Sunday, February 6, 2011

Cries in The Dark: Thoughts and Facts on The Teen Suicide Epidemic

A disturbing trend has been developing in western society during the last few decades. A silent epidemic is plaguing the developed world, largely unreported by the mainstream media, although well documented by health professional organizations worldwide. It is the alarming increase in suicide rates amongst our very young, with particularly pronounced increases amongst the teenage and adolescent population.

Teen suicide statistics

The increase in suicide rates and violence in adolescents and young adults are a disturbing trend in contemporary American society. The statistics as reported by the CDC’s National Center for Injury Prevention and Control (NCIPC) state that from 1952-1995, the incidence of suicide among adolescents and young adults has nearly tripled. From 1980-1997, the rate of suicides amongst young people aged between 15-19 years of age has increased by 11% and in young people between 10-14 years of age, suicide rates have increased by a shoking109%. Firearm-related suicides accounted for 62% of the increase in the overall rate of suicide from 1980-1997 in youths between 15-19 in the US.

Currently suicide is deemed to be the third leading cause of death in the 15 - 24 age group in the United States, behind unintentional injury and homicide. Young females attempt suicide more frequently than young males. Young males are, however, more likely to complete the suicidal act. In particular, white males sadly lead the overall statistics for teen suicide deaths.

The statistics for the UK reveal a similar pattern. The British mental health organization Mind reports that suicide accounts for 20% of all deaths amongst young people aged 15-24 and is the second most common cause of death amongst young people after accidental death. Mind’s statistics reveal the same trend of young males being more likely than females in succeeding in bringing their suicide attempt to completion. The suicide rate in young men in the UK has doubled since 1985 in the 15-24 year old age group. The BBC reports that suicide in young males has increased by 72% in the past twenty years.

Mind reports that UK teen suicide statistics lag behind the European numbers and Australian organizations seem to also confirm a rise in self-harm amongst their young, suggesting that the increase in suicide deaths in adolescents is a sadly growing phenomenon around the world.

Suggested causes

Research shows that teen suicide crosses all class and race boundaries. There has not as yet been a definitive and valid theory explaining why teens are taking their own lives in such great numbers in recent years, but links have been observed between certain social and personal factors and a young person committing suicide. Suicides can be triggered by events such as the loss of a boyfriend, poor school grades, an unwanted pregnancy, a recent fight with parents, problems integrating with peers. But if we look deeper we will usually be able to see the presence of ongoing problems, problems that have been there for a while.

Ongoing difficulties in the relationships with parents and family are common. It is not unusual to find in the young lives of these troubled teens a history of neglect, lack of attention and family support, excessive pressure for achievement put onto the young adult or a history of physical, emotional or sexual abuse within the family. Be aware that abuse does not have to be present at the time in which suicidal feelings start manifesting: suicidal feelings can be the consequence of abuse that occurred in early childhood or many years before the actual suicidal tendencies start to erupt into consciousness. Other factors are presented by difficulties integrating into stepfamilies or recovering from the distress of parental divorce. The increase in divorce and the gradual disintegration of the traditional stability of the family unit is definitely a factor in the increase of suicide in young people. Children find the separation of their parents very hard. Separations and divorces are often quite justified and necessary, even for the good of the child. It is unfortunately, however, a fact that the arguments and pain leading to the break up, the stress of a divorce, the abandonment experienced by kids that loose a parent to custody battles, can be very distressing. It is important that, as a society, we learn to deal with divorce and custody issues in ways that are not traumatic for our young.

Another commonly suggested cause is that of undiagnosed mental disorders such as depression, manic/depression, the beginning of a psychosis and a host of smaller psychological disorders. The National Institute for Mental Health (NIMH) states that depression in children and adolescents is strongly associated with suicidal behavior and that the risk of suicide may rise, particularly among adolescent boys, if the depression is accompanied by abuse of alcohol or drugs. A history of substance abuse has been observed often with suicidal teens, which may be using them to self-medicate symptoms of depression as well as a way to be accepted within peer groups. The researchers associated with NIMH have found that among adolescents who develop depression, as many as 7% may actually commit suicide. The NIMH therefore recommends paying particular attention to signs of depression in teens and for doctors and parents to take all threats of suicide very seriously.

