They may also be at greater risk for self-harm. “ADHD has a positive association with suicide or suicidal behavior and ideation. While the association may be dependent on other factors, individuals with ADHD have a higher likelihood of attempting or completing suicide,” explains Sussan Nwogwugwu, Board Certified Psychiatric Mental Health Nurse Practitioner for Done, a digital health company that helps those living with ADHD. As we bring insight to issues surrounding suicide during Suicide Prevention Awareness Month, we look at reasons for the link between ADHD and suicide, groups that may be more at risk for suicidal ideations, and resources that can help kids and their parents.

Understanding ADHD and Suicide

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that is commonly diagnosed in kids. ADHD leads to physical, mental, and emotional symptoms that impacts a child’s developmental functioning. A mental health or healthcare professional who makes the ADHD diagnosis looks for specific criteria. Extreme difficulty with paying attention is a sign of ADHD. Kids may have trouble paying attention in school or focusing on specific instructions during activities. Being easily distracted is another symptom, along with not following through on finishing projects or chores. Constantly losing important items can also be a warning sign. Children with ADHD can also have symptoms of hyperactivity and impulsivity. This includes excessive talking, interrupting others or an inability to wait to speak, trouble with taking part in quiet activities, and a hard time staying still or seated. Some of those traits can make kids more susceptible to thoughts of suicide. “ADHD, especially when untreated, can lead to feelings of low self-esteem, which combined with the impulsivity that can often accompany ADHD, can lead to increased suicidal ideation and even suicidal gestures or parasuicidal behavior,” says Zoe A. Martinez MD, PhD, Regional Medical Director at Done.

Impulsivity and Suicidality

The nature of impulsivity has a lot to do with the link to suicide. “People with high impulses don’t think things through. Sometimes they act and don’t really give full consideration to outcomes,” notes Mayra Mendez, PhD, LMFT, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John’s Child and Family Development Center. Other conditions also play a part. “It’s really important to understand…that it doesn’t happen in isolation. There are usually other things going on,” adds Dr. Mendez. Research shows that depression in someone with ADHD significantly increases the possibility of suicide. Someone with ADHD who also deals with anxiety is at greater risk. Family history and the household dynamic can also be a contributing factor. “Raising children with ADHD in dysfunctional settings increases their stress. The low tolerance to stress increases the risk for suicide significantly,” explains Nwogwugwu. “In addition, other predisposing factors include a history of a substance use disorder, lower-level education, and experiencing parental domestic violence during childhood.”  Gender also plays a part. Studies show that girls with ADHD have a higher rate of suicidal ideations than boys. However, when looking at suicide completion, research notes that the numbers are higher among males than females with ADHD and comorbid diagnoses, such as depression.  Understanding the link between ADHD and suicide is the first step in offering children and their parents the help that they need.

Signs and Resources

It’s critical for caregivers and loved ones to know what signs to look for in a child with ADHD who is coping with suicidal thoughts.  “We might see a lot more withdrawing, maybe sadness, a person that’s looking down, but not always. Sometimes they mask sad feelings really well,” notes Dr. Mendez. Feelings of hopelessness or disinterest in life are also red flags.  Experts say raising the level of awareness of issues children with ADHD face, as well as raising awareness about signs of suicide, is imperative. Erasing the stigma associated with bringing up these issues, and addressing risk factors, is also key. “The differences imply the need for targeted interventions that address specific gender vulnerabilities,” notes Nwogwugwu. “While pharmacological interventions are critical, it is essential to incorporate psychosocial strategies that target organizational, attention, and social skills,” she adds. Methods to cope with mental health issues, as well as ADHD symptoms, can help lessen the risk of suicidal thoughts. Organizations and websites offer an abundance of resources. “Individuals, families, and caregivers could benefit from a multiplicity of resources to deal with the problem. Some of the resources include the Attention Deficit Disorder Association, Mental Health America, National Alliance on Mental Illness, [and] National Institute of Mental Health,” recommends Nwogwugwu.  CHADD also offers an enormous amount of information for those living with ADHD, including magazines, newsletters, and a supportive community. Your child’s pediatrician and mental health facilities can also give a wealth of information. Ultimately, experts say that being prepared is one of the best ways to help someone you love deal with thoughts of suicide.  “Be aware of your triggers,” Nwogwugwu concludes. “Seek emotional and professional support when necessary.”