Learn about the benefits and risks of antidepressant medications, and how to monitor depressed patients. Educate the family regarding the following warning signs that warrant contacting you: new or more frequent thoughts of wanting to die; self-destructive behavior; signs of increased anxiety/panic, agitation, aggressiveness, impulsivity, insomnia or irritability; new or more involuntary restlessness (akathisia), such as pacing or fidgeting; extreme degree of elation or energy; fast, driven speech; or new onset of unrealistic plans or goals.
Risk factors for suicide
Fixed risk factors
• Family history of suicide or suicide attempts.
• History of adoption.
• Male gender.
• Parental mental health problems.
• Lesbian, gay, bisexual, or questioning sexual orientation.
• Transgender identification.
• A history of physical or sexual abuse.
• Previous suicide attempt.
Social/environmental risk factors
• Bullying.
• Impaired parent-child relationship.
• Living outside of the home (homeless or in a corrections facility or group home).
• Difficulties in school.
• Neither working nor attending school.
• Social isolation.
• Presence of stressful life events, such as legal or romantic difficulties or an argument with a parent.
• An unsupported social environment for LGBTQ adolescents.
Personal mental health problems
• Sleep disturbances.
• Depression.
• Bipolar disorder.
• Substance intoxication and substance use disorders.
• Psychosis.
• Posttraumatic stress disorder.
• Panic attacks.
• A history of aggression.
• Impulsivity.
• Severe anger.
• Pathologic Internet use.
Source: Pediatrics. 2016 June 27 doi: 10.1542/peds.2016-1420.