Dr. Richard O'Connor
(860) 364-9300

Teen Suicide

A continued rise in teen suicide rates is concerning mental health professionals, educators, and youth workers. In the past 25 years, while the general incidence of suicide has decreased, the rate for those between 15 and 24 has tripled. It is generally considered to be the second or third most common cause of death among adolescents, even though it is seriously underreported. 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.
No talk of suicide should be taken lightly. It indicates the need for professional help. Any suicidal gesture, no matter how "harmless" it seems, demands immediate professional attention.
Indicators of developing depression in adolescents include:
• Unhappiness
• Gradual withdrawal into helplessness and apathy
• Isolated behavior
• Drop in school performance
• Loss of interest in activities that 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

More 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

A recent article by Jane Brody in the New York Times summarized research describing the major risk factors of suicide among young people:
1. Depression — often not recognized. In younger children and in adolescent boys, it often seems to be 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.
2. 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.
3. Behavioral problems — getting in trouble in school or with the law, fighting with parents — 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.
4. 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.
5. Previous attempts. Half of all children who have made one suicide attempt will make another, sometimes as many as two a year until they succeed.

 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. 

Depression can usually be treated effectively and efficiently once it's recognized. 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.

November 2, 2011

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Undoing Depression

Dr. Richard O'Connor maintains an office in Sharon, Connecticut. Call 860-364-9300 or email rchrdoconnor@gmail.com to arrange an initial consultation.