Teen Suicide - The Unknown Epidimic
Every year, thousands of youth die in the United States, not by cancer, car
accidents, and other diseases, but by their own hand. These people make the choice that
they want to die and they take there own life. Suicide, the term given to the act of killing
oneself, is the third leading cause of death among people that are 15 to 25 years of age. It
is estimated that 500,000 teenagers try to kill themselves during the course of one year.
During the adolescent years, normal teenagers experience strong feelings of stress,
confusion, self-doubt, pressure to succeed, financial uncertainty, and other fears while
growing up. These feelings in themselves are not harmful, but normal. However those who
can not handle these situations are ones that are prone to suicide. Many people believe
that suicides are isolated incedents, but they are far from that. Suicide among teenagers is
indeed an epidimic that should be focused on and dealt with immediately. This essay will
focus on the causes of suicide, the signs of a person that is suicide prone, and what one
should do for a person who may be a target for suicide.
The main two causes for teen suicide is the mental disease of depression and family
problems. 90% of teen suicide victims have at least one diagnosable, active psychiatric
illness at the time of death, which is most often depression, substance abuse, or behavior
disorders. Only 33-50% of victims was known by their doctors as having a mental illness
at the time of their death, and only 15% were in treatment at the time of death. The
pressures of modern life are greater these days and competition for good grades and
college admission is difficult, which are extra stressors on already unsure teens. Some even
think it's because there is more violence in the media. Lack of parental interest may make
them feel alone and anonymous. They believe that their parents don't understand them and
when they try to express their feelings they feel that their parents either denied or ignored
their attempt to communicate feelings of unhappiness, frustration, or failure. Many
children grow up in divorced households or both parent's work and their families spend
little time together. Even the threat of AIDS is a factor that contributes to higher suicide
rate. Stressful life events, such as the loss of an important person or school failure, often
encourages suicides. People who have worked with depressed teens see a common pattern
of unhappiness, feelings of inner disturbance, chaos, low self-worth, hopelessness and
anger. Suicidal teens generally feel that their emotions are played down, not taken
seriously, or met with opposition by other people, but it should always be taken seriously.
Those who believe in the finality of death (i.e., that there is no after-life), are the ones
who advocate suicide and regard it as a matter of personal choice. On the other hand,
those who firmly believe in some form of existence after death on earth, condemn suicide
and judge it to be a major sin. However, there are ways of watching for warning signs of a
suicidal person and depression.
Some noticeable signs that are prevalent among people thinking about suicide are
talking about suicide, statements about hopelessness, helplessness, or worthlessness. They
may have a obsession with death or suddenly become happier and calmer. They have a
loss of interest in things they usually care about. They might stop visiting or calling people
that they care about. They even start making arrangements or putting their affairs in order
and give away their things. Teens should learn that with treatment, depression ends, but
someone who is experiencing deep depression might not be able to think about that. They
can't see the way out of the problem and think suicide is the only choice.
Some hotlines, and web sites that help with people are Counselors Counseling,
Teen Suicide Help, and there are many others that exist. These people who work for these
hotlines, and the counselors out there are educated to help people who are suffering
from deep depression, and suicide. They don't even have to be suicidal...they might just
This article delves into the unpleasant subject of youth suicide. Issues related to childhood suicide are introduced, including elements of Piaget's developmental theory, myths surrounding childhood suicide, childhood depression and other pre-emptive characteristics of suicide, as well as a potential treatment option (i.e., play therapy). After segueing into the subject of adolescent suicide, Piaget's theory is once again broached by highlighting a concept known as adolescent egocentrism, and its corresponding manifestations (e.g., imaginary audience, the personal fable). Predisposing factors that contribute toward teen suicide and a brief commentary on treatment are included. Finally, gender-related matters are covered, including statistical information and a gender-identity theory, which correlates "event centered" stage of development with suicide.
