Catching Teens in Time

Moody. Difficult. Distant. Teenagers can be all these things and more. Most of the time such behavior means little--just adolescents going through the motions of growing up. But for more than 2,000 American teenagers who end their lives each year, these are the signs of impending disaster. The suicide rate for adolescents has more than doubled since the 1960s. So the challenge for parents is to be able to tell the difference between normal teen angst and terminal despair.

Solving that puzzle is even more imperative at this time of year. Late spring and early summer are the most common seasons for teens to make suicide attempts, say experts. "Lots of things change," explains psychologist Herbert Nieburg, director of behavioral medicine at Four Winds Hospital in Katonah, N.Y. "They may be leaving school and going off to college. They may be moving. There may be a breakup of a romantic relationship." Ohio State University psychologist Carl Tishler concurs. "Parents and teachers need to recognize that sometimes it's a very, very sad experience for kids to graduate from high school." At times this sadness is expressed in recklessness, Tishler says. "It may not be that someone says, 'I'm going to go out and kill myself.' But there are so many unconscious bad feelings. They get drunk, they slam into a bridge abutment, and they die."

Luckily, there are recognizable warning signs, many experts agree. Ninety percent of suicidal teens are depressed, and depression tends to cause certain types of behavioral changes. "There's no one symptom that's going to leap out to a parent," says Kay Redfield Jamison, professor of psychiatry at the Johns Hopkins School of Medicine and the author of Night Falls Fast: Understanding Suicide. "It's rather a whole cluster of changes in behavior and mood and sleep and eating patterns and energy levels." Professionals tell parents to look for dramatic changes in behavior or appearance, changes in weight, changes in performance in school. Any talk about wanting to die or commit suicide should make a parent go on red alert.

Another strong signal is continuing alcohol or drug use. "Substance abuse is very significant," says Nieburg. "One of the first things kids will do to try to make their pain go away is to try and medicate it. They don't go to the doctor and get Prozac or Zoloft. They use marijuana, cocaine, amphetamines, ecstasy, PCP, LSD. They want to get away from the pain."

Be aware that certain kids are more at risk. A teen with a family history of suicide or depression is more likely to make an attempt. So is someone who has already made an attempt. A teen with a life-threatening illness like HIV infection or a history of physical, emotional or sexual abuse is a prime suicide candidate. Several studies have shown that gay teens are significantly more likely to try to take their own lives. A teen in a home with firearms is at greater risk, as shooting is the most frequent method chosen by adolescents to kill themselves. (Experts suggest keeping guns locked up or out of the house altogether.)

Studies also show that males act very differently from females when it comes to suicide. Attempts are common among girls, but completion is quite rare. "Boys are five times as likely to commit suicide, and they're much less likely to talk about it," says psychiatrist David Schaffer, president of the American Foundation for Suicide Prevention. "If a boy talks about suicide, that statistically carries a far higher risk of some tragedy occurring than when a girl does."

Despite this very real threat during the teen years, many families are loath to discuss the topic with their kids. "There's this notion about depression, and certainly about suicide, that if you ask or mention the subject, you're going to make it happen," says Jamison. Quite the contrary, she says; talking with a son or daughter about dark feelings will help assuage the sense of hopelessness the child may have.

What should you do if you think your teenager is suicidal? "Stay calm, cool and collected," advises Nieburg. Enlist the help of a professional, whether a psychologist, psychiatrist, school counselor or social worker. Pediatricians and doctors can also be of assistance. Still another source to turn to can be a clergy member. If there's an emergency, call 911 or take your child to a hospital emergency room.

Despite the extent of knowledge today, signs of deep trouble too often go unheeded. "In nearly every case of suicide I have reviewed, clues to the adolescent's plans were overlooked or downplayed," says psychiatrist Andrew Slaby in his helpful book No One Saw My Pain: Why Teens Kill Themselves. "They weren't intentionally missed but unknowingly missed."

Not every suicide can be prevented, but parents who keep a close eye on their teenagers and work hard at communicating with them are the ones most likely to save their children's lives.