Monday, November 9, 2009

Suicide is Contagious


A bright teenager attending a prestigious high school commits suicide. A number of the student’s classmates end their lives in the same way. Gunn High School, May, 2009? No! Plano, Texas, February, 1983. This began a twelve month period during which seven teenagers, from one of the best school districts in one of the most affluent cities in the country, ended their lives.  In New York's Westchester and Putnam counties five boys died by their own hand in February 1984. In Omaha Nebraska at the beginning of 1986, three students from the same high school who vaguely knew one another ended their lives (Leo, Taylor, et. al, 1986). So the most recent deaths by four Gunn High School teens by willingly stepping in front of commuter trains are not at all bizarre but the most recent examples of the tragic but understood phenomena of cluster teen suicides (Fernandez & Samuels, 2009).


What makes teens so vulnerable? During puberty boys’ testosterone rises to almost twenty times its pre-puberty level and doubles in girls. The hypothalamus that monitors many bodily functions, including sex, becomes less sensitive to sex hormones and waits until those urges are very strong before it signals self control. The brain is beginning to become more efficient at fourteen by eliminating unused nerve pathways, but it takes about four years to complete the process. The pleasure centers develop more quickly than the impulse control system of the prefrontal cortex. Consequently early adolescents are more emotional than those older, young adults and extreme emotional states, both positive and negative, are more frequent. The body is rapidly changing with pressures for girls to be slimmer than is humanly possible but frequently represented by the media and emphasized by parents and peers. Puberty and life style also disrupt adolescent sleep cycles so that while teenagers need nine hours of sleep, they get seven hours or less. With sleep deprivation comes irritability and impaired decision making.


So what are the risk factors that when added to the dramatic biological and sociological influences of adolescence leads to an increased likelihood of suicide? According to the Center for Disease Control and Prevention (CDC), girls are twice as likely to seriously think about suicide with Hispanic females most often attempting suicide (CDC, 2007). However, boys are four times more likely to die from suicide as girls. Hispanic and white boys most often have a plan, and Hispanic boys most frequently require medical treatment after a suicide attempt. Suicide becomes a solution to problems connected to depression. A suicide plan is thought of as a solution to intolerable emotional pain. Family conflicts, economic stress, relocation, isolation from friends, a victim of bullying, gender identity confusion, history of a suicide attempt by a family member, friend or neighbor are all risk factors.When according to the CDC (2007) one in six high school students in the past twelve months think about suicide, and when 13% of those surveyed said they had a plan, and one in twelve students had attempted to kill themselves at least once, risk factors cannot be minimized or overlooked and action is required.  First, this information needs to be shared with high risk groups, like students who are members of a community in which a student suicided.  Students need to be told that depression is a mental illness that can be successfully treated with psychotherapy and/or antidepressants (use of anti-depressants needs to monitored carefully as this class of drugs may increase the risk of suicide among adolescents - c.f. Simon, 2006). Students should also be told that the way to get help is to talk to their doctors, parents, or teachers.

When made aware of friends who talk about being unhappy or alone, or who have sudden changes in behavior that may include either sleeping excessively or very little, eating very little or way too much, or have wide variations in mood and irritability, a professional consultation must be sought. Take all threats to hurt one self or others seriously and seek professional advice. Opportunities for students to talk in small groups and share concerns for classmates mitigate isolation and promotes accessing professional help. Professionals can offer consultation and advice when students gather to grieve the loss of a classmate.  Adults who are vigilant and supervise their children can prevent a tragedy such as when the mother of a Gunn teenager followed her son to the train tracks. The National Suicide Hotline is 1-800-suicide (784-2433). In Santa Barbara call 211 or 1-800-400-1572. In Ventura County call 805-652-6727. Remember that most health insurance plans have some mental health benefits. Become knowledgeable, informed and act to prevent suicide.



References:

Centers for Disease Control (2007). School health policies and programs study: Suicide prevention. Journal of School Health, 77(8).

Fernandez, L., & Samuels, D. (2009). A fourth Palo Alto high school student, 16, kills self on Caltrain tracks. San Jose Mercury News, Oct, 21.


Leo, J., Taylor, E., et. al. (1986). Behavior: Could suicide be contagious? Time Magazine. Feb., 24th.

Simon, G.E. (2006). The antidepressant quandary: Considering suicide risk when treating adolescent depression. The New England Journal of Medicine. 355(26), pp. 2722-2723.

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