help from a trusted adult, whether it’s a parent, friend of the family, teacher, guidance counselor, or religious leader.

Q: What signs of depression should parents be on the lookout for in their children?

DiSanto: Some of the classic signs of depression parents should be on the lookout for are:

• Slipping in grades
• Sudden change in behaviors
• Being in bed all the time
• Withdrawing from activities
• Sudden friendship group change
• Dropping out of things that they used to enjoy
• Giving stuff away

Prior to suicide attempts, a lot of kids will verbalize vague statements like, “I don’t want to live anymore” or “I just want to be gone.” The hard thing is that a lot of kids will verbalize that in the heat of a moment, but it’s always important to follow up. Even if you, as a parent, believe they don’t mean that, you should never assume that you know how your kid is really feeling. To follow up this statement, you could say, “You said you didn’t want to be here anymore. Can you explain that? Does that mean you don’t want to be in this house with our family, or do you not want to be alive?”

Q: What should you do if you believe your teen may be depressed or suicidal?

DiSanto: If you notice the warning signs of depression in your child, don’t be afraid to ask if they are thinking of harming themselves or someone else. Remember that talking about suicide is not going to put the idea in their head. The idea may come into their head whether you talk about it or not. Most kids have had someone in their school, someone they know, or have heard about someone online who has committed suicide. So, it’s being talked about through other avenues, and if the parent abdicates that responsibility to talk to their child about it, then the only thing that kid hears about suicide is what they’re hearing from friends and what they see online.

If you believe your child may be depressed or suicidal, it’s important to have an immediate safety plan. If they are actively suicidal, that may involve calling 911 or going to the emergency room. You can also call the suicide hotline at 988.

If there’s not an immediate risk of harm, you should try to create a protective environment. Make sure all the guns and weapons are locked. If your child is cutting or burning, make sure to get those items away from them. If there are substances in the house that they could overdose on, make sure all those are locked away and safe.

You should also alert others who are close to them so that they can help keep them safe.

Don’t be afraid to get help at school, from a therapist, or from a doctor. A lot of parents don’t pursue help out of fear of alienating their kid or making their kid mad. Your kid may even threaten you, but you have to get your child help yourself. Most kids are not going to say, “Thank you so much for asking. I want help.” Setting up an appointment with their primary care provider or mental health crisis services to develop a safety plan is crucial.


Dr. DiSanto practices at Statesville Family Practice, located at 310 Davie Avenue. She treats patients of all ages. If you would like to schedule you or your child’s next appointment, call 704-873-3269.

If you or someone you know is struggling with mental health issues or thoughts of suicide, it’s essential to seek help from a mental health professional, counselor, or a helpline like the National Suicide Prevention Lifeline (988 in the United States). Remember that there is help available,
and people care about your wellbeing.

About Iredell Health System

Iredell Health System includes Iredell Memorial Hospital; Iredell Mooresville; two urgent care centers; Iredell Home Health; Iredell Wound Care & Hyperbaric Center; Community and Corporate Wellness; Occupational Medicine; the Iredell Physician Network and more. Iredell Memorial Hospital is the largest and only nonprofit hospital in Iredell County. The comprehensive healthcare facility has 247 beds; more than 1,800 employees; and has 260 physicians representing various specialties. Centers of excellence include Women’s and Children’s; Cardiovascular; Cancer; Surgical Services and Wellness & Prevention. The Health System’s second campus, Iredell Mooresville, is home to the area’s only 24-hour urgent care facility, as well as an ambulatory surgery center, imaging center, rehabilitation services, and physician practices. The mission of Iredell Health System is to inspire wellbeing. For a comprehensive list of services and programs, visit www.iredellhealth.org.