James Donaldson: James Donaldson on Mental Health - When Bad Breakups Lead to Suicidal Thoughts

Breaking up is hard to do for college students—and may trigger suicidal ideation.

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KEY POINTS

- Breakups are associated with an increased risk of suicidal thinking in young adults.

- Young adults who are already depressed may have a worsening of symptoms after a breakup.

- Campus mental health services have experience helping college students cope with a breakup.

- Parents are an important source of support when a student is going through a breakup.

Nadine comes to my office for the first time just after winter break. Her boyfriend of 2 years broke up with her by text the day before Christmas, and now she is back at school without her main support.

They share the same friend group, and she is uncomfortable being with her friends if he is around. Worse yet, he is flirting with one of her close friends. She feels betrayed.

She was already feeling depressed before the breakup and now is starting to wonder if life is worth living. Her parents encourage her to come to see a therapist and psychiatrist. Her father is being treated for depression and his mother died by suicide, so they want her to get help as soon as possible.

Nadine’s parents are wise to refer her to treatment, as Nadine has many risk factors for suicidal behaviors. A family history of suicide, feeling depressed, and a recent stressful life event—in this case, a breakup—all increase the risk of suicide. There is no one cause of suicidal thinking or attempts, but in my experience as a college psychiatrist for over thirty years, a breakup can be a precipitating factor.

A recent study of university students with a median age of 20 years showed that breakups were associated with a 25 percent increase in the prevalence of suicidal thinking. This study reviewed other studies that demonstrated an increased risk of suicidal thinking in young adults after a breakup.

Keep in mind that in young adults, the prefrontal cortex has not finished developing. This part of the brain helps with executive function and planning for the future. After a breakup, a college student may struggle to see that their pain is temporary and their future is bright. If a student is already experiencing depression, a breakup could make them feel worse.

Why are some breakups experienced as bad, and others as just a part of life? The breakups that appear to be especially upsetting to students include longer relationships that the student thought would lead to marriage, ones that come as a complete surprise, and ones that involve friend groups. Even having many friends may not soften the blow, as young people can feel a profound sense of rejection when a relationship does not work out.

When I talk with patients about breakups, I always listen and offer empathy. I also remind them that in college, they may experience different relationships which will teach them what qualities they want in a future partner. Often, with time, they realize there were problems with the relationship and it was bound to end.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space. #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

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While many youths experience breakups and most will not have suicidal thoughts, it is important to check in with your child when they are going through a breakup. Do they have other friends to turn to? Are they overwhelmed with sadness?

If they describe being very depressed and unable to get out of bed, they should seek urgent help from a therapist or psychiatrist. And if they mention that they’re not sure if life is worth living, it is a good idea to ask them if they have plans of suicide or have taken actions that will lead to self-harm (like gathering pills or buying weapons).

Plans or actions taken regarding suicide would require an emergency evaluation by calling 988 and/or going to the emergency room. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a great tool that anyone can use to evaluate these risks.

Here are steps that will support your child after a breakup:

- Say that you would like to check in with them more frequently while they are going through this difficult time.

- Ask if they are spending time with friends.

- Encourage them to seek mental health services if they describe being depressed or having difficulty functioning.

- Seek urgent mental health services if they are having passive suicidal thoughts that life is not worth living.

- Seek emergency medical care if they have thought about plans or taken action to harm themselves.

While we parents understand the vicissitudes of life, including breakups, college students can be profoundly distressed after the end of a relationship. Listening to them can help them feel less alone and allow them to see a future filled with joy, purpose, and meaningful relationships.

If you or someone you know is having thoughts of suicide, seek help right away. For immediate help in the U.S., 24/7: Call 988 or go to 988lifeline.org. Outside of the U.S., visit the International Resources page for suicide hotlines in your country. To find a therapist near you, see the Psychology Today Therapy Directory.