Depression is a treatable condition. Often all that is needed is an attentive listening ear, ongoing support from a skilled counselor to help the young person to identify and release the real cause of their distress. Treating depression with medication has become very popular in recent years, and recommended by many mental health organizations, but personally I remain a skeptic and would only advocated in the most severe cases. If you choose to go the medication route, make sure to choose antidepressant medication wisely, as some anti-depressant medication that works for adults is not suitable for kids. Paxil, for example, a very common antidepressant medication that is FDA approved for adults, is not approved for children and adolescents. Recent research on Paxil has shown that it is actually likely to increase suicidal feelings and motivation to carry out such feelings in young people quite significantly. If by any chance your child is already taking such medication, do not discontinue it, as this is a medication that needs to be stopped in a very gradual way. For more information on this topic consult the web site of the FDA/CDER in the bibliography at the end of this article.

Teen suicide has also been linked to a history of disruptive behavior. It is a mistake to think of potential suicides as only sensitive, introverted types, as suicides are also committed by the rebellious and disruptive type of adolescent who’s continually getting in trouble and displaying aggressive behavior. This aggressive behavior is also a symptom of self-destructive tendencies and sometimes just another way of manifesting symptoms of depression. Adolescents, especially males, can act angry and sulky instead of sad when depressed, making it difficult for parents to recognize the suicidal tendencies in their child.

Suicidal tendencies can also result from reacting badly to a traumatic event, such as the death of a loved one or an assault, and in this case can be seen as a form of Post Traumatic Stress Disorder (PTSD). If something traumatic has happen to your child or teen, make sure they have ample support in coming to terms with whatever has occurred, enrolling help from a professional, if you feel you are not able to help on your own.

It is important to note that kids that have a history of previous suicide attempts are very likely to attempt suicide again. So it is wise not make the assumption that repeated suicide attempts are just a cry for help that will not materialize as, statistically, many adolescents that try repeatedly to take their lives eventually succeed, even if by accident. Also bear in mind that easy access to firearms and medication make it easier for the idea of suicide to become a fact. Easy access to firearms is definitely a fact in rise in suicide rate. However, suicide is also increasing in the UK, where firearms are not easily available. Make sure to always keep any potentially lethal weapons or substances out of the reach of your young, especially if you are living with a teen at risk.

Warning signs and prevention

Many suicides can be prevented by becoming aware of warning signs. Most adolescents don’t really want to die, they just want the pain they feel to stop and do not know how to communicate in order to get the help they need. They are often locked into an inner world that has swallowed them up whole and have no idea how to climb back out of the pain they have inside. Adolescence is a difficult time even for the most adjusted of teenagers. They are ravaged by new hormones, changing from children to adults, are confused about their identity, developing their first relationships outside the family as independent beings, experiencing the first rejections in love, struggling to be accepted by their friends. It is a time fraught with change and insecurity. Some adolescents buckle under the pressure and start to fall through the cracks. By paying attention to the warning signs we can help them to not slip away from us to an untimely end.

It is first of all important to learn to recognize the signs of depression in a child or teen. Symptoms of depression can manifest outwardly as general unhappiness, gradual withdrawal into oneself, general apathy, isolated behavior, reckless or dangerous behavior, a drop in school performance, loss of interest in activities that formerly were sources of enjoyment and a possible abuse of drugs or alcohol. On a physical level, as fatigue, lack of energy or motivation, change in sleep and eating habits, self-neglect, loss of concentration, increase in physical complaints. Emotionally, depression might manifest as a preoccupation with sad thoughts or death, sudden outbursts of temper, irritability and restlessness. In most cases, many of these symptoms will be present. If you spot some of these symptoms in your child, make sure to consult the opinion of a mental health professional and provide the appropriate treatment for your child. If choosing therapy as a means of treatment, it is often advisable that the whole family consider treatment, as in most cases the suicidal teen is a symptom of a family problem rather than the problem of the child alone.

