What is teenage suicide?

Introduction

The statistics on teenage suicide are shocking. Suicide is the fifth leading cause of death for those under age fifteen, and it is the second leading cause of death for those ages fifteen to twenty-four.

In 1960, the suicide rate among fifteen- to nineteen-year-olds was 3.6 per 100,000. By 1990, 11.1 out of every 100,000 teenagers fifteen and older committed suicide, according to the US Centers for Disease Control and Prevention (CDC). In 1997, about 9 percent of suicides in the United States were committed by people aged nineteen or younger. Suicide rates declined between 1990 and 2000, but rose back to their previous levels between 2000 and 2010. Perhaps even more disturbing are the statistics regarding the classification of attempted suicides. Although it is difficult to determine accurately, it is estimated that for every teenager who commits suicide there are approximately fifty teenagers who attempt to take their own lives. A nationwide survey by the CDC found that 16 percent of high school students had seriously considered suicide.

Females attempt suicide at higher rates than males but are less likely to succeed. Males are much more likely to use violent and lethal methods for trying to kill themselves, such as shooting or hanging. Females are more likely to use passive means to commit suicide; the use of drugs and poisons, for example, is more prevalent among females than males. Culture can also affect suicide rates, with the CDC's study finding that Native American, Alaskan Native, and Hispanic youth were more likely to report attempting suicide than their African American and white peers.

As alarming as these facts may be, it should be noted that suicide is still rare among the young. Nevertheless, preventing suicide would save thousands of adolescent lives each year. The problem of suicide is complex, and studying it has been especially difficult because suicidal death is often denied by both the medical professional and the victim’s family. The whole subject of suicide is carefully avoided by many people. As a result, the actual suicide rate among adolescents may be significantly higher than the official statistics indicate.

Contributing Factors

There are no simple answers to explain why adolescents attempt suicide, just as there are no simple solutions that will prevent its occurrence; however, researchers have discovered several factors that are clearly related to this drastic measure. These include family relations, depression, social interaction, and the adolescent’s concept of death.

Family factors have been found to be highly correlated with adolescent suicide. A majority of adolescent suicide attempters come from families in which home harmony is lacking. Often there is a significant amount of conflict between the adolescent and his or her parents and a complete breakdown in communications. Many suicidal youths feel unloved, unwanted, and alienated from the family. Almost every study of suicidal adolescents has found a lack of family cohesion.

Most adolescents who attempt suicide have experienced serious emotional difficulty prior to their attempt. For the majority, this history involves a significant problem with depression. The type of chronic depression that leads some adolescents to commit suicide is vastly different from the occasional “blues” most people experience from time to time. When depression is life-threatening, adolescents typically feel extremely hopeless and helpless and believe there is no way to improve their situation. These feelings of deep despair frequently lead to a negative self-appraisal in which the young person questions his or her ability to cope with life.

Further complicating the picture is the fact that clinically depressed adolescents have severe problems with relating to other people. As a result, they often feel isolated, which is a significant factor in the decision to end one’s life. They may become withdrawn from their peer group and develop the idea that there is something wrong with society. At the same time, they lack the ability to recognize how their inappropriate behavior adversely affects other people.

Another factor that may contribute to suicidal thoughts is the adolescent’s conception of death. Because of developmental factors, a young person’s cognitive limitations may lead to a distorted, incomplete, or unrealistic understanding of death. Death may not be seen as a permanent end to life and to all contact with the living; suicide may be viewed as a way to punish one’s enemies while maintaining the ability to observe their anguish from a different dimension of life. The harsh and unpleasant reality of death may not be realized. Fantasy, drama, and “magical thinking” may give a picture of death that is appealing and positive. Adolescents’ limited ability to comprehend death in a realistic manner may be further affected by the depiction of death in the songs they hear, the literature they read, and the films they watch. Frequently death is romanticized. Often it is presented in euphemistic terms, such as “gone to sleep” or “passed away.” At other times it is trivialized to such an extent that it is the stimulus for laughter and fun. Death and violence are treated in a remarkably antiseptic fashion.

Prevention Attempts

Suicide is a tragic event for both the victim and the victim’s family. It is also one of the most difficult problems confronting persons in the helping professions. In response, experts have focused their attention on trying to understand better how to prevent suicide and how to treat those who have made unsuccessful attempts to take their own lives.

It is believed that many suicides can be prevented if significant adults in the life of the adolescent are aware of various warning signals that often precede a suicide attempt. Most adolescents contemplating suicide will emit some clues or hints about their serious troubles or will call for help in some way. Some of the clues are easy to recognize, but some are very difficult to identify.

The adolescent may display a radical shift in characteristic behaviors related to academics, social habits, and relationships. There may be a change in sleeping habits; adolescents who kill themselves often exhibit difficulty in falling asleep or maintaining sleep. They are likely to be exhausted, irritable, and anxious. Others may sleep excessively. Any deviation from a usual sleep pattern should be noted. The individual may experience a loss of appetite with accompanying weight loss. A change in eating habits is often very obvious.

A pervasive feeling of hopelessness or helplessness may be observed. These feelings are strong indicators of suicide potential. Hopelessness is demonstrated by the adolescent’s belief that his or her situation will never get better. It is believed that current feelings will never change. Helplessness is the belief that one is powerless to change anything. The more intense these feelings are, the more likely it is that suicide will be attempted. The adolescent may express suicidal thoughts and impulses. The suicidal adolescent may joke about suicide and even outline plans for death. He or she may talk about another person’s suicidal thoughts or inquire about death and the hereafter. Frequently, prized possessions will be given away. Numerous studies have demonstrated that drug abuse
is often associated with suicide attempts. A history of drug or alcohol abuse should be considered in the overall assessment of suicide potential for adolescents.

