Teen Suicide Overview

The teenage years are a period of turmoil for just about everyone. You're learning new social roles, developing new relationships, getting used to the changes in your body, making decisions about your future. And when you're looking for answers to problems, it can seem like no one has them. That can make a person feel quite alone.

Too often, as the daily news tells us, the search for answers to these challenges is complicated by problems outside teens' control, such as divorce, family alcholism, domestic violence or even sexual abuse. In such an environment, normal problems--tough enough to deal with in a loving family -- can seem insurmountable. Many teens who feel they have nowhere to turn will "medicate" their pain with drugs or alcohol. Or they will express their rage and frustration in acts of violence or destruction.

Depression is also a very common illness among teenagers. The feelings of helplessness and worthlessness that can accompany it, along with disturbances in sleep or apetite, can fuel a downward spiral of health and grades, further clouding perspective, making even thought seem intolerably difficult.

If you are suffering situations and feelings like these, you may need some extra help to hold on. If you're depressed or angry, if you're abusing substances to hold back the pain or to feel like you fit in, its vital that you try to break through the feeling of isolation you may have and talk your feelings over with someone, preferably a mental health professional.

It's vital that you break through the isolation because studies have shown that teens who are feeling depressed, abusing substances or acting out their violent feelings are at high risk for suicide.

What To Look For

Everyone has normal mood swings in which he or she occasionally feels sad. But when that depressed mood lingers for more than two weeks, serious depression could be setting in.

* If several of the statements below describe you or a friend, it might be appropriate for you to seek help by talking to a mental health professional such as a psychiatrist or other trusted adult, such as a parent or a school counselor, about how you feel.

• I am sleeping much later than I used to.
• I'm not sleeping well and wake up early in the morning.
• I'm beginning to take a lot of naps.
• My appetite has changed, and I've noticeably lost or gained weight.
• I feel restless.
• I have withdrawn from friends and family.
• I can't concentrate very well.
• I've lost interest or pleasure in activities that I once enjoyed.
• I feel hopeless or guilty.
• I've had sudden mood or behavior changes: I used to be quiet and now I am hyperactive; or once I was outgoing and now I'm withdrawn.
• I feel that life isn't worth living.

Very Important Things to Keep in Mind

• Young people who have attempted suicide in the past or who talk about suicide are at greater risk of future attempts. Listen for hints like "I'd be better off dead" or "I won't be a problem for you much longer" or "Nothing matters; it's no use."
• Adolescents who consider suicide generally feel alone, hopeless and rejected. They are more vulnerable to having these feelings if they have been abused, feel they have been recently humiliated in front of family or friends, have parents with alcohol or drug problems, or have a family life affected by parental discord, disruptions, separation or divorce. However, a teenager may be depressed and/or suicidal without any of these.
• Some teens who abuse alcohol or drugs are more likely to consider, attempt or succeed at suicide than are non-abusers. According to a recent government report, The Economic Costs of Alcohol and Drug Abuse and Mental Illness: 1985 (published jointly in 1990 by the Public Health Service and the Alcohol Drug Abuse and Mental Health Administration) shows that thirteen percent of people who committ suicide did so because they were abusing alcohol at the time.
• Teenagers who are planning to commit suicide might "clean house" by giving away favorite possessions, cleaning their rooms or throwing things away. They may also become suddenly cheerful after a period of depression, because they think they have "found the solution" by deciding to end their lives.
• One of the most dangerous times of a teen's life is when he or she has suffered a loss or humiliation of some kind: loss of self-esteem by doing poorly on a test, the breakup with a boyfriend or girlfriend, or the trauma of parents' divorce.

New Findings

Every day, psychiatric research is finding new clues to the causes of depression and suicide. Among them:

• Depression and the risk for suicide might have biological as well as psychological causes. Studies have found that some people who are depressed have altered levels of certain brain chemicals. Other studies have shown that aggressive and impulsive people who make violent suicide attempts have reduced amounts of serotonin, a key brain chemical.
• A family history of suicide is a significant risk factor in a young person. The family link might be because young people often identify with those closest to them and are likely to repeat their actions. However, there may be a genetic link as well, because biological relatives of a suicidal person are six times more likely to attempt or succeed in suicide than are adoptive relatives.

Some Numbers

Increased awareness of the problem may have helped slow the rate of teen suicide in recent years. Still, the numbers show that teen suicide remains a very serious problem, and many think the actual number of suicides is two to three times higher than statistics indicate.

• Suicide is the third leading cause of death among young people aged 15-24. More than 13 of every 100,000 people aged 15 to 24 committed suicide in 1990. Experts estimate that each year nearly 5,000 teenagers commit suicide.
• White males have had the highest increase in suicide, which rose 50 percent between 1970 and 1978. The incidence for white females increased 12 percent. Recent studies show suicide among young blacks is also a major problem.
• The ratio of male to female suicides is four to one. However, young women attempt suicide four times more frequently.
• Reports of suicide "clusters," in which one suicide appears to trigger several others within a group such as a school or community, have increased.