Become aware of the most common signs displayed by pre-suicidal adolescents such as talking about death and wanting to die, suicidal thoughts, plans, or fantasies, giving away personal possessions, telling a friend about suicidal plans and writing a suicidal note. Most kids that take their lives talk to at least one person before the fact and often have attempted to communicate their desperation several times before killing themselves. Watch out for sentences such as “ oh you would all be better off if I were dead” or “ I wish I were not here”. These are comments to not be taken lightly that can reveal a true suicidal mood, even if said in jest. Become aware that pre-suicidal people, young and adult alike, will often seem happier a few days before they take their lives. So, if you are dealing with a very depressed child that suddenly starts acting very cheerful, bear in mind that this sometimes means that they have made the decision to quit trying. Tidying up their room and personal belongings and giving away precious possessions is also a common warning sign.

Are we providing our kids with a world worth living in?

I cannot close this article without exploring the wider issues of this phenomenon. As I was researching the facts and figures, the causes and solutions presented by most of the official bodies, I felt dissatisfied. Children have always entered into puberty and gone through the trials of adolescence. Mental illness and depression have always existed in this world. Many generations have existed and survived in times in which there was no such thing as counseling and medication. And yet this generation of children is displaying more emotional and psychological problems than any before it. It would seem that our young are struggling in unprecedented ways. There is something about our present world that is very harsh on our kids. Despite our apparent progress as a society, the wealth and abundance we have compared to less affluent parts of our world, it appears that in many ways we are displaying the symptoms of a dying culture. Depression is not increasing just in our young but in the population at large. The statistics of suicide in the elderly are also skyrocketing. We seem to be quite an unhappy collective.

My questions brought me to briefly brainstorm with a colleague, Dr Richard Jordan, a professional on the ground, a psychologist that has had much experience working with troubled teens. I asked him why he felt adolescents were leaving us in droves. He replied that children pick up the energy of the unresolved issues of the generation that precedes them, the unresolved baggage of their parents and the collective, through a process know as intergenerational transmission. Dr. Jordan confirmed my thoughts with regards to the effects of our present society on the mental health of our young, observing that many of the values on which our consumerist society is based are driving us away from what really matters. In his opinion it is this lack of true values that is affecting our young on all levels of their being. He says ”These kids do not seem to need to live decades of chasing the illusion to get the sense that, ultimately, all is empty and meaningless. Our children are finding no inspiration. They are present with a sense of hopelessness. There's a puzzling wisdom coming through this generation of children. I sure can't explain it. But they are showing us something.”

Indeed I think they are. I strongly believe that today’s kids are our teachers. By their reacting to junk food with ADD, by their rebelling to our crazy lifestyle with increased violence and substance abuse, by their decision to opt out completely though depression and the very final act of taking their lives, our young people are giving us no choice but to listen to their voice. They are forcing us to start asking ourselves some tough questions. Might there be something wrong with the values our society embraces, more and more to do with money, status, success at the expense of the Soul? Might there be something wrong with a society that pays a pop singer in a month more money than an educator will earn in a lifetime? Might there be something wrong with a society that discards its elders? A society that uses the resources of Earth as if there was no tomorrow, poisoning the waters, the air and the food that are fundamental for our survival? What kind of world are we passing onto our children? Is something missing? What needs to change?

I believe our kids are asking for us for a world that is more meaningful, more aware and more respectful for life and for what is true and real. And that they are willing to vote with their feet to obtain it. As individuals, as teachers and parents, we can prevent suicide in our teens in many ways, by spotting the sign and addressing their problems. But as a collective, we need to accept that there are no quick fixes. We are being asked for radical change. For a true rethinking of our society’s priorities. We need to stop ignoring the cry of our youth. We need to provide them with a world worth living for.

©2004 Katie Gallanti. All rights reserved. This article was first published in Children of the New Earth Magazine in January 2004.

AACAP, 2004. Teen Suicide.

BBC News, 2001. Teen male suicides hit 'crisis' levels

Dr. Richard Jordan

FDA/CDER, 2003. Questions and Answers on Paxil.

NCIPC. 2002. Suicide amongst the young.

NIMH, 2000 Depression in children and adolescents.

Mind, 2004. Suicide in Young People.

O’Connor, R. 2000. Teen suicide.

SAVE, 2003. Symptoms and danger signs.

Surgeon General, 1999. At a glance: Suicide amongst the young.

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