Psychological Pain Explained

Intense psychological pain (referred to as psychache) is a commonality across all theories about youth and suicide. Common sources of psychological pain can be relationships and self-esteem or identity.

“Parents should watch for excessive shame, guilt, loneliness, humiliation, or angst,” says Dr. Jessica Tomasula, licensed pediatric psychologist and manager of behavioral health services at WakeMed Children’s. Listen for talk about feeling as though they’re a burden to others (e.g., can’t do anything right, everyone would be better off without me) or a lack of belongingness (e.g., feeling dejected or alone).

“It’s important for parents to remember that what may seem like a common experience in adolescence can prove to be catastrophic if a child ruminates on these experiences and, thereby, continues to silently suffer with psychache,” says Dr. Tomasula. “Some common situations to pay close attention to are break-ups, embarrassing moments within a group, or failure at an athletic or academic event.”

Know the Risks

Families should be aware of the environmental, health and historical risk factors and warning signs of suicide. Yet, keep in mind that there is no one cause of suicide. Risk factors increase the chance that a person may take their life; however, most people who seek professional help and learn to manage mental health concerns can live healthy lives.

Dr. Tomasula recommends learning more about risks of suicide. Visit the National Institute of Mental Health for a helpful infographic and list of warning signs.

Suicide Risks and Warning Signs

Seek help if a child is talking about any of the following warning signs.

• Killing themselves
• Feeling hopeless
• Having no reason to live
• Being a burden to others
• Feeling trapped
• Unbearable pain

Self-Harm Behaviors

• Cutting
• Scratching
• Biting
• Burning skin
• Head banging
• Hitting oneself
• Jumping from high places

Watch for Behavior Changes

Pay attention and talk to your child about what’s going on if you notice concerning changes in their mood or any of the following behaviors. Be careful not to judge your child and make sure they know that you are concerned and love them.

• Suicide-related communication
• Isolating from others
• Loss of interest in favorite activities or possessions
• Visiting or calling others to say goodbye
• Dangerous behaviors
• Reckless driving
• Aggression
• Self-harm
• Sleep problems (too much or not enough)
• Use of drugs or alcohol

How to Support a Child whose Friend or Classmate Died by Suicide

Dr. Tomasula recommends parents learn more about healing conversations, personal support for survivors of suicide loss. Learn more via the following resources:

• Healing Conversations
• Grief and Loss
• 10 Ways to Support Someone Who Has Lost a Loved One to Suicide
• Responding to Suicide Survivors

Lead with Empathy

Talking with your kids is key to helping them with any mental or physical health concerns. Self-harm or suicide are real concerns for all ages, but adolescents and young adults are at an increased risk, and the world they’re growing up in isn’t getting any simpler.

If you can lead with empathy and really try to be understanding of loneliness, anxieties or frustrations, there’s a good chance that your kids will be more trusting and open when it comes to their emotions. Let them know at a young age that it’s ok to feel sad, angry, or indifferent at times while letting them know you care about how they feel and are ready to listen and help anytime.

Coping with Life

Life is full of unexpected change, new challenges and plenty of unknowns so we all need a set of coping skills in our toolbox. One of the best things parents can do is proactively help their children find some healthy coping methods.

“By exploring different ways to manage and alleviate stress, anxiety, fear, loneliness, anger and other difficult emotions, parents might even discover some tools of their own,” says Dr. Tomasula. “Encourage the practice of coping skills so the whole family is more naturally inclined to use them when needed.”

Keep in mind that what is helpful for one person won’t necessarily help others.

“The goal is to show your children healthy coping skills and be supportive and help children to find what works for them.”

Communication Tips

• Talk in private.
• Be open, honest and present.
• Really listen.
• Let them share at their own pace.
• Don’t pass judgement.
• Tell them you care.
• Avoid giving advice or debating things.
• Don’t minimize their emotions.
• Advise them to call a helpline.
• Tell them you will make an appointment for or with them.
• Keep checking in with them.
• Let them know they are loved and not alone.

Listen & Love

“Don’t be afraid to ask if they are thinking about suicide,” says Dr. Tomasula. “You don’t need special training to have a conversation about mental health, but taking time to review some helpful tools, resources and creative tips will help you prepare and take the important steps to getting your loved ones support or treatment.”

What Can You Do Right Now?

See These Resources

Wake County Crisis and Assessment Services: 984-974-4800

Wake Behavioral Health Urgent Care: 919-703-2845

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

National Suicide Prevention Text TALK: 741741

Psychology Today (Outpatient Therapy Provider Search Option)

Suicide Prevention Resource Center (Resources for Survivors of Suicide Loss)

Adolescent Self Injury Foundation

See conversation starters and important questions to ask.