Teenage suicide

Teenage suicide is a profoundly tragic and unsettling event. The rise in adolescent suicide in the United States has been so dramatic since the 1960s that it cannot be ignored as a passing problem; attention has been directed toward gaining insight into the myths, causes, warning signs, treatments, and preventive measures of adolescent suicide.

TYPE OF PSYCHOLOGY: Developmental psychology

Introduction

Teenage suicide remains a persistent public health crisis in many countries, including the United States. The World Health Organization reported that self-harm was one of the leading causes of death among adolescents (ages fifteen to nineteen) and young adults (ages twenty to twenty-four) in 2020. In 2022, according to the US Centers for Disease Control and Prevention (CDC), suicide was the third leading cause of death for those between the ages of fifteen and nineteen in the US.

After declining between 1990 and 2000, youth suicide rates in the US remained about the same until 2007, when they began to increase through 2021. The CDC determined that, between 2009 and 2019, US high school students were increasingly likely to experience feelings of hopelessness, consider dying by suicide, and attempt to die by suicide. According to the American Foundation for Suicide Prevention (AFSB), young people aged fifteen to twenty-four had a suicide rate of 13.62 per 100,000 individuals in 2022. Rising rates of suicide and attempted suicide among adolescents in the 2010s and early 2020s occurred alongside a rising prevalence of mental health issues in young people, including depression and anxiety.

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. Young women attempt suicide at higher rates than young men, but are less likely to succeed. Young men are much more likely to use violent and lethal methods, such as shooting or hanging. Young women are more likely to use passive means to die by suicide; the use of drugs and poisons, for example, is more prevalent among young women than young men.

Culture and ethnicity can also affect suicide rates, with the CDC's study finding that American Indian, Alaskan Native, and Latino youth were more likely to report attempting suicide than their Black and White peers. Increases in teenage suicide and suicide attempts in the early 2000s were not equal across these age groups; for example, from 1991 to 2017, suicide attempts by White teens rose 18 percent, but increased by 73 percent among Black teens during the same period.

Suicide and attempted suicide rates also vary among adolescents based on sexual orientation and gender identity; adolescents who identify as LGBTQ+ have higher rates of suicide attempts and dying by suicide than the rest of the population. A 2023 survey conducted by the Trevor Project found that 41 percent LGBTQ+ teens in the US had considered suicide in the previous year. The Trevor Project noted that youth who have multiple marginalized social identities, including those who are bisexual, nonbinary, transgender youth, and/or LGBTQ+ youth of color, experience even higher disparities in rates of suicidal thoughts and behaviors than other LGBTQ+ youth.

As alarming as these facts may be, it should be noted that suicide is still relatively 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 professionals 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 adolescents who attempt suicide come from families in which home harmony is lacking. Often there is a significant amount of conflict between the adolescent and their 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.

Larger events such as disasters, economic recession, and war have also at times been correlated with a rise in teenage suicides, although the adolescents most likely to be affected by these external factors are those already living with mental health issues. This became particularly apparent during the global COVID-19 pandemic, which reached the US in early 2020 and soon had a negative impact on mental health across nearly all age groups. Adolescents were particularly affected; in early 2021, during some of the deadliest months of the pandemic up to that point, emergency room visits for attempted suicide rose 53 percent for young women and 4 percent for young men. Many experts pointed to the isolation brought on by lockdowns, school closures, and social distancing as a major factor in the rise of mental health issues in adolescents during this time.

Most adolescents who attempt suicide have experienced serious emotional difficulty prior to their attempt. For the majority, this history involves a significant problem with clinical depression. The type of chronic depression that leads some adolescents to die by 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 their 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.

Additionally, as social media websites have become increasingly popular in the twenty-first century, cases of teenage suicides are increasingly being linked to depression possibly caused by cyberbullying. While a direct cause and effect has not necessarily been proven yet, a significant correlation has been discovered as several parents of teens who have committed suicide have reported that their adolescents had been active on sites such as Facebook and Twitter and had mentioned incidents of being bullied by peers in these accessible online formats. In 2013, a cluster of international suicides committed by teens who had been using and had been bullied on the anonymous and largely unregulated social media site Ask.fm prompted the mother of one of the teens to circulate a petition demanding that the site be shut down. Studies have been ongoing to conduct further definitive research on the potential correlation between teenage suicide and cyberbullying.

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 realistically 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. In American culture, death and violence are sometimes treated in a remarkably antiseptic fashion.

Preventing 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 present 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 die by suicide 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 their 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. They may mention 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, they 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.

A number of nonprofit organizations, as well as local and national governments, provide suicide prevention hotlines; individuals experiencing a mental health crisis or suicidal thoughts, or anyone concerned about an individual experiencing these things, can contact these hotlines for immediate support. For example, the United States offers a National Suicide Prevention Lifeline—988—which came about from the combined efforts of the US Department of Health and Human Services (HHS), the Federal Communications Commission (FCC), and the Department of Veterans Affairs (VA). The 988 hotline became active on July 16, 2022.

Treatment

The treatment of suicidal behavior in young people demands that attention be given to both the immediate crisis 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, overcome the perceived meaninglessness of their existence, and 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 critically important that the talking process includes effective listening. Although it is difficult to listen to an individual who is suicidal, it is essential 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 vital in this process. The young person considering suicide is so overwhelmed by their 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; online resources are also available from many organizations, including video calls with therapists and health professionals. 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 suicides 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 prior 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 die by 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 tried to die by suicide.

Bibliography

Curtin, Sally C., and Matthew F. Garnett. "Suicide and Homicide Death Rates among Youth and Young Adults Aged 10–24: United States, 2001–2021." NCHS Data Brief No. 471, National Center for Health Statistics, CDC, June 2023, www.cdc.gov/nchs/products/databriefs/db471.htm. Accessed 30 July 2024.

"Facts about Suicide among LGBTQ+ Young People." The Trevor Project, 1 Jan. 2024, www.thetrevorproject.org/resources/article/facts-about-lgbtq-youth-suicide/. Accessed 30 July 2024.

Huddle, Lorena, and Jay Schleifer. Teen Suicide. Rosen, 2012.

Jones, Sherry Everett, Kathleen A. Ethier, Marci Hertz, et al. "Mental Health, Suicidality, and Connectedness Among High School Students During the COVID-19 Pandemic—Adolescent Behaviors and Experiences Survey, United States, January–June 2021." Centers for Disease Control and Prevention, 1 Apr. 2022, www.cdc.gov/mmwr/volumes/71/su/su7103a3.htm. Accessed 30 July 2024.

Kaplan, Cynthia S., and Blaise Aguirre. Helping Your Troubled Teen: Learn to Recognize, Understand, and Address the Destructive Behavior of Today’s Teens and Preteens. Fair Winds, 2007.

Miller, David Neil. Child and Adolescent Suicidal Behavior: School-Based Prevention, Assessment, and Intervention. Guilford, 2011.

"Older Adolescent (15 to 19 Years) and Young Adult (20 to 24 Years) Mortality." World Health Organization, 28 Jan. 2022, www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-older-adolescent-(15-to-19-years)-and-young-adult-(20-to-24-years)-mortality. Accessed 30 July 2024.

Pappas, Stephanie. "Social Media Cyber Bullying Linked to Teen Depression." Scientific American, 23 June 2015, www.scientificamerican.com/article/social-media-cyber-bullying-linked-to-teen-depression/. 24 Feb. 2016.

Petti, T. A., and C. N. Larson. “Depression and Suicide.” Handbook of Adolescent Psychology. Ed. Vincent B. Van Hassett and Michel Herson. Free, 1995.

Richtel, Matt. "‘It’s Life or Death’: The Mental Health Crisis Among U.S. Teens." The New York Times, 3 May 2022, www.nytimes.com/2022/04/23/health/mental-health-crisis-teens.html. Accessed 30 July 2024.

"Suicide Statistics." American Foundation for Prevention of Suicide, 11 May 2024, afsp.org/suicide-statistics/. Accessed 30 July 2024.

"U.S. Transition to 988 Suicide & Crisis Lifeline Begins Saturday." United States Department of Health and Human Services, 15 July 2022, www.hhs.gov/about/news/2022/07/15/us-transition-988-suicide-crisis-lifeline-begins-saturday.html. Accessed 30 July 2024.

Wirchel, Dana, and Robin E. Gearing. “Child and Adolescent Suicide.” Suicide Assessment and Treatment: Empirical and Evidence-Based Practices. Springer, 2010, pp. 171–98.