Teen Depression & Suicide
Teenagers are a vulnerable group. They experience tremendous pressure from all sides: from inside their changing bodies, from their parents, from their schools and from their peers. No one can be perfect in every area and so everyone is doing poorly in something. But teenagers can feel isolated with their failures and setbacks, lacking the perspective that older people have that “we’re all in this together.” Teenagers are intent on fitting in, looking good, being acceptable. If the only group they can fit into is a violent, drug-ridden street gang, then that’ll be the group they might very well join, especially if they have little support elsewhere or few sources of success and strength. Because the pressure is so intense, many teens do not cope well. Their survival strategies depend to a large extent on their genetic make-up and the strategies they learn at home. Some teenagers have “hardy” genes that help them survive and thrive under stressful conditions. They can laugh their way through almost anything or simply tough it out. Others, however, have anxious genes. Under stress they may worry, have trouble sleeping, have an intensification of earlier signs of OCD (obsessive-compulsive disorder), develop panic attacks or have an aggravation of nervous habits and tics, among other symptoms. Some kids are genetically fine, but they lack stress-management strategies. This group may explode in rage when feeling pressured or turn to drugs, alcohol or other substances to soothe their nerves. (There may be a genetic basis to those who actually become addicted to substances.) Then there is the group that carries depression genes. When the stress is poured on, this group may experience mild, moderate or severe depression, depending on the combination of genes, family characteristics, available social support and personal coping mechanisms.
Depressed teens are a group of particular concern because these kids may actually try to resolve their pain with suicide. Not all depressed teens are suicidal. However, all depressed teens need help in order to learn to manage bouts of depression throughout the lifespan. Teen depression is not just adolescent moodiness. It is a mental illness. Even when depression doesn’t lead to suicidal behavior, it can cause other problems. For example, academic performance may drop sharply. The youngster may try to self-medicate with cutting or other forms of self-mutilation or using drugs or alcohol. Depressed teens are more at risk for eating disorders, internet addiction and running away from home. In some cases, they may become violent. Untreated depression is a painful condition even if it doesn’t lead to dangerous or dysfunctional behavior. In susceptible people, it will recur during periods of stress unless the sufferer knows techniques that reduce stress, prevent depression or resolve it rapidly.
Symptoms of Depression:
If a child has several of the following symptoms, a professional assessment for depression may be in order:
• sudden weight loss without dieting
• sudden weight gain
• withdrawal from some people (not necessarily all)
• change in sleep habits (more or less than previously)
• lack of pleasure in anything or any activity
• difficulty making decisions or concentrating
• persistent sadness or hopelessness
• agitation, restlessness
• irritability or hositility
• chronic fatigue
• feelings of worthlessness, inadequacy
• sensitivity to criticism
• feelings of guilt
• thoughts/discussion about suicide.
Teens are very focused in the present. They have trouble imagining that in a few years life can improve tremendously. Their impulsivity can lead them to put an end to it all right now because they just can’t see any way out. Teens who know other teens who’ve committed suicide are at a higher risk for this behavior. Also, teens who have a family history of mental illness and suicide are more likely candidates for this “solution” as are teens who have clinical depression or who suffer from active addiction. Teens who’ve already made a suicide attempt have a higher chance of committing suicide successfully. Vulnerable teenagers who suffer a serious loss (like the breakup of a romantic relationship) may try to stop the pain with suicide. A history of physical or sexual abuse, incarceration, alienation from parents and refusal to access mental health services all increases suicidal risk. Males have a higher “success” rate for suicide than females, but females make many more suicide attempts than do males. Although no one can reliably predict suicide, there are warning signs that parents should take seriously and follow up with. According to the American Academy of Child and Adolescent Psychiatry these signs are:
• change in eating and sleeping habits
• withdrawal from friends, family, and regular activities
• violent behavior or running away
• substance abuse
• neglect of personal grooming
• personality change
• difficulty concentrating, persistent boredom
• drop in academic performance
• marked personality change
• frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
• loss of interest in pleasurable activities
• Speaking positively about death or romanticizing dying (“If I died, people will appreciate me more.”)
• Writing about death, dying, or suicide.
• Engaging in reckless or dangerous behavior; being injured frequently in accidents.
• Giving away or discard favorite possessions.
• Saying permanent sounding goodbyes to friends and family
• Seeking out weapons, pills, or other lethal tools
A teenager who is planning to commit suicide may also:
• complain of being a bad person or feeling rotten inside
• give verbal hints with statements such as: I won’t be a problem for you much longer, Nothing matters, It’s no use, and I won’t see you again
• become suddenly cheerful after a period of depression
• have signs of psychosis (hallucinations or bizarre thoughts)
The Academy recommends taking a child’s suicidal statements seriously. If a child or adolescent says, “I want to kill myself,” or “Im going to commit suicide,” ask him what he means. Don’t be afraid of saying the word “suicide.” You won’t be giving the teen an idea that he hadn’t thought about. Instead, you’ll help her think things through. Ask about depression, anxiety and unhappiness. Don’t just tell the child “not to talk that way.” In addition, seek assistance from a qualified mental health professional.
Helping Teens with Depression:
True depression is a physical disorder, not just a psychological one. It is not a matter of bad attitude or lazy thinking. Rather, under certain situations, sensitive genes lead to a profound disturbance in pleasure centers in the brain. When this occurs, both physical and psychological treatment yields the most successful recovery. Physical treatments may be medical and/or naturopathic. When a teenager is suffering a deep clinical depression, professional treatment is essential. Good parenting techniques always help but cannot, in and of themselves, cure depression. Even medical help cannot always prevent suicide—ultimately mental illness sometimes has lethal consequences. However, there are many things that parents can do to help prevent episodes of depression and help create a healing environment when depression does occur. Parents can help buffer teens from stress by keeping the doors of communication open. Make it easy for your kids to talk to you. Keep criticism to a minimum; instead, give praise and positive feedback generously. Have fun with your teenager and try to make your home pleasant, comfortable and safe. Keep conflict down with your spouse. Avoid drama. Take care of yourself and create a healthy model of stress management strategies for your kids to learn from. Create a positive atmosphere. Have a dinner table several times a week and use it to have discussions on politics, human nature, interesting things in the news or whatever—keep talking with your kids. Make your values clear.
Bring tradition and ritual into your home. Accept all feelings without correction or disapproval. Ask for behavioral change gently and respectfully. Never yell at your teenager. Never insult, name call, use sarcasm or any other form of verbal abuse. Instead, be sensitive to your teen’s feelings at all times. Discipline when necessary but only after you’ve warned a child that discipline will occur and only with mild discipline—never affecting the teen’s social life (see Raise Your Kids without Raising Your Voice for safe and effective ways of guiding teenagers). If your teen demonstrates any of the symptoms of depression or suicidality, talk to him or her about what you are observing and arrange an appointment with a mental health professional.