Today’s topic deals with a topic few people want to hear about—suicide. Unfortunately, it is becoming more and more prevalent to the point that routine screening of all adolescents for suicidal thoughts and behaviors is or should occur during routine office visits. Parents should be aware of certain physical symptoms could signal emotional problems as well. These symptoms include chronic headache and abdominal pain, usually without any conclusive evidence to explain the symptoms. Screening by parents and healthcare providers should watch for changes in functioning at school, work or at home, changes in mood or affect, and direct questioning about suicide and plans. Discussion should include coping ideas and reassurance of social support.
In the 10-14, 15-20 and 20-24 year old groups, suicide is the third leading cause of death, with females attempting suicide 2 to 4 times more than males, usually through ingestion of various substances. However, males are more than e to 4 times more successful in taking their lives, usually by more violent methods such as firearms and hanging. Gay, lesbian, and bisexual youth have higher rates of suicide attempts than their heterosexual peers.
There are certain risk factors that are common with suicide or attempts, including a history of previous suicide attempts, mood disorders, drug or alcohol abuse, a family history of suicide, family history of mental illness or substance abuse, history of sexual or physical abuse, dysfunