Dealing with Suicide or an Unexpected Death: A Guideline for Parents

by Anita Gurian, Ph.D.


Although it’s hard to believe that teenagers could be so desperately unhappy that they would plan to kill themselves, suicide is the third leading cause of death (behind accidents and homicides) for teenagers. Each year more than 5,000 U.S. teenagers commit suicide.  

For many teenagers, adolescence is a period marked by role experimentation that will hopefully lead to the development of a sense of personal identity.  For some teenagers, however, adolescence can lead to confusion, isolation, and alienation, and result in drug and alcohol abuse, sexual promiscuity, and a sense of hopelessness and helplessness.

Ninety percent of adolescents who die by suicide have a mental disorder at the time of their death.  The most common diagnoses are: depressive disorder, antisocial disorder, substance abuse, anxiety disorder.  Depression alone or in combination with aggressive behavior and/or substance abuse or anxiety has been found in over half of all suicide victims.

This is the journal entry of a fifteen-year-old girl with a history of depression who attempted suicide by slashing her wrists after her boyfriend dated another girl:  “I am worthless.  I am of no use to anyone and no one is of any use to me.  What if I kill myself?  How can you kill nothing?  I have known nothing.  The future looks worse; if I wake up tomorrow it won’t be any different.  There’ll still be more of the same.  I need people and there aren’t any who care.  If I disappeared no one would know.

Thoughts of hopelessness, often a characteristic of depression, are common in adolescents contemplating suicide.  These teenagers believe that things will never get better; they find it difficult to understand that depressed feelings are temporary and will abate.  They perceive themselves to be the cause of negative events, believe they have no control over what happens to them, and nothing they do will change things.  This bleak view of the future, combined with an impulsive style, may influence suicidal behavior. 

Warning Signs

These mental disorders are highly treatable, and parents, educators, and mental health professionals should be alert to the following warning signs: 

  • Feelings of hopelessness
  • Nervousness agitation or irritability
  • Overreaction to a recent humiliating experience
  • Drug or alcohol abuse
  • Changes in eating and sleeping habits
  • Withdrawal from friends, family and regular activities
  • Violent actions, rebellious behavior or running away
  • Neglect of personal appearance
  • Persistent boredom, difficulty concentrating
  • Frequent complains about physical symptoms, such as stomachaches, headaches, etc
  • Loss of interest in activities formerly found pleasurable
  • Poems, essays, and drawing that refer to death

A teenager planning suicide may:

  • Complain of being a bad person or feeling rotten inside.
  • Have recently experienced a loss such as a breakup, divorce or other family trauma.
  • Give verbal hints with statements such as:  “I won’t be a problem much longer; Nothing matters; it’s no use, I won’t see you again; I can’t take it any more; Nobody cares.
  • Put his or her affairs in order; give away favorite possessions, clean their room.
  • Make a direct statement such as “I want to die, I want to kill myself” which should always be taken seriously and assistance sought from a mental health professional.

Intervention and Treatment

For each completed suicide, there are an estimated 8 – 25 attempted suicides. The adolescent who has made a suicide attempt or is showing the warning signs should have a psychiatric evaluation that includes assessment of the adolescent’s mental state and the nature of family interaction. Treatment plans may include:

- Psychopharmacologic treatment of associated psychiatric disorders.  
- Psychological treatment in the form of therapy can be: 
  • Cognitive behavior therapy
  • Dialectical behavior therapy
  • Interpersonal therapy
  • Family counseling
  • Group therapy

Suicidal behavior is contagious; it is therefore imperative for mental health professionals to be available in schools, camps or other places where groups of teenagers are present, to help them deal with their feelings and reactions.

Prevention

In the Surgeon General’s Call to Action to Prevent Suicide, 1999, Dr. David Satcher stated that “Interventions have a much greater likelihood of success if they involve the community through a variety of services and providers.  Schools, parents and the public health community are vital to that process.”

With support from family and community resources and professional treatment, teenagers who show suicidal behavior can be helped, tragic actions prevented, and healthier behaviors established.

Resources

American Academy of Child & Adolescent Psychiatry
3615 Wisconsin Ave., NW
Washington, DC 20016-3007
Phone: 202/966-7300
Fax: 202/966-2891
Web site: www.aacap.org

American Association of Suicidolgy
4201 Connecticut Ave., NW
Suite 408
Washington, DC 20008
Phone: 202/237-2280
Fax: 202/237-2282
Web site: www.suicidology.org

American Foundation for Suicide Prevention
120 Wall St., 22nd Floor
New York, NY 10005
Phone: 888/333-AFSP (2377) (toll-free)
212/363-3500
Fax: 212/363-6237
Web site: www.afsp.org

SAVE (Suicide Awareness Voices of Education)
8120 Penn Ave. S., Suite 470
Bloomington, MN 55431
Phone: 952-946-7998
Web site: www.save.org

SPAN-USA (Suicide Prevention Advocacy Network)
1025 Vermont Ave., NW, Suite 1066
Washington, DC  20005
Phone: 202-449-3600
Fax: 202-449-3601
Web site: www.spanusa.org

Yellow Ribbon Suicide Prevention Program
P.O. Box 644
Westminster, CO 80030-0644
Phone: 303-429-3530
Fax: 303-426-4496
Web site: www.yellowribbon.org

1-800-SUICIDE - The Hotline for Suicide Crisis