Suicide, suicidal ideation

Eating disorders are serious psychiatric disorders associated with high levels of suicidality, particularly if depression is also present. Parents should take very seriously morbid or black thoughts, or self destructive acts, by their eating disordered child. An attempt at suicide in these individuals may be  different than that associated with suicide attempts in the general population. The illness may produce impulsive self-destructive behaviors that need to be immediately managed by prevention (locking up knives, razors, etc.), close surveillance and possibly hospitalization. 


  • threats or talk of suicide;
  • making final arrangements, saying goodbye;
  • expression of hopelessness: "You'd be better off without me";
  • sudden mood swings, abrupt changes is personality, sadness, frequent crying;
  • loss of interest in hobbies, sport, work, school;
  • withdrawal from family, friends, peers;
  • focus on death which may surface in art work, poems or stories;
  • inability to concentrate, make decisions or accept alternatives;
  • excessive feelings of guilt, self blame, failure, worthlessness, poor self esteem;
  • fatigue, sleep disturbance;
  • increased or decreased appetite;
  • noticeable behavior change - risk taking, running away, impulsiveness, rebellious, restlessness, agitation, indifference, destructive;
  • self criticism: "I can't do anything right" or "I'm too fat": increased use of drugs or alcohol.

It's imperative to take any and all suicidal statements or threats very seriously. It is not permissible for the eating disorder or the individual suffering to use a threat as a means of trying to control a loved one. Therefore, especially with minors, when a statement is made that is threatening -- i.e. "if you make me eat that then I will slit my wrists" or "I'm better of dead" or "I want to die" -- then in a matter of fact manner inquire if they are saying this to threaten or if they have a plan and intention. If they are unable to identify a specific plan for keeping themselves safe then take them to the nearest emergency room to be assessed or if unable to do that call 911 or other emergency services. Here are additional suicide prevention resources and hotlines in USA, Canada, UK, France and Australia.

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