Irritability, Agitation May Signal Deep Scars Among Children

Hyderabad: Irritability, agitation, crying, and withdrawal by suffering silently, is all that children try to explain the pain they couldn't convey in words. Until they resorted to taking the most devastating step: ending their life.

“Depression in children does not come out in words. It usually comes out in the form of behavioural change. It could be withdrawal, irritability, aggression, or sudden academic decline, watching too much TV or other gadgets, which is often interpreted as carelessness in a majority of households even today,” said Dr Sona Kakkar, a psychiatrist at Columbia Hospital.

Lately, the country has witnessed a spate in suicides involving children. While most suicide case files reached closure without an actual reason, experts say child suicides are more about ignored early warning signs, often by circles they are closely connected to — parents, schools, and institutions.

According to data from the National Crime Records Bureau (NCRB), children suicides accounted for almost 7.6 per cent of the total suicides reported across the country in 2023, which according to experts is an underreported number.

On December 30, a 14-year-old boy was reported to have died by suicide in Macherial. In another case reported recently, a nine-year-old boy died by suicide in the washroom. Even as months passed by, no specific reasons were known.

While the most common explanation to these cases is portrayed as academic pressure, mental health experts say the problem is far more complex and often requires understanding how children process distress and how parents and institutions respond to early warning signs.

As part of a research, Dr Ramees Razzak, a child rehabilitation psychologist, had conducted a psychological autopsy of seven children aged between 12-16 years. “We found recurring patterns in most cases. Social withdrawal, excessive screen and gaming addiction, difficulty in coping with personal losses such as break-ups, poor family communication, and exposure to suicide through peers or media. Many of the children also had background stressors like substance exposure, family conflict and behavioural difficulties, making them especially vulnerable,” he said.

According to Dr Ramees Razzak, triggers to suicide among youth can be situational and environmental more than individual. “Heartbreaks, bullying by both peers and authoritarian figures, domestic violence, abuse within the family, pressure or expectations, and history of deliberative self-harm (DSH) also play crucial roles in children suicides,” he said.

Lack of resilience to failure is another factor, experts said.

Speaking to Deccan Chronicle, Dr Hrishikesh Giridhar, child and adolescent psychiatrist, said, “Children today are less resilient to failure. Parenting does not have a proper boundary. It is either too permissive or too strict. These boundaries play a very important role in teaching children how to handle stress,” he said.

A chunk of suicides were reported in Gurukul schools and the most common pattern emerging was the child urging their parents to take them back home.

Experts say such requests often root from feelings of abandonment and hopelessness, which are the main red flags, especially in residential schools and hostels. “When a child feels unseen, unheard and believes no one will rescue them, they stop seeing a future. Hopelessness is the biggest danger,” Dr Kakkar said.

Exposure to social media and violent online content has intensified the problem, Dr Giridhar said. “A child starts learning about the concept of death around the age of seven. But due to exposure to violent content and social media, children are now encountering ideas they cannot emotionally process. WHO had advised parents to refrain from letting their children get exposed to the screen before they turn three but that’s rarely followed.”

There have been documented cases of suicides triggered by bullying at educational institutions, often by teachers or other authoritarian figures related to school uniform or fees. A 13-year-old boy had died by suicide after his parents were reportedly unable to pay the school fee, in Petbasheerabad.

To this, Dr Kakkar said, “We need schools to shift from having a disciplinarian approach to a more empathy-driven approach. Teachers have to be well-trained to behave empathetically, especially with children. Imagine a teacher telling a student that it's okay to not wear a perfect new uniform but to make himself capable of uplifting his family's financial condition. That approach makes a huge difference in a child's life.”

Despite repeated incidents, systemic follow-up remains weak. “We do not conduct psychological postmortems. After a child’s death, inquiries end with labels like ‘stress’ or ‘family issues’, without examining deeper institutional failures,” he said.

While the problem persists, most educational institutions, where children spend a majority of their time, operate without accountability and proper counsellors. While the (NEP) National Education Policy 2020 has made it mandatory for schools and all educational institutes to appoint a certified psychologist or counsellor on a full-time basis, most schools lack trained professionals.

“Counsellors are especially crucial because they are trained to understand behavioural changes, unlike most people,” Dr Kakkar said.

Dr Ramees said most institutions either lack professionals or have under-trained staff who do not fulfil the purpose: “Underqualified or part-time employed counsellors are being appointed in most of the schools due to various reasons that do not fulfil their prime purpose. Most of them do not have the expertise to deal with students facing mental health challenges. Also, in many schools, teachers or special educators are being made to take up the role of a counsellor. In such situations, rather than prioritizing exact mental health challenges, the children are made to focus on academics, grades and discipline.”

Experts also warned of unwanted trauma being thrown onto children by their parents. “Putting on their own pent up emotions and unresolved traumas onto the children, having spousal conflicts before them and limiting their child's screen-time would help greatly in reducing child suicides as a parent,” Dr Ramees said.