Teen Suicide: Understanding the Risks and Warning Signs

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In some age groups, suicide accounts for more deaths than cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and all the various chronic lung diseases combined.

According to the American Foundation for Suicide Prevention (AFSP) and the Centers for Disease Control and Prevention (CDC), after a period of some decline in between 1995 and 2001, teen suicide rates have been rising again. This has sounded alarm bells for suicide prevention researchers and activists whose efforts to increase public awareness about the problem and the factors that contribute to it were seen by many as largely responsible for the earlier rate decline. So while a lot has already been done to better inform the public about the signs and risk factors for suicide, it’s clear we’re not yet doing enough to help those whose whole life appears to lie before them from putting an end to it prematurely.

According to the National Institutes for Mental Health (NIMH), younger individuals comprise one of the higher risk groups for suicide. The risk is greatest among post-teen younger adults (ages 20-24), where the rates of suicide are almost twice that of teens aged 15-19. Still, for the 15-24 age group, suicide ranks as the third leading cause of death. (It’s the second leading cause of death in the 10-25 age group.) In fact, according to the National Alliance on Mental Illness (NAMI), in some recent surveys — including the CDC’s 2010 web-based survey (WISQARS) — suicide accounted for more deaths in this particular age group than cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and all the various chronic lung diseases combined. And one can only speculate about the proportion of fatal car crashes (the leading cause of death for teens and young adults), which often involve alcohol and drug use, which are at least in part influenced by the same underlying psychological stressors that so often predispose a person to suicide.

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As tragic as any suicide is, it’s even more tragic that it still occurs with such alarming frequency when there are so many avenues available for possible prevention. Suicide has long been known to be highly correlated with the presence of mental, behavioral, and substance abuse disorders of some type. In fact, most victims of suicide qualify for one or more mental disorder diagnoses. And most of these conditions are treatable. So it’s logical to assume that most suicides could be prevented if there were better general awareness about the warning signs that someone might be in need of professional help and if the appropriate intervention were secured in time.

According to NAMI, some of the most common signs that someone is in the kind of psychological distress that puts them at greater risk for self-harm include:

  • Extreme changes in personality
  • An apparent loss of interest in activities that used to be enjoyable
  • Significant changes in appetite or eating patterns
  • Difficulty falling asleep, waking early, or wanting to sleep all day
  • Loss of energy/feelings of fatigue
  • Feelings of worthlessness or guilt
  • Withdrawal from family, friends and usual activities
  • Neglect of personal appearance or hygiene
  • Sadness, moodiness, heightened irritability, or indifference
  • Difficulty concentrating or remembering things
  • Extreme anxiety or panic
  • Drug or alcohol use or abuse
  • Aggressive, destructive, or defiant behavior
  • Poor performance at school or other occupational endeavors
  • Bizarre behaviors and beliefs beliefs, paranoia, and hallucinations

Unfortunately, not all of the signs mentioned are always so easy to detect. Folks in distress and at risk for suicide are often good at masking their feelings and keeping their emotional pain private. But it’s also easy to inadvertently overlook indicators that are more clear and overt. A person’s troublesome behavior might come to the attention of others, but those observing the behavior might not make the connection between the behavioral “cry for help” and the person’s underlying psychological pain. And sometimes, even when a potential suicide victim has given the most glaring and direct indicators, such as mentioning they’ve been thinking about “ending it all” or perhaps even “threatening” or gesturing self-harm, the appropriate significance is not appreciated. It’s never safe to assume that someone might be doing or saying things or making gestures merely “to get attention” or “manipulating” for some other purpose. Self-destructive threats and gestures should always be taken seriously and reported to those who can help facilitate getting the person appropriate help. And when you suspect someone is harboring thoughts of self-harm, you shouldn’t be afraid to ask. Many fear that if they ask such direct questions, they’ll only give the person in distress “the idea” to actually do something self-destructive. But in fact, folks who are in a frame of mind where such ideas might be entertained don’t need anyone giving them the idea and many times they’ll honestly acknowledge when asked if indeed they have been having thoughts of hurting themselves or of taking their own life.

It’s well known that certain stresses can increase the immediate risk for self-harm. Bullying is one source of such stress, and I’ve written before on the correlation between bullying and suicide (see, for example “Cyberbullying: When Meanness Goes Online”). But there are other stressors, some of which are particularly common to adolescents, such as breaking up with a girlfriend or boyfriend; experiencing academic failure; dealing with family conflicts, separation, divorce, etc.; that also increase the risk of self-harm. And incarceration, for any reason, and even if only briefly, is a highly significant stressor and risk factor.

Most researchers agree that many factors contribute to the risk of suicide. And evidence is mounting that certain aspects of brain chemistry and hereditary factors play more important roles than we once thought. And while we now have many good medicines to help rectify brain chemical imbalances, unless the person receiving drug therapy has regular, ongoing medical supervision and care, and complies with that care, the risk of suicide might not be successfully mitigated and might even increase. While not all the causes of suicide are firmly known, two co-occurring factors appear nearly universal:

  • The person is in deep psychological pain, and
  • there appears no other escape route from this pain than putting an end to life.

Suicide is a very permanent solution to what is almost always a temporary problem. But the person experiencing the problem cannot see it as something temporary that can be eventually overcome.

After a suicide, friends and loved ones often question themselves about what they might have said or done differently to possibly help avert the disaster. Some struggle with feelings of guilt. Suicide’s impact never stops with the person who took his or her life. It affects everyone. That’s why it’s so important for all of us to heighten our awareness of those at greatest risk, to know the warning signs, and to have the courage to take appropriate action when we sense that someone might be in the kind of pain that could prompt them to take the ultimate escape route.

All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by on and was last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

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