By any measure, Joseph was an exceptional teenager. An excellent student, he brought his sensitivity to his writing, violin playing, and figure drawing. If he was passionate about nature – and he loved camping and hiking – he was even more so about his relationships with family and friends. He also struggled with depression. 

At age 17, Joseph killed himself.

While Joseph undoubtedly felt very much alone, that is, unfortunately, not the case. Suicide is the third leading cause of death in adolescents and the second leading cause of death among college age youth, according to Mental Health America. Each year more than 5,000 U.S. teenagers commit suicide, according to the American Academy of Child and Adolescent Psychiatry.

About 90% of suicides involve mental illness (usually depression) and/or addiction (alcohol or drugs), according to the Suicide Prevention Resource Center. According to the National Alliance on Mental Illness, there are several factors that predispose a teen to consider suicide:

• Prior suicide attempt,
• Co-occurring mental and alcohol or substance abuse disorders,
• Family history of suicide,
• Parental psychopathology,
• Hopelessness,
• Impulsive and/or aggressive tendencies,
• Easy access to lethal methods, especially guns,
• Exposure to the suicide of a family member, friend, or other significant person,
• History of physical or sexual abuse,
• Impaired parent-child relationships,
• Life stressors, especially interpersonal losses and legal or disciplinary problems, and
• Lack of involvement in school and/or work (“drifting”).

It is key to identify psychiatric problems early – but that can be difficult because teens often deny that there is a problem and because the problems manifest themselves differently in adolescents than in adults.

“Teens who are depressed can be in the moment and have fun; they can go to parties and be with their friends,” say Randy Brooks Miller, RNC, a youth suicide expert with Kennedy Health System. “This isn’t the way we think a depressed person acts, so we tend
to dismiss our concerns.” With teens, notes the U.S. Preventive Services Task Force, it helps to look for these behavioral changes:

• Sadness or hopelessness,
• Irritability, anger, or hostility,
• Tearfulness or frequent crying,
• Withdrawal from friends and family,
• Loss of interest in activities, and
• Changes in eating and sleeping habits.

While there is usually an underlying cause to adolescent suicide, there is also typically a precipitating event. Sometimes it is a bad grade on a test or major paper, sometimes it is being dumped by a boyfriend or girlfriend, sometimes it is a bullying incident at school or being left off an Internet friend list. In a moment of pain and humiliation and rejection, the teen may be unable to get past the feeling, may just want the pain to stop. “Sometimes the premeditation period is only a half hour for teens,” says Richard Watkin, M.Ed., Director of Consultation and Education at The Mental Health Association of Southwestern New Jersey.

When it comes to troubled teens, it is important to trust your instincts, says Watkin. If you think there may be a problem, you could very well be right. “Open up the lines of communication,” suggests Miller. It is important to listen to the adolescent and acknowledge his or her feelings. “You don’t have to agree with everything,” says Watkin. “The key words are ventilate and validate.” It helps to find out if the
adolescent has a plan to carry out the suicide; the more detailed the plan, the greater the risk of suicide.

And seek help from a physician or qualified mental health professional. Some people think they can help youth on their own. “But
you wouldn’t try to treat someone’s diabetes on your own, so why would you try to help a suicide without a professional?” says Watkin.
Help often consists of short-term therapy combined with medication. While there have been concerns over possible danger of giving anti-depressants to teens, it can be safe and effective, “when prescribed and monitored by a medical professional who has performed a thorough psychiatric evaluation, taking into account co-morbidities,” says Miller. “For instance, if a teen has depression and anxiety, it is important to treat both conditions.”

“Suicide is the most preventable cause of death there is,” says Watkin. We just need to be aware and open to talk.

For more information regarding treatment options, please contact the ACCESS Center at Kennedy Health System at 1-800-528-3425. In a crisis situation, please call the Steininger Behavioral Care Services Hotline at 856-428-HELP (4357) or CONTACT Community Helplines serving Camden, Cumberland, Gloucester, and Salem Counties at 1-877-266-8222 (CONTACT’s crisis hotline is available 24 hours a day, 7 days a week).