Teenage suicide occurs at an alarming rate and can be directly attributed to
three main causes: depression, substance abuse, and relationships. This terrible
phenomenon is rapidly increasing in the United States and only in the last
decade has any serious attention been paid to the underlying causes. Suicide is
the third leading cause of death for young people between the ages of 15-25,
with only accidents and homicide being more common! Most teenagers express
various warning signs before they attempt suicide. Therefore, suicide is a
preventable occurrence in the vast majority of cases. Depression is by far the
leading cause of teenage suicide. Depression is a disease that afflicts the
human psyche in such a way that the afflicted tends to act and react abnormally
toward others and themselves. Therefore it comes as no surprise to discover that
adolescent depression is strongly linked to teenage suicide. Adolescent suicide
is now responsible for more deaths in youths aged 15 to 19 than cardiovascular
disease or cancer (Blackman, 1995). Despite this increased suicide rate,
depression in this age group is greatly underdiagnosed and leads to serious
difficulties in school, work, and personal adjustment, which may often continue
into adulthood. Brown (1996) has said the reason why depression is often
overlooked in children and adolescents is because “children are not always
able to express how they feel.” Sometimes the symptoms of mood disorders take
on different forms in children than in adults. Adolescence is a time of
emotional turmoil, mood swings, gloomy thoughts and heightened sensitivity. It
is a time of rebellion and experimentation. Blackman (1995) observed that the
“challenge is to identify depressive symptomatology which may be superimposed
on the backdrop of a more transient, but expected, developmental storm.”
Therefore, diagnosis should not lie only in the physician’s hands but be
associated with parents, teachers and anyone who interacts with the child on a
regular basis. Unlike adult depression, symptoms of youth depression are often
masked. Instead of expressing sadness, teenagers may express boredom and
irritability, or may choose to engage in risky behaviors (Oster &
Montgomery, 1996). Mood disorders are often accompanied by other psychological
problems such as anxiety (Oster & Montgomery, 1996), eating disorders,
hyperactivity, substance abuse, and suicide, all of which can hide depressive
symptoms. The signs of clinical depression include marked changes in mood and
associated behaviors that range from sadness, withdrawal, and decreased energy
to intense feelings of hopelessness and suicidal thoughts. Depression is often
described as “an exaggeration of the duration and intensity of normal mood
changes” (Brown, 1996). Key indicators of adolescent depression include a
drastic change in eating and sleeping patterns, significant loss of interest in
previous activity interests (Blackman, 1995), disruptive behavior, peer
problems, increased irritability and aggression (Brown, 1996). Blackman (1995)
proposed that “formal psychological testing may be helpful in complicated
presentations that do not lend themselves easily to diagnosis.” For many
teens, symptoms of depression are directly related to low self-esteem stemming
from increased emphasis on peer popularity. For other teens, depression arises
from poor family relations, which could include decreased family support and
perceived rejection by parents (Lasko, 1996). Oster & Montgomery (1996)
stated that “when parents are struggling over marital or career problems, or
are ill themselves, teens may feel the tension and try to distract their
parents.” This “distraction” may include increased disruptive behavior,
self-inflicted isolation, or even verbal threats of suicide. So how can we
determine if someone should be diagnosed as depressed or suicidal? Brown (1996)
suggested the best way to diagnose is to “screen out the vulnerable groups of
children and adolescents for the risk factors of suicide and then refer them for
treatment.” Some of these “risk factors” include verbal signs of suicide
within the last three months, prior attempts at suicide, indications of severe
mood problems, or excessive alcohol and/or drug use. Many physicians tend to
think of depression as an illness of adulthood. In fact, Brown (1996) stated
that “it was only in the 1980’s that mood disorders in children were
included in the category of diagnosed psychiatric illnesses.” In actuality,
7-14% of children will experience an episode of major depression before the age
of 15. In a sampling of 100,000 adolescents, two to three thousand will have
mood disorders out of which 8-10 will commit suicide (Brown, 1996). Blackman
(1995) remarked that the suicide rate for adolescents has increased more than
200% over the last decade. Brown (1996) added that an estimated 2000 teenagers a
year commit suicide each year in the United States, making it the leading cause
of death after accidents and homicide. Blackman (1995) stated that it is not
uncommon for young people to be preoccupied with issues of mortality and to
contemplate the effect their death would have on close family and friends. Once
it has been determined that the adolescent has the disease of depression, what
can be done about it? Blackman (1995) has suggested two main avenues to
treatment: “psychotherapy and medication.” The majority of the cases of
adolescent depression are mild and can be dealt with through several
psychotherapy sessions with intense listening, advice and encouragement. For the
more severe cases of depression, especially those with constant symptoms,
medication me be necessary and without pharmaceutical treatment, depressive
conditions could escalate and become fatal. Brown 91996) added that regardless
of the type of treatment chosen, “it is important for children suffering from
mood disorders to receive prompt treatment because early onset places children
at a greater risk for multiple episodes of depression and suicide throughout
their life span.” Until recently, the health professionals have largely
ignored adolescent depression, but now several means of diagnosis and treatment
exist. “ Although most teenagers can successfully climb the mountain of
emotional and psychological obstacles that lie in their paths, there are some
who find themselves overwhelmed and full of stress” (Brown, 1996). With the
help of teachers, school counselors, mental health professionals, parents, and
other caring adults, the severity of a teen’s depression can not only be
accurately evaluated, but plans can be made toto improve his or her well-being
and ability to fully engage life (Blackman, 1995) The second most common cause
of teenage suicide is alcohol and drug use. Although it is illegal for anyone
under the age of 21 to purchase, posses, and consume alcohol, many teenagers do
drink. As a result, in addition to breaking the law, these teens are
particularly vulnerable to the various problems that alcohol can cause. Teens
who are shy in social situations often use alcohol to loosen up and frequently
end up making fools of themselves and doing things that they later regret. Still
other teens seek friendship and companionship by using alcohol so they can join
the “in crowd”. Other teens are simply emulating their parents or trying to
“escape’ from their home environments. What many teens fail to realize are
all of the negative effects drinking can have on their minds and bodies.
According to the National Clearinghouse for Alcohol and Drug Information,
“Long-term effects of heavy alcohol use include loss of appetite, vitamin
deficiencies, stomach ailments, sexual impotence, liver damage, heart and
central nervous system damage, and memory loss.” Some of the common signs for
teens with alcohol related problems include, an inability to control their
drinking-it seems that regardless of what limits are decided on beforehand, they
frequently wind up drinking too much. Two, using alcohol to escape their
problems. Three, changing from their usual reserved character into the “life
of the party. Four, a change in personality- turning from Dr. Jeckyl into Mr.
Hyde. Five, achieving a high tolerance level-able to drink everyone under the
table. Other troubling signs are blackouts, problems at work or school related
to drinking and parental concerns over their drinking habits. Alcohol is a
central nervous system depressant. It affects virtually every organ in the body,
and chronic use can lead to numerous preventable diseases including alcoholism.
According to the 1994 Monitoring the future survey, “alcohol remains the
number one substance used by 8th, 10th, and 12th graders. Over 50% of 12th
graders report drinking alcohol within the past month.” These disturbing
statistics outline a problem of overwhelming proportions. Each child who begins
drinking before they reach a significant level of physical and mental maturity
is increasing their chances of disease and suicide 100 fold. Support groups such
as Alcoholics Anonymous and Al-Anon/Alateen have set up teen hotlines and
meetings to help troubled teens with their dependence problems and to help them
work out any issues which may be troubling them or to an impartial ear when
listening to potential suicide victims. These programs can be a great benefit to
troubled teens but it takes a community effort to steer these people in the
right direction. The third leading cause of teen suicide is problematic
relationships. Every year an estimated 80,000 teenagers in the United States try
to kill themselves. That’s 219 kids a day, one teenager, every six minutes.
According to Baptist Hospital East, “Losses are a major factor in
precipitating or aggravating the depression which often precedes a suicide
attempt.” Some of the types of losses include:  The death of a parent;
 The death of a sibling or other important family member;  The
divorce of their parents;  The death of a pet;  A close friend
or relative’s move to another city  Feeling rejected by peers;
 Not being chosen for an athletic team or squad or some other activity
in which they are interested. Extensive studies have been conducted by Baptist
Hospital East to determine whether there is a “suicide personality”- a type
of teenager who is more likely to try and take his or her own life. Researchers
Garfinkle and Slabby found the following trends among teens who attempted
suicide:  The rate of parental absence was three times higher. 
Parental unemployment was twice as high  A family history of suicide or
psychiatric problems was the most predictable variable.  Psychiatric
illness was four times as common.  Alcohol and substance abuse was the
most frequently found type off family  Psychiatric problem. 
Conflict with parents was the number one precipitating event in young people who
attempted suicide, followed by general family conflict.  Drug overdoses
accounted for 90 percent of all attempts.  Attempts occurred most
frequently in the fall and winter. In closing, although experts cannot predict
which teens will attempt suicide, they agree that most adolescents who make an
attempt do not want to die. What they want is to change their lives and make
them worth living or perhaps send a signal to a loved one that they are
miserable and need help. Being a teenager is hard under the very best of
circumstances. Most teens are not emotionally equipped to deal with the vast
number of curveballs life can throw at you without a good built-in support
system. The momentary pain they are experiencing blinds them to their other
options and to the real solutions, especially if they are experiencing
depression and rejection for the first time. When drugs and alcohol are thrown
into the mix, things can turn ugly very quickly. They view suicide as the only
way to escape from their suffering. This is simply not the case, if parents,
teachers, and friends were all better educated to the causes and signs of this
terrible problem, teenage suicide in the United States could be reduced to a
trickle. Help stop this needless waste of human life, help a teen today!
Remember, that one day soon it could be your own son or daughter facing this
critical junction in their life. Will you be able to communicate these thoughts
to them and possibly save their life, or have you been daydreaming through my
entire speech and just wish I would shut-up?