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Doc's Corner: Understanding and Preventing Adolescent Suicide: Part I 
December 12th, 2018

Adolescent suicide has become a national health crisis. Although it is difficult to talk about, and most of us would like to act like it doesn’t exist, knowing some of the causes, risk factors, and ways to get help can save tremendous distress, and even lives.

The Center for Disease Control (CDC) reports that it is the second leading cause of death among youth, ages 15-19. In 2016, 2,061 adolescent suicide deaths were reported, accounting for 18 percent of all reported deaths in this age group. Males are much more likely to die by suicide, by almost three times as much as females. While females have higher incidence of suicidal ideation and behavior, males are more likely to carry out the acts. Almost 20 percent of teenagers have contemplated suicide in the last year.

The causes and risk factors of suicidal thoughts and behaviors are a combination of biological, psychological, and environmental factors. Mental health issues are clearly related to such thoughts. 20 percent of youth have a significant mental health issue, including depression and bipolar disorder which are most commonly associated with suicidal threat. Other psychological disorders are also related, including anxiety, conduct disorders, substance abuse, post-traumatic stress, and eating disorders. When these problems are combined with external circumstances for teens, they often feel overwhelmed. Interpersonal losses, disciplinary problems, school failures, conflicts with peers, and bullying can lead to a sense of hopelessness. Adverse Childhood Events (ACE) and significant and serious family issues, like physical and sexual abuse, are high risk factors. Children who have gender identity or sexual identity conflicts are at high risk, with LBGT adolescents having the highest rates of suicidal ideation. Suicide is a relatively rare event, and difficult to predict, but there are some warning signs. As listed by the American Psychological Association, these include:

  • Talking about dying or suicide: Any mention of such thoughts should always be taken seriously, and evaluated.
  • Recent loss: Including death, divorce, separation, break up
  • Change in personality: withdrawn, anxious, irritable, indecisive, apathetic (Note: These can be indicators of problems other than suicidal thinking).
  • Change in behavior: can’t concentrate, perform routine tasks
  • Change in sleep patterns: insomnia, too much sleep
  • Fear of losing control: acting in erratic or self-harming ways
  • Low self-esteem: feeling worthless, shame, guilty, self-hatred
  • No hope for the future: sense of hopelessness and no ability to see things getting better
  • Inability to experience pleasure: especially from events which used to be fun
  • Giving away prized possessions
  • Prior suicide attempts
  • Increased drug or alcohol use
  • Preoccupation with death and dying

I know that the issue is overwhelming and daunting. Knowing the risk factors and recognizing warning signs can definitely reduce acting out. In the next article, Part II, I will discuss preventive measures parents can take, as well as specific actions to take if you have concerns. The most important is to take all verbalizations or signs as very serious, and to immediately seek professional, therapeutic evaluation and help. Thinking that these thoughts will pass is not a good strategy. Proper assessment and treatment is essential. If you have concerns, do not be afraid to talk to your children, and ask them how they feel. Parents sometimes think that bringing up these issues can put thoughts in their children’s heads – instead, it is a message and assurance that someone cares, and will give them the opportunity to talk about their problems.

Remember, if you have issues you would like to see addressed, please email me at askdrgelbart@gmail.com.

Moe Gelbart, Ph.D. 
Executive Director, Thelma McMillen Center