A variable that is often mentioned in suicide assessment is that of recent loss. If the adolescent has experienced the loss of a parent through death, divorce, or separation, he or she may be at higher risk. This is especially true if the family is significantly destabilized or the loss was particularly traumatic. A radical change in emotions is another warning sign. The suicidal adolescent will often exhibit emotions that are uncharacteristic for the individual. These may include anger, aggression, loneliness, guilt, grief, and disappointment. Typically, the emotion will be evident to an excessive degree.

Any one of these factors may be present in the adolescent’s life and not indicate any serious suicidal tendency; however, the combination of several of these signs should serve as a critical warning and result in some preventive action.

Treatment

The treatment of suicidal behavior in young people demands that attention be given to both the immediate crisis situation and the underlying problems. Psychologists have sought to discover how this can best be done. Any effort to understand the dynamics of the suicidal person must begin with the assumption that most adolescents who are suicidal do not actually want to die. They want to improve their lives in some manner, they want to overcome the perceived meaninglessness of their existence, and they want to remove the psychological pain they are experiencing.

The first step in direct intervention is to encourage talking. Open and honest communication is essential. Direct questions regarding suicidal thoughts or plans should be asked. It simply is not true that talking about suicide will encourage a young person to attempt it. It is extremely important that the talking process include effective listening. Although it is difficult to listen to an individual who is suicidal, it is very important to do so in a manner that is accepting and calm. Listening is a powerful demonstration of caring and concern.

As the adolescent perceives that someone is trying to understand, it becomes easier to move from a state of hopelessness to hope and from isolation to involvement. Those in deep despair must come to believe that they can expect to improve. They must acknowledge that they are not helpless. Reassurance from another person is very important in this process. The young person considering suicide is so overwhelmed by his or her situation that there may seem to be no other way of escape. Confronting this attitude and pointing out how irrational it is does not help. A better response is to show empathy for the person’s pain, then take a positive position that will encourage discussion about hopes and plans for the future.

Adolescents need the assurance that something is being done. They need to feel that things will improve. They must also be advised, however, that the suicidal urges they are experiencing may not disappear immediately and that movement toward a better future is a step-by-step process. The suicidal young person must feel confident that help is available and can be called on as needed. The adolescent contemplating suicide should never be left alone.

If the risk of suicide appears immediate, professional help is indicated. Most desirable would be a mental health expert with a special interest in adolescent problems or in suicide. Phone-in suicide prevention centers are located in virtually every large city and many smaller towns, and they are excellent resources for a suicidal person or for someone who is concerned about that person. To address long-term problems, therapy for the adolescent who attempts suicide should ideally include the parents. Family relationships must be changed to assist the young person in feeling less alienated and worthless.

Suicidal Personalities

Suicide has apparently been practiced to some degree since the beginning of recorded history; however, it was not until the nineteenth century that suicide came to be considered a psychological problem. Since that time, several theories that examine the suicidal personality have been developed.

Émile Durkheim
was one of the first to offer a theoretical explanation for suicidal behavior. In the late nineteenth century, he conducted a now-classic study of suicide and published a book, Le Suicide: Étude de sociologie (1897; Suicide: A Study in Sociology, 1951). He concluded that suicide is often a severe consequence of the lack of group involvement. He divided suicide into three groupings: egoistic, altruistic, and anomic suicides.

The egoistic suicide is representative of those who are poorly integrated into society. These individuals feel set apart from their social unit and experience a severe sense of isolation. He theorized that people with strong links to their communities are less likely to take their lives. Altruistic suicide occurs when individuals become so immersed in their identity group that group goals and ideals become more important than their own lives. A good example of this type of suicide would be the Japanese kamikaze pilots in World War II: They were willing to give up their lives to help their country. The third type, anomic suicide, occurs when an individual’s sense of integration in the group has dissolved. When caught in sudden societal or personal change that creates significant alienation or confusion, some may view suicide as the only option available.

Psychologists with a psychodynamic orientation explain suicide in terms of intrapsychic conflict. Emphasis is placed on understanding the individual’s internal emotional makeup. Suicide is viewed as a result of turning anger and hostility inward. Sigmund Freud discussed the life instinct versus the drive toward death or destruction. Alfred Adler believed that feelings of inferiority and aggression can interact in such a way as to bring a wish for death to punish loved ones. Harry Stack Sullivan viewed suicide as the struggle between the “good me,” “bad me,” and “not-me.”

Other areas of psychology offer different explanations for suicidal behavior. Cognitive psychologists believe that suicide results from the individual’s failure to use appropriate problem-solving skills. Faulty assessment of the present or future is also critical and may result in a perspective marked by hopelessness. Behavioral psychologists propose that past experiences with suicide make the behavior an option that may be considered; other people who have taken their lives may serve as models. Biological psychologists are interested in discovering any physiological factors that are related to suicide. It is suggested that chemicals in the brain may be linked to disorders that predispose an individual to commit suicide.

Research in the area of suicide is very difficult to conduct. Identification of those individuals who are of high or low suicidal risk is complex, and ethical considerations deem many research possibilities questionable or unacceptable. Theory construction and testing will continue, however, and the crisis of adolescent suicide demands that research address the causes of suicide, its prevention, and treatment for those who have been unsuccessful in suicide attempts.

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