My 4-Year-Old Daughter Made a Suicidal Comment—What Do I Do?

I want to start with empathy for you, and how hard that was to hear from your daughter. Any comment that hints at a possibility of our child wanting to die hurts a parent's heart. This topic of utmost importance does not get discussed as much as it should, so thank you for bringing it up.

Understand Their Emotions

The first step when hearing a comment like this from a young child is to better understand what they want to convey. Our adult brains often interpret young child statements very differently from their intention. In my work, I often follow up on comments by children of all ages that initially sound suicidal, and find out they are expressing something else.

Developmentally, 4-year-olds typically do not understand death as permanent. I would be interested to know when she said "go away forever," was she picturing going somewhere on an adventure? Examples of follow-up questions include, "Where do you want to go? What do you think would happen if you could go away forever?" The answer to this second question may reveal her true motives, such as "I would never get in trouble again!"

Still Take It as a Sign

Even when the comment is not actually about wanting to die, however, the information within it is still important. For your young daughter, it sounds like saying this in her upset moment communicated a wish to escape. This is not uncommon for our brains! When difficult emotions feel overwhelming, it's a natural impulse to want to get away from them. For adults, that can look like numbing out on social media or with alcohol; ultimately, however, these are not healthy behaviors and what needs to happen instead is to build better coping skills.

A preschooler is still developing what we call emotional literacy, which includes labeling emotions, understanding what different ones feel like in their bodies, and figuring out how to express them in appropriate and healthy ways. The tremendous growth transforming their brains brings bad and good news: the bad news is they rely heavily on others (us) to help them manage strong emotions and do not yet have consistent emotional regulation; the good news is their plastic brains are prime for learning to pave the way for better regulation in a few short years.

How Parents Can Respond

With your daughter, focus on the upset of that moment. This works closer to the actual moment you question her, since preschoolers can barely remember what they had for lunch an hour earlier! However, you can guide a brief discussion to help her build her own emotional awareness, as well as your understanding of her inner, emotional life. Possible questions:

• "What feeling were you having right before you said you wanted to go away forever?" (You may want to show her a simple, visual chart of different choices, or use emojis.)
• "How did this feel in your body?" This age group can be quite creative with metaphors, like volcanoes exploding, or a rainstorm crying.
• "If you could go away forever, how would you feel?" Again, this answer could reveal the true motive behind the comment, or make her think twice about what she wants ("I would miss you!")

Validate whichever emotions she brings up, and then help her identify healthier ways to deal with them so they don't feel so overwhelming. Some common strategies for young children include deep, belly breaths, snuggling with a comfort item (maybe you!), or even a spurt of intense, physical exercise to release tension (jumping jacks for 30 seconds or a few laps around the yard). At this age, she will not remember to use these tricks in the heat of the emotional moment, so expect to remind her. However, over time and with practice, she will need the reminder less often.

When to Do More

Rates of depression in children ages 3-5 are almost at 0, according to the Centers for Disease Control and Prevention (CDC); however, these rates increase steadily with age. Suicidal ideation in young children although rare, is not impossible. Any mental health concern involves an array of problems and how they fit together, not just a comment that occurred once. As you stay observant of your daughter, watch for the following:

• General mood: depression in children and teens is characterized more often by irritability, and not sadness like we expect for adults. Obviously, young children's moods swing all kinds of directions, so look for how she generally presents: withdrawn and lethargic? Curious and energetic? Cranky and easily upset?
• Interest in activities: does she show enjoyment and interest in fun activities? A loss of interest and difficulty enjoying activities can be a hallmark sign of depression.
• Changes in sleep and appetite: difficulty sleeping and not feeling hungry, or needing more sleep are common.
• More statements about wishing she weren't here, or wanting to die. This in itself warrants immediately contacting a child mental health professional.

For a depression diagnosis, these symptoms (and possibly others) would occur for at least two weeks. If you notice these symptoms in your daughter, or are unsure, you can seek an evaluation with a mental health professional. Make sure this person has experience with young children. A depression evaluation usually consists of an interview and does not require a battery of tests.

The Bottom Line

A child making a one-time comment about wanting to go away forever deserves exploration and understanding. It is likely that helping your daughter feel more prepared to manage strong emotions rather than the urge to escape them is what she needs at her age. However, you know your daughter best, and if you have other concerns about her mood and behavior seeming out of the norm for her age, a professional evaluation can give you more information and possibly peace of mind. As a psychologist, I remind people that mental health is health; when we talk about wanting "happy and healthy" children, this includes their mental health. Tuning into your daughter's heart and mind at age 4 will lay the foundation for building a deeper understanding of who she is, now and as she gets older.

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Emily Edlynn, Ph.D., is the author of The Art and Science of Mom parenting blog and a mother of three from Oak Park, Illinois. She is a clinical psychologist in private practice who specializes in working with children and adolescents.

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