What You Can Do

Most people who are depressed or who are thinking about suicide don't or won't talk about how they are feeling. They feel worthless. They have no hope. They deny their emotions or think that talking about their emotions will be a "burden" on others because no one cares. Or they are afraid others will make fun of them.

That's understandable, because when someone mentions suicide, others may treat it as a joke or deny it. Those reactions only make the problem worse. So, if a friend or relative brings up the subject, take it seriously and take some time to talk about it.

• Reassure that person that he or she does have someone to turn to. Family, friends, school counselors, physicians or teachers are probably very willing to listen. It's just hard to know how to tell them we want to talk about something as serious as our emotions.
• Don't lecture or point out all the reasons a person has to live. Instead, listen and reassure the individual that depression and suicidal tendencies can be treated. Depressive disorders respond readily to treatments such as psychotherapy or appropriate medication. Antidepressants can act within two to three weeks and often are used in addition to psychotherapy. Nearly 90 percent of all depressed people respond to these treatments.
• You can find help by contacting your local chapter of the American Psychiatric Association, which can suggest a psychiatrist. Psychiatrists are physicians who have special training in emotional and mental health. Other sources include your local mental health association, your family physician, a county medical society, a local hospital's department of psychiatry, a community mental health center, a mood disorders program affiliated with a university or medical school, or a family service/social agency.

(c) Copyright 1988 American Psychiatric Association

Produced by the APA Joint Commission on Public Affairs and the Division of Public Affairs. This document contains the text of a pamphlet developed for educational purposes and does not necessarily reflect opinion or policy of the American Psychiatric Association.

Additional Resources

Anderson, Luleen S. Sunday Came Early This Week. Cambridge, Massachusetts: Schenkman, 1982.

Blumenthal, Susan and Kupfer, Davis. Suicide Across the Life Cycle. Washington, DC: American Psychiatric Press, Inc., 1990.

Bolton, Iris. My Son, My Son. Atlanta, Georgia: The Bolton Press, 1983.

Elkind, David. The Hurried Child: Growing Up Too Fast Too Soon. Reading, Massachusetts: Addison-Wesley, 1981. (Good for parents.)

Hewett, J.H. After Suicide. Philadelphia, Pennsylvania: Westminster Press, 1980. (Consoling book for suicide survivors.)

Hyde, Margaret O. and Elizabeth H. Forsythe. Suicide: The Hidden Epidemic. New York: Franklin Watts, 1987.

Klagsbrun, Francine. Too Young to Die: Youth and Suicide. New York: Pocket Books, 1984. (Good overview. Best on teenage suicide.)

Klerman, Gerald L. Suicide and Depression Among Adolescents and Young Adults. Washington, DC: American Psychiatric Press, Inc. 1986.

Madison, Arnold. Suicide and Young People. Boston: Clarion/Houghton Mifflin, 1981.

Mark, John E. and Holly Hickler. Vivienne: The Life and Suicide of an Adolescent Girl. New York: NAI Books, 1982.

McCoy, Kathleen. Coping with Teenage Depression: A Parent's Guide. New York: NAI Books, 1982.

Roy, Alec, editor. Suicide. Baltimore, Maryland: Williams and Wilkins, 1986.

Spillard, A. Grief After Suicide. Waukesha, Wisconsin: Mental Health Association of Waukesha County, Inc., no date. (Excellent pamphlet for suicide survivors. Send 50 cents to WMHA, 2220 Silvernail Rd., Pewaukee, WI 53072.

Weller, Elizabeth B., M.D. and Ronald A. Weller, M.D. Current Perspectives on Major Depressive Disorders in Children. Washington, DC: American Psychiatric Press, Inc. 1984.

Other Resources

Facts for Families series of fact sheets available through the American Academy of Child and Adolescent Psychiatry (see address below).

From Adina Wrobleski, Suicidologist: Afterwords, A Letter about Suicide and Grief. Adina Wrobleski, editor, Minneapolis, Minnesota. ($10 a year). A newsletter aimed at the public and busy professionals who want to keep abreast of the news on suicide, but don't have time for research and journal reading.

Organizations

American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Avenue, N.W.
Washington, DC 20016
(Please enclose a self-addressed, stamped envelope.)

American Academy of Pediatrics
141 Northwest Point Boulevard, P.O. Box 927
Elk Grove Village, Illinois 60007

American Association of Suicidology
2459 South Ash Street
Denver, Colorado 80222

The Compassionate Friends
P.O. Box 3696
Oak Bridge, Illinois 60522
(312) 323-5010
(For parents who have lost a child)

National Alliance for the Mentally Ill
1200 15th Street, N.W.
Washington, DC 20005

National Committee of Youth Suicide Prevention
666 Fifth Avenue, 13th Floor
New York, New York 10103
(212) 957-9292

National Depressive and Manic Depressive Association
P.O. Box 753
Northbrook, Illinois 60062

National Institute of Mental Health
5600 Fishers Lane
Rockville, Maryland 20857

National Mental Health Association
1021 Prince Street
Alexandria, Virginia 22314-2932