Keywords Adolescent Egocentrism; Event-Centered Stage of Development; Imaginary Audience; Personal Fable; Piaget's Developmental Stages; Play Therapy; Childhood Suicide
Suicide is a disquieting reality that afflicts many young people—making it the third leading cause of death (according to the National Institute for Mental Health) for people between the ages of fifteen and twenty-four in 2007. The National Institute for Mental Health indicates that in 2007, per 100,000 people, suicide deaths account for .9 children between the ages of 10 and 14, 6.9 teenagers between the ages of 15 and 19, and 12.7 young adults between the ages of 20 and 24. Bereaved family members who survive these permanent, self-inflicted tragedies are left to scrutinize over the emotionally agonizing and mystifying details that contributed toward their child's untimely demise. Therefore, research and clinical professionals are often bewildered by child suicide cases. Perhaps one of the reasons why childhood suicide is underestimated relates to the romanticized notion people tend to extend toward childhood itself. Most people view childhood as a carefree, buoyant existence brimming with promise, possibility, endless play dates, and accompanied by the creation of naïve, imaginative fantasies with very few pragmatic responsibilities to shoulder.
Piaget's Stages of Development
Additionally, many people deem childhood suicide as cognitively unfeasible, given that the brain is still in the process of developing and cannot comprehend concepts that are categorically irrevocable, let alone contrive such destructive schemes. For example, according to renowned child psychologist Jean Piaget, children in the preoperational stage of development (i.e., ages 2-7) are still unable to grasp certain intellectual principles such as reversibility and decentration (Burger, 1991; Gainotti, 1997; Siegler & Ellis, 1996; Sigelman & Rider, 2006; Singer & Revenson, 1996; Favre & Bizzini, 1995), which mentally conceptualizes the multi-dimensional aspects of problems. By the time children reach the concrete operations stage, which roughly lasts between the ages of 7 and 12, they have made significant strides in their thought processes and can master sequential relationships and classify objects in accordance with their various physical properties (i.e., types of cars; types of dogs) (Mareschal & Shultz, 1999).
However, it is not until children reach adolescence, or the formal operations stage, when they are able to fully enter into the complex realm of abstract thinking. At this age, they can derive conclusions to hypothetical ideas, whereas beforehand they were limited to that which they could tangibly grasp through their five senses. These intellectual augmentations allow the adolescent to "think outside" of the conventional box that had been placed before them throughout their formative years, namely the rules and values that had been imposed upon them by parents, teachers, and society as a whole. It makes "neurological sense," therefore, that the adolescent era is inexorably linked with suicide, since teenagers are more apt to be rebellious and can examine their dilemmas from a variety of angles, thus believing that they had exhausted all options before settling on suicide as a final determination.
Myths of Youth Suicide
According to Greene, there are many myths that accompany childhood suicide, and that these myths ultimately serve as barriers toward conquering such a devastating phenomenon (1994). Many people mistakenly presume that children under the age of six do not commit suicide. They also think that children in their latent period of growth (i.e., 6-12 years of age) are not capable of such obliteration. In reality, Greene eludes to the existence of several documented cases of young children within these age ranges who have countered against the will to live. Although evidence on this is unclear, Dervic, Friedrich, and Oquendo indicate that children cannot quite grasp the permanence of suicide until age 10 (2006). Or, as Fritz indicates, children may be drawn to the prospect of their own mortality, but do not possess the intellectual skill set to interpret and verbalize their destructive motivations (2004). Instead, they habitually choreograph death-defying activities to increase their fatal odds. As Greene points out, when young children make resolute statements such as "I'm going to jump off the house!," they are often perceived as eliciting attention-seeking behavior; but when such misdeeds are actually implemented, they are often regarded as accidental.
Another myth involves the lack of weapons a child has within reach that may facilitate his suicidal pact. To some degree, this assumption has been squashed with the circulation of several media reports regarding the deadly recourse to which many youngsters resort (Children with Guns, 2000). Additionally, children often carry out their deadly, self-imposed intentions through accessible means such as consuming toxic concoctions or bolting into oncoming traffic. Additional myths that circulate around childhood suicide include the belief that children cannot fully understand the finality of death, and that depression, which is a likely antecedent to suicide, does not occur until adolescence (Brådvik, Mattisson, & Bogren, et al, 2008; Herskowitz, 1990). To rebut the first belief while operating in concurrence with Piaget's aforementioned premise, children do, in fact, cultivate an ability to distinguish between that which is reversible and irreversible by age 7. And with regard to depression, it is true that Freud elaborated on the roots of adolescent depression, saying that it stemmed from a "diseased superego." Freud also posed that depression was a result of the grievances related to parental attachments that had not been properly resolved (Polmear, 2004). Thus, Freud's inference suggests that the onset of depression coincides with puberty.
However, a substantial amount of current research proves that throughout the last 50 years, childhood depression and correlating suicide rates have significantly increased along with our understanding of the depressed person's symptomology (Murphy, 2004). For example, because young children tend to discern life's pertinent lessons through the process of play, an absence of such recreational indulgence (i.e., anhedonia) carries tremendous ramifications and is a primary indicator of depression. Indeed, the literature surrounding childhood depression is quite expansive and covers the following categories:
- Utilization of the Berkley Puppet Interview as a diagnostic tool for childhood depression and anxiety (Luby, Belden, & Sullivan, et al, 2007);
- The adverse reaction that some children yield when alleviating depression through psychotropic medication (Bylund & Reed, 2007);
- Family factors that influence childhood depression (Wang & Crane, 2001);
- The concomitance between childhood depression and other ailments such as cancer (Koocher, O'Malley, Gogan, & Foster, 1980) and ADHD (Redy & Devi, 2007).
In addition to depression, specific motivations surrounding childhood suicide puzzle experts and the layperson alike. Many decades ago, Gunther reported on possible incentives for childhood suicide by accounts made on behalf of children who had previously plotted their own demise (1967; Cytryn & McKnew, 1998; Pelkonen & Marttunen, 2003; Stefanowski-Harding, 1990). A history of prior attempts and sudden personality changes (e.g., shy to talkative; submissive to aggressive) are strong indications that a suicide attempt will subsequently repeat itself, along with feelings of invisibility, social isolation, hopelessness, and academic failure. These facts tend to couple with a specific trigger, usually revolving around the child's perception that he was recipient to undue punishment over a particular event. Family factors that contribute toward suicide consist of parental substance abuse, divorce or separation, abuse, rejection, parental psychopathology (e.g., depression, parental suicide or suicide attempts), as well as good parental intentions that have gone awry, including parents that are either overprotective or those who demand perfection. A suicidal child tends to be hypersensitive, depressed, anxious, and angry. Such angst may manifest through health maladies, oppositional behavior, sleep disturbances, or an overriding aversion toward school. Additionally, young children often conjure up enigmatic portrayals to help comprehend the inexplicable nature of death, particularly if they had recently lost a love one (Shaw & Schelkun, 1965). Oftentimes, death is explained to children in ethereal terms such as "Mommy is in heaven now," or "Grandpa is smiling at you from the clouds," and children select suicide as a means to reunite with their beloved in such a mysterious fantasyland.
Treating the Suicidal Child
Children who have demonstrated some form of suicidal ideation, such as those with a history of previous attempts, would highly benefit from therapy. Since children are ill equipped to both conceptualize and articulate their inner demons, non-verbal therapeutic alternatives such as play therapy (Landreth, 2002; Schaefer & O'Connor, 1983) should be considered. Play therapies have tremendously assisted children who have encountered a variety of psychosocial distress, including survivors of abuse, those in the throes of grief, and children who are terminally ill. The ways in which therapists elicit pertinent information from children via play therapy includes art (e.g., drawings, clay), as well as puppets, sand and water trays, and through storytelling techniques. The premise behind this therapeutic modality is that although children cannot directly understand or articulate their feelings (e.g., "I'm lonely"), such sentiments will manifest throughout the process of play. For example, the lonely child might portray a solitary puppet who is consistently estranged from the other puppets. The suicidal child might draw graphic depictions of a person getting hit by cars, or being held at gunpoint. From that point, the therapist encourages the child and his family to infuse change into the play characters that he has created, which eventually seek to transcend into the child's life. The following passage describes the resolution of a young girl's school phobia through this process:
Ann and her parents negotiate new solutions via the puppet play. The gorilla agrees to be more patient with the puppy and the cat. When the puppy runs away, the gorilla does not yell at the cat, but they express their worries about the puppy and together go look for the puppy. When they find her, the puppy is excited and hugs the cat and the gorilla. They go home together, the gorilla carrying the puppy on his back. When the therapist processes the play with the family, the dad reports that he used to carry Ann on his back when she was younger and got tired during long walks. The family transfers the "new solution" from the puppet play to their "real" life by changing their morning routine. Dad gets up a little...