The teen years are a time of tremendous potential and growth, but they can also be a very stressful period. This is especially true for youths who are struggling emotionally, mentally or socially.
Many youths think about and attempt suicide. When this happens, it’s important that families know the warning signs.
Causes
Adolescence is a time of intense emotional development. During this period, kids draw conclusions about themselves, others and God. When those conclusions are negative, a youth may be more likely to think about or attempt suicide.
Other risk factors include a previous suicide attempt, drug or alcohol use, disciplinary problems and involvement in high-risk behavior. A family history of mental illness increases the risk for teen suicide, as does a history of abuse and domestic violence.
A serious problem with adolescent suicide is that teens often have access to lethal weapons, such as firearms. Also, they often have easy access to drugs and alcohol that can depress the brain and disinhibit thinking. They can use these substances to escape their troubles temporarily but then they cannot solve those problems and may feel hopeless about their future. They may become addicted to the drugs or they may overdose and die. The risk of suicide rises with the level of dependency on drugs and alcohol.
Signs
Some teens have risk factors that increase their chances of suicide. They may be a victim of a suicide attempt in the past, or have a family history of depression, or a psychiatric disorder like bipolar or anxiety. They may also have alcohol or drug problems, get in trouble at school or with the law, or engage in high-risk behaviors. Other risk factors include a family history of violence, bullying and a lack of support from friends and family.
Teens can often hide their feelings or act differently, making it hard to know what they are going through. But a preoccupation with death, a sudden change in their personality or behavior, isolation from friends, withdrawal from activities they once enjoyed and poor school performance can be warning signs. Any talk of suicide or self-injury is a serious concern. Also, if they have access to lethal means like pills or firearms, they should be evaluated right away.
Treatment
The risk of suicide in young people is a complex matter. It is a result of interaction between biological, psychological and socio-cultural factors. Youths who have not developed good coping skills, who have major psychological or behavioural symptoms and who are living in unstable homes and families are more likely to commit suicide.
A person who has had suicidal thoughts or an attempt at suicide needs careful evaluation in hospital. They should not be discharged from the emergency department without a thorough clinical and laboratory assessment. The patient should be asked to provide a full account of events and their own account should be carefully checked. Be particularly wary of a sudden excessive elevation of mood in someone who was previously severely depressed. It may indicate that the person has finally decided to take their life. Also be wary of a youth who is grossly agitated, pacing the floor and breathing rapidly. This can be a sign of psychosis and may lead to self harm or attempted suicide.
Prevention
The prevention of youth suicide can involve community-based efforts including school gatekeeper training, general suicide education, screening programs, peer support programs and crisis centers or hotlines. Community-based organizations should also consider the social inequities that may impact their populations and design comprehensive intervention strategies.
Parents, teachers and others should be vigilant about sudden changes in a child’s mood or behavior. They should take warning signs seriously, especially if they involve self-harm or a plan to kill themselves. Signs include increased absenteeism, withdrawal from friends and activities, sleep problems, a change in appetite or sudden weight loss, erratic behaviors and drawings or writings that depict death or suicide.
It is important for friends of a suicidal youth to stay with them or make sure they are not alone at all times and to talk with an adult they trust about their friend’s behavior. It is also important to encourage the friend to seek expert help by calling a crisis hotline or going to a hospital emergency room for evaluation.