Adolescence is a time of significant emotional, mental and social change. It can bring a wide variety of challenges, including depression and suicide.
If your teen talks about suicide, take it seriously. Help them find treatment and support. Safely store all medicines, firearms and lethal chemicals. Provide a secure environment and check in frequently with them.
Risk factors
As adolescents move through a time of significant cognitive, mental, emotional and social change, they may be vulnerable to developing psychosocial stressors that can lead to suicide. These factors can be related to medical, physical or life changes; having a family history of mood disorders, depression or suicide; or the impact of negative experiences like sexual or other types of abuse or violence, bullying, or relationship problems.
Risk factors also include having access to suicide means such as pills or a gun, having a previous history of suicidal thoughts or attempts, and a history of depression, anxiety or other mood disorders. Teens who are bullied at school or who have a close friend who has committed suicide are also at increased risk for suicidal behavior.
Some studies have shown that family conflict, especially a strained parent-child relationship, can be a risk factor for suicide. Additionally, having a family member who has incarcerated or died by suicide is associated with a higher risk of suicide in youths.
Symptoms
A teen’s thoughts and actions can be caused by acute stress or from chronic depression. Symptoms include major mood changes, thoughts of suicide or death, a change in school performance, impulsive behavior, drug and alcohol abuse and self-destructive behaviors such as running into traffic, cutting or burning oneself or writing messages in a journal or on a social media site.
Youths may also try to numb or escape their problems by using drugs and alcohol which are not only depressants but can cause hallucinations. This numbing or clouding of the conscious state can lead to a suicide attempt as the youth becomes lost in his/her emotions and lacks control of their choices.
Often the suicide rate is influenced by events such as a friend or relative’s suicide, bullying and/or rejection, poor relationships with family members and/or school and work pressures. In addition, suicides are more common among those of lower socioeconomic status. Warning signs for suicide can be missed if a parent is not attentive to the child or teen’s feelings and behavior.
Treatment
There is much that can be done to prevent suicide among youths. Pediatric health clinicians, community mental health providers, school administrators, teachers and staff, coaches, club and other extracurricular activity leaders, family members and friends, and others can play a role in recognizing and responding to warning signs such as talking about or making a suicide plan; serious depression with hopelessness; frequent complaining of physical symptoms; becoming preoccupied with dying and giving away prized possessions; withdrawal from social activities and a decline in interest in hobbies; and sleep disturbances.
Treatments include psychotherapeutic strategies with demonstrated benefits in reducing suicidal thoughts and behaviors and effective medication treatments for disorders associated with suicide risk. Screening programs that identify high-risk adolescents and young adults are essential and should be used in combination with interventions to address risk factors (e.g., promoting self-esteem and teaching stress management; developing peer support networks; restricting access to lethal means). There are also a number of suicide cluster prevention programs that target friends and families of those who have died by suicide or attempted it.
Prevention
The good news is that much is known about the prevention of youth suicide. The main focus is on reducing the risk factors that increase the chance of a suicide attempt or death. These include:
A stable physical and emotional home environment. This includes good family communication and a safe space for youth to express their emotions without fear of punishment. Access to psychiatric treatment.
A healthy social network. This includes supportive peers, a sense of belonging, and active engagement in the community. A safe and secure workplace or school. This includes clear policies that prohibit bullying and harassment. A well-trained and caring gatekeeper – such as a teacher, parent, coach or activity leader – who can recognize warning signs and respond effectively. Training includes implementing responsible media reporting, educating about the impact of culture on suicide and developing skills to support coping and help-seeking behaviors. Postvention interventions also need to include a suite of services and ensure ongoing options.