by Dr. Richard O'Connor

Suicide is the third leading cause of death in people between the ages of 15 and 24 after motor vehicle accidents and homicides.

The incidence of teen suicide rose in four years from representing 6.7 percent of each 100,000 adolescent deaths in 2003 to 9.4 percent in 2007, according to the most recent figures released in September 2007 by the National Centers for Disease Control.

No one has advanced a good theory explaining why teens are taking their own lives in greater numbers, but it's important for everyone to be aware of the problem.

Research has found that the major risk factors of suicide among young people are depression, substance abuse, behavior problems, availability of a gun, previous suicide attempts, a family history of depression or substance abuse, and a recent traumatic event. 

Depression
Depression is often not recognized.  In younger children and in adolescent boys, it may seem that the child is simply angry or sullen.

If this lasts more than a week or so with no relief, and if there are other signs of depression — changes in appetite, activity level, sleep pattern; loss of interest in activities that normally give pleasure; social withdrawal; thoughts of death or punishment — it should be taken seriously.

Signs of developing depression in teens include:

• Unhappiness
• Gradual withdrawal into helplessness and apathy
• Isolated behavior
• Drop in school performance
• Loss of interest in activities that formerly were sources of enjoyment
• Feelings of worthlessness, hopelessness, helplessness
• Fatigue or lack of energy or motivation
• Change in sleep habits
• Change in eating habits
• Self-neglect
• Preoccupation with sad thoughts or death
• Loss of concentration
• Increase in physical complaints
• Sudden outbursts of temper
• Reckless or dangerous behavior
• Increased drug or alcohol abuse
• Irritability; restlessness  

Parents are bound to have trouble understanding a depressed teen's confusing signals; after all, who does not want to think of their child as happy and confident.  But parents must pay attention to serious depression; the risks are too great if they don't.

Substance abuse
Sometimes teens try alcohol or other drugs to relieve depression.  Unfortunately the drugs themselves have a depressant effect, and lower inhibitions against self-injurious behavior.  Some young people who have never expressed a suicidal thought have taken their own lives when they got drunk to ease the pain of a disappointment or loss.  But they only felt worse while drunk, and committed a rash, impulsive act which they wouldn't have done sober.

Behavior problems
Getting in trouble in school or with the law, fighting with parents, and other behavior problems are the third risk factor for suicide.  We tend to think of potential suicides as sensitive, shy people who are overwhelmed by life.  We don't see the cocky, obnoxious adolescent as potentially self-destructive, even though his behavior — continually getting in trouble, keeping the world at arm's length — has exactly that effect.

I recently re-read The Catcher in the Rye and was amazed to see Holden Caulfield, whom I had so identified myself with, from my now-adult perspective.  Though I still felt sympathetic, I was struck by how depressed and self-destructive his behavior seemed.

Availability of a gun
This makes the consequences of an impulsive act much more lethal.  Surprisingly, even when a child has made one attempt, parents often fail to remove guns from the home.  How many fatal, impulsive decisions have been aided by the presence of a handgun in the home?

If you have a gun in your home, you are
FIVE times more likely to have a suicide
in your house than homes without a gun.

It is also important to limit the person's access to large amounts of medication, or other lethal means of committing suicide.

Previous suicide attempts
Half of all children who have made one suicide attempt will make another, sometimes as many as two a year until they succeed.  The majority of suicide attempts are expressions of extreme distress and not just harmless bids for attention.

Other factors
Other factors include a family history of depression or substance abuse, and a recent traumatic event. 

Some children who take their own lives are indeed the opposite of the rebellious teen.  They are anxious, insecure kids who have a desperate desire to be liked, to fit in, to do well.  Their expectations are so high that they demand too much of themselves, so are condemned to constant disappointment.

A traumatic event, which can seem minor viewed from an adult perspective, is enough to push them over the edge into a severe depression.  Being jilted, failing a test, getting into an accident — they have the sense that their life is a delicate balance, and one failure or disappointment seems to threaten the whole house of cards.

GET HELP

No talk of suicide should be taken lightly.  It indicates the need for immediate professional help.  Any suicidal gesture, no matter how "harmless" it seems, demands immediate professional attention.

Risk getting involved. If you suspect suicidal thoughts or behavior, ask the teen directly if she or he is considering suicide. Don't avoid the subject or wait for the teen to come to you.

Be alert to the teen's feelings. The severity of the problem should be judged from the teen's perception, not by adult standards.  If a teen perceives something as a problem, it is a problem for him or her.

Never agree to keep the discussion of suicide with a teen a secret.  Agree to give help and support in getting professional help.

Never leave a suicidal person alone.  Get help!

Imminent danger signs include:

• Talking about death and wanting to die
• Suicidal thoughts, plans, or fantasies
• Previous suicide attempts
• Friends who have attempted suicide
• Giving away personal possessions
• Telling a friend about suicidal plans
• Writing a note  

Prevent Suicide
Adults can help prevent suicide by fostering open, honest communication with teens.  If a teen trusts you enough to come to you with a problem, take time to listen immediately.  Delay may only fuel feelings of doom in the teen. 

The following strategies may be helpful when dealing with teens and suicide:

• Talk about suicide in an open manner. Teens need to be given a chance to discuss suicide by voicing their thoughts and opinions. Candid discussion is important particularly when a teen suicide has occurred in a community.
• Let young people know about hotline telephone numbersand crisis intervention services that are accessible locally.
• Model healthy behavior and positive problem-solving approaches. Adults can be models for young people by dealing with their own stress in a constructive manner.
• Use television shows, films, newspaper articles and other media as a trigger for a discussion of effective ways to deal with stress and depression.
• Provide opportunities for group support. Teens sharing problems with other teens who help find solutions can be beneficial.

Adults need to take the possibility of teen suicide seriously even if their community has not experienced one. Teen depression and thoughts of suicide are more common than many adults assume and there are as many as 50 to 100 suicide attempts for every young person who actually takes his or her own life.

Help, Support, Prevention  -  More Information
Emotional Health  -  Teen Depression  -  Bipolar Disorder

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