I need to talk with you about a matter of life and death: suicide. Suicide is the second leading cause of death for young people 10-24 years old, according to recent reports from the Centers for Disease Control and Prevention. For students in grades 9-12, the CDC found that 17 percent reported seriously considering suicide in the preceding 12 months, and 8 percent reported making one or more suicide attempts during this time. These data are from teenagers in school. The rates would be much higher if the survey included teens who dropped out of school.
Suicide… youth increasing…why? Ever since 2004 when the U.S. Food and Drug Administration added a black box warning that antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs) may increase suicidal thoughts and behavior in a small number of children and adolescents, doctors may have become more reluctant to prescribe these medications for these age groups. SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). SSRIs are safer than older antidepressant medications because they cause fewer side effects and less harm if taken in an overdose. The benefits of antidepressants in children and adolescents with major depression appear to be much greater than the small risk of suicide attempts resulting from these medications, according to a 2007 review of published pediatric studies.
Social media may also contribute to the increasing youth suicide rates. The Kaiser Family Foundation found that the average media time use of 8-18 year-olds was more than seven and a half hours a day. Teens who are the heaviest media users report more sadness and boredom., online bullying or cyberbullying, is the “most common online risk for all teens,” according to the American Academy of Pediatrics. Cyberbullying has been shown to cause higher levels of depression and anxiety and has been connected to more cases of youth suicide than traditional bullying. Those most at risk for cyberbullying include lesbian, gay, bisexual and transgender youth (54 percent) followed by female teens (21 percent). Among middle-school children, cyberbullying victims and offenders were up to two times more likely to attempt suicide than those who were neither.
Suicide …young girls…increasing…why? Among girls 10-14 years old, the suicide rates increased 200 percent between 1999 and 2014. The timing of puberty in girls is partly to blame: puberty may start as early as age eight in girls, at least two years before it usually starts in boys. During puberty, the psychosocial changes (self-concept and independence) and physical changes (growth spurt and sexual development) often overlap. A new study published in Pediatrics in May has supported other research that has shown that when girls start breast development early, they are more likely to experience depression , a risk factor for suicide.
Suicide…know the risk factors and signs, including psychiatric disorders like depression, death of someone close (especially if by suicide), exposure to violence or having been abused, substance abuse, self-harm (such as cutting), talking or writing about suicide or death, or prior suicide attempts.
Suicide…build key protective factors…prevent suicide:
- Good problem-solving abilities to figure out effective ways to manage problems in non-violent ways
- Strong connections to family, friends and community
Restricted access to highly lethal means of suicide, including firearms. Firearms in the home, even if unloaded and locked up, are associated with a higher risk of adolescent suicide.
- Cultural and religious beliefs that discourage suicide
- Access to both SSRIs and psychotherapy
- A good relationship with a medical care provider
- Start early in building protective factors in your children.
- Closely monitor your children’s use of social media and develop a Family Online Agreement. Use your own media time to visit helpful websites like aap.org.
- Talk with your children about violence and suicides on television, in movies, and in the news.
- Teach them that if a friend tells them about suicidal thoughts — they must tell an adult right away!
- Take all suicidal behavior seriously, even if it could not have been lethal, such as taking a few pills.
If someone is suicidal, call the U.S. National Suicide Prevention Lifeline 24/7 at 1-800-273-TALK (8255) or take them to the nearest Emergency Room.