Devastating News

A few days ago, I learned that 9-year-old Madison Whitsett from Birmingham, Alabama, committed suicide. I have gleaned 3 facts from major news outlets – Madison was diagnosed with ADHD, she was being bullied at school, and she had recently started new medication. Although Madison’s parents have not divulged the name of the medication, some have stated that suicidal thoughts are listed as one of the side effects. I am profoundly devastated by this news. My heart breaks for this precious baby, her family, and the entire community.

I thought long and hard about writing this blog post, feeling unsure of what I might say or how I might tackle such a difficult conversation. I don’t know this family personally. However, as a practicing psychiatrist, I treat children who are victims of bullying, struggle with depression, and contemplate suicide almost every day. My only desire is to support and educate.  I wish to shine light on a conversation that no parent ever wants to have to address with their children, but we no longer have the luxury not to.

Below I share some points about the connection between bullying, depression, and suicide. I hope we can start a dialogue today. Let’s engage in thoughtful discussion that will lead to meaningful change in our schools so that the tragedy that is suicide no longer exists.

What is bullying?

According to www.stopbullying.gov, bullying is defined as unwanted, aggressive behavior among school-aged children that is repetitive, involves a real or perceived power imbalance, and is designed to cause fear, distress, or harm.

The 4 types of bullying

1. Verbal – saying or writing mean things, name calling, teasing
2. Social (relational) – behaviors that malign a child’s reputation or negatively impact relationships with peers, intentionally leaving someone, spreading rumors
3. Physical – hurting someone’s body or possessions such as pushing, hitting, or kicking or intentionally damaging someone’s belongings
4. Cyberbullying – intentional and repeated mistreatment of others through technology such as social media or texting

According to statistics from PACER’s National Bullying Prevention Center Statistics:

1. Almost 21% (or 1 in 5) students report being bullied in 2016
2. Bullying occurs most commonly in the school hallway or stairwell (42%). Other locations include – inside the classroom (34%), in the cafeteria (22%), outside on school grounds (19%), on the school bus (10%), and in the bathroom or locker room (9%)
3. 43% of bullied students notify an adult at the school
4. Almost 60% of bullying incidents stop when a peer steps in on behalf of the victimized student
5. Most common reasons for being bullied are physical appearance, race/ethnicity, gender, disability, religion, and sexual orientation
6. Consequences of bullying – decline in grades, school avoidance, higher rates of absenteeism, sleep disturbance, anxiety, depression, suicidal ideation, poor self-esteem, strained relationships with family and friends, worsening physical health (headaches, stomachaches)
7. Compared to their peers, students with disabilities worry more about school safety and being injured 
8. Students receiving special education services report being told not to tattle almost twice as often as those students not in special education
9. While suicide is not a normal response to being bullied, students who bully others, are bullied, or witness bullying are more likely to report suicidal behavior 
10. One study showed that bullied students are 2.2 times more likely to endorse thoughts of suicide and 2.6 times more likely to attempt suicide

The US Department of Justice found that 160,000 kids skip school every day out of fear of being bullied

Do psychiatric medications cause suicide?

Parents often ask me this question, and it’s a reasonable question. No one wants to start a child on medication that will make his or her symptoms worse or lead to suicide. Although the Food and Drug Administration (FDA) reported an increase in suicidal thoughts among children and adolescents who take antidepressants, there were no completed suicides. Furthermore, youth with depression contemplate suicide more often. Untreated depression also increases the risk of suicide. However, between 1992 and 2001, the rate of suicide dropped greater than 25%; young people were prescribed antidepressants at much higher numbers during this time period.

Nevertheless, we watch children very closely after starting new psychiatric medication and especially when initiating antidepressants. Contact your physician immediately, call 911, or go to the nearest emergency room if your child displays warning signs: appears more depressed or very agitated, engages in self-injurious behavior (cutting, scratching themselves), or voices thoughts of suicide. Additionally, I recommend that parents monitor social media, texts, and internet searches. I also suggest that parents keep medications locked up and strongly consider removing guns from the house as other precautions.

Check out http://parentsmedguide.org for additional information.

What can we do?

As parents and educators, it is imperative that we create a supportive and nurturing environment for our children. This means we should:

1. Listen – Be available and engaged when they are ready to talk
2. Validate – Let them know you get it. Tell them you understand how difficult these experiences are for them. Don’t minimize what happened to them or downplay their feelings. Don’t suggest they change who they are or act differently.
3. Ask – Follow back up with them to see if the bullying has subsided or persists
4. Act – Do something. Intervene. Don’t just sit and watch. Teach peers to stand alongside the bullied and speak out against bullying. Bystanders are critical allies. Also, provide consequences for those students who violate rules.
5. Refer – Refer victims and bullies for counseling. Research shows higher rates of depression and anxiety among both groups. We need to teach our children not to suffer silence. Show them how to get help!