Once again the recent holidays were pierced by the tragedy of a local high school senior who died by suicide. Having taken pills, she went to sleep. Her parents were sleeping in the next room. She never woke.
The reality of this type of event is horrifying. Pain and grief reverberate on every level of the community. There are always unanswered questions that haunt family, friends, school and community connections. The unthinkable has happened. Any parent, if only for a moment, dares to ask, “Could My Teen Commit Suicide?”
The Society for the Prevention of Teen Suicide (SPTS) would say that if that question motivates parents to learn more about the warning signs of suicide, find to a way to speak to their teens, and reach for help– it might be one of the most important questions they consider.
- Suicide is the third leading cause of death in teens.
- While suicide is not a common event for most teens, one study found that 20% of high school teens admit to thinking about suicide.
- The National Institute of Mental Health believes that there may be as many as 25 attempted suicides for every teen who dies by suicide.
- Nearly 1 in 10 drug-related hospital emergency department visits are made by adolescents involved in suicide attempts – with females making more than 72 percent of these attempts.
- Whereas more girls than boys attempt suicide, more boys actually commit suicide (nearly 5 times as many boys between the ages of 15-24 died by suicide than girls). It is uncertain if boys use more lethal means or if for boys suicide is beyond “a cry for help.”
- In one year almost 3.000,000 teens in the US attempted or seriously considered suicide (SAMHSA, 2002).
The frightening reality is that attempting suicide is one of the strongest predictors for completed suicide.
What Are the Warning Signs?
While most parents of teens are at some point put on a “need to know basis” by their youngsters, the warning signs of suicide are often reflected across a number of dimensions in a teen’s feelings and behavior. The Society for Prevention of Teen Suicide uses the Acronym “FACTS” as a guide for keeping possible warning signs in mind: F (Feelings), A (Actions), C (Changes in Patterns), T (Threats) and S (Situations).
Feelings- Untreated depression is considered the single most significant risk factor for completed suicide in adolescents. A teen may express depression in feelings of sadness, lethargy, hopelessness, loneliness, guilt, shame, anxiety or worry. Often there is an expression of self-deprecation and self-condemnation – “I’ll always be a loser.”
Actions- The behavior of teens is important to consider because depression in teens is often masked by use of drugs and alcohol as well as “acting out” behavior. This can show as irritability, cutting and school problems, risk taking behavior, promiscuity, defiance of curfews or parental requests. Too often the teen’s provocative behavior trips cycles of fighting and animosity between parent and teen creating distance – “Just leave me alone – Get off my back!”
Changes– In some ways no one knows their teen like the parent. Changes in personality and day to day patterns of sleeping, eating, involvement with friends, interest in activities, and sudden elation after being depressed are signs that warrant attention.
When one mother heard that her college freshman son had quit the soccer team and was unhappy with his roommates — she got into her car and drove 4 hours to see him.
Threats–Any verbalized or veiled threat – “Who cares if I’m dead or alive, anyway?” – said directly, posted on face book, sent as emails or sudden interest in death and dying in the news, removal of prescription medication from its usual spot etc., cannot be ignored.
Situations of Risk– there are certain situations that may jeopardize a teen’s coping capacity and increase the chances of feeling there is no solution – no way to stop the pain. These can include:
- Prior Suicide Attempt
- Bullying and Cyberbullying ( the warning signs of bullying and suicide go hand in hand)
- Gay, Lesbian, Transgendered Youth ( victimization and bullying, fear of family reactions, shame, or guilt with lack of support)
- Exposure to the Suicide of a Close Friend or School Peer
- Family History of Suicide
- Death of a Parent or Sibling
How Does a Parent Respond to Warning Signs?
Speak With Your Teen
Spend time and share your love, concerns and your wish to help –
- “I know we have been yelling at each other lately but it dawned on me that you have been struggling. I almost missed it. I want to help…”
- “I notice that you haven’t been sleeping. That happens to me when I’m worried or upset. Are you feeling that way some nights?…”
Don’t be Afraid to Ask about Suicide
Speaking about suicide does not plant the idea. Kids know about suicide from suicidal peers as well as the media. They just may not know how to speak about it. Dr. Maureen Underwood, author of Lifelines: A Suicide Prevention Program reports that in 30 years of training in suicide prevention there has never been a case of planting the ideas. There are not only numerous examples of research and intervention without harm; but examples of kids who have saved other kids by learning to speak about suicide to parents and teachers.
As one mother said to me “I had to ask him if he was suicidal because if he was – he would have been left alone with it.”
Act on What You Hear
If you think your child is actively suicidal or can be – bring him/her to an emergency room. In addition you and your child can get help and resources from organizations like the American Foundation of Suicide Prevention,The National Suicide Prevention Lifeline (1-800-273-TALK (8255) and The Society for the Prevention of Teen Suicide. Often the school or family physician can also steer a parent in the direction of local professionals and resources.
Just as intolerable emotional pain, depression and acting out patterns do not emerge in a day – such feelings don’t disappear in a day. It takes “ staying connected” – changing plans to be home with teens, driving together to stay connected each morning, touching base for an evening snack, going together to therapy, seeking help to stop or address bullying, etc. to find the time and words needed between a parent and a teen. In this regard, think of it as joint or combined effort to support the reasons to live.
One father sensing that his son could not find a way to tell him that he was gay, asked if they could both come to speak about it in my office. The father feared that they were arguing because they really were tense about talking. They worked together to find the words to explain and accept each other.
Support Teen “Buddy Care”
Much like other insider groups, be they uniformed services or military, teens can often have a code of silence that keeps adults “out of the loop.” One way to protect your own teen as well as their friends is to speak with them about the warning signs of suicide and inform them of their power to protect each other.
Teens are often more eager to help each other than themselves. Central to teen suicide prevention is a teen’s recognition that telling you or another adult about their friend’s desperation or suicide attempt doesn’t betray a friend – it saves a life.
The Protective Factors
In suicide assessment, protective factors are the presence or existence of reasons for living. They can include social support, self-esteem, spirituality, proper treatment and the assets that your teen can’t quite see about himself/herself. As a parent you are an invaluable part of this protection.
With a teen who is depressed and unable to see straight – you too can feel like you are walking in the dark without a lighted way. The best that you can do is get help, hold on to hope and hold on to your teen with all your heart.