It’s a balancing act to discuss adoption as trauma. The idea of adoption as trauma is relatively new, and I understand that it’s disconcerting for many people. Separation from one’s mother as baby or child is traumatizing; we are hardwired to connect with our mothers. Adoptees often undergo additional separation from caregivers in a foster home or orphanage. Those losses can be traumatic as well, and the trauma can manifest over time or later in life. Depression is also disconcerting, to the 19 million Americans who struggle with it and to those who love the people who are struggling. Many adoptees struggle as children, as teens, and as adults with anxiety and depression. Talking about these medical conditions can be hard. Still, as anyone involved in adoption or in life knows, not talking about difficult, uncomfortable things rarely ends well.

It’s also a balancing act to encourage discussion about suicide without encouraging suicide. Same with remembering those who have died by suicide without inadvertently glamorizing suicide. High schools, for example, face this dilemma when a student has died by suicide, not wanting to trigger any sort of imitation, or “suicide cluster.”

Suicide is the third top cause of death among 10 to 14 year olds, and the second top cause among 15 to 24 year olds.

My post Suicide and Adoption: We Need to Stop Whispering has been shared on Facebook about 800 times since I published it last Monday. There have been several thousand views and visitors, and I have heard personally from many people. Clearly, it struck a chord, and we need to keep this conversation going, even if it is complicated and difficult to balance.

For anyone in crisis, call this number: 1-800-273-8255. You can call the number if you are considering suicide or if someone you know is. Available anytime, day or night. 24/7/365.

Two significant resources are the Suicide Prevention Lifeline and the American Foundation for Suicide Prevention. Both have huge amounts of information, research, and more. I’ve reached out to both organizations above, asking if they would consider providing adoptee-specific information on their websites.  I’ve offered to draft material and network with them about this, and I hope I hear back soon. Please reach out to them as well.

Here are suggestions for talking with someone who may be suicidal. I share this because there are many resources available for this tough stuff.

Most suicide attempts are rooted in some sort of trauma and/or depression. Many people who have considered or died by suicide have also been diagnosed with depression and/or Post-Traumatic Stress Disorder. President Obama in February signed a suicide prevention law to make it easier for U.S. military veterans to access mental health resources. The law also provides funding to recruit and retain professionals to help veterans struggling with PTSD and other challenges.

Here’s an eye-opener: Former foster care children are almost twice as likely as US war veterans to suffer from PTSD. You can read more in this Casey Foundation report.

I’ve cited, several times, the American Academy of Pediatric’s report that adoptees are 4 times as likely to attempt suicide as non-adopted people but it bears sharing again. Read the report here.

We can recognize that trauma is a part of adoption, without claiming that all adopted people are affected the same way. Many do just fine, handling challenges with resilience and strength. Many struggle, and those are the ones I want to recognize, acknowledge, and assist, if possible.

Here are some strategies and resources:

• Learn about trauma in adoption. “Assume that all children who have been adopted or fostered have experienced trauma.” That is a central quote from the American Academy of Pediatrics guide for pediatricians, “Helping Foster and Adoptive Families Cope With Trauma.” Share this resource with your pediatrician.

• Learn about signs that someone is considering suicide and about suicide prevention.

• Work to remove fear and shame around depression, and around reaching out to others about depression and PTSD. Here is a powerful TED talk: “Revealing a Heartbreaking Secret on the TED Stage.” Another resource: “What Do I Do If My Teen Is Thinking About Suicide?”

• Make suicide awareness a component of pre-adoptive parent training classes. Suicide awareness should be part of information provided to prospective parents about trauma, depression, and anxiety disorders, and their frequent appearance in adoptees.

• Insist on speakers in pre- and post-adoption workshops who have struggled with depression and trauma. Agencies: Improve networking with adult adoptees and adoptees who are therapists, so that adoption agencies have several speakers to provide for families.

• Understand why access to medical histories for adoptees is essential. Denial of that information (which could be lifesaving), in regard to mental illness and other medical conditions, is unconscionable. The American Adoption Congress has focused its legislative advocacy efforts on opening access to original birth certificates. Information is available here.

• Advocate for adoption competency among therapists. Suggest that families also look for therapists trained in childhood trauma, as well as in adoption-related issues.

• Advocate for strong post-adoption mental health services for everyone: the adoptee, the adoptive parents, and the first/birth parents.

• Suggest, promote, and provide workshops with titles like “Depression Among Teenage Adoptees: What It Looks Like, What Can Help,” or “The Presence of Suicide in Adoption,” or “PTSD and Adoptees: The Realities and the Treatments,” and “Adult Adoptees Speak Out About Depression, Anxiety, and Suicide Prevention.”

• Learn about the impact of bullying and cyberbullying on children and teens. According to the site stopbullying.gov, “Although kids who are bullied are at risk of suicide, bullying alone is not the cause. Many issues contribute to suicide risk, including depression, problems at home, and trauma history. Additionally, specific groups have an increased risk of suicide, including American Indian and Alaskan Native, Asian American, lesbian, gay, bisexual, and transgender youth. This risk can be increased further when these kids are not supported by parents, peers, and schools. Bullying can make an unsupportive situation worse.”

• Adoption agencies and adoption-related organizations: Provide current, substantial lists of resources to families about therapists, therapies, articles, podcasts, videos, and more related to adoption, depression, and suicide prevention.

• Learn about psychotherapies that can benefit people struggling with depression and trauma. The National Institute of Mental Health has clear information: Psychotherapies. One therapy, Dialectical Behavior Therapy (DBT) is for chronically suicidal people diagnosed with borderline personality disorder, and is also used for substance dependence, PTSD, and depression.

• Learn about the role of addiction in adoption, and how addiction and substance abuse intersect with trauma and depression. One resource is a YouTube video by Paul Sunderland, titled Adoption and Addiction.

Fill yourself and your loved ones with accurate information, with hope, and with attention to deep listening. Let go of shame and fear about mental illness, and encourage others to do so as well. All of us in the adoption community can work together in a powerful way to increase awareness of suicide, and to promote suicide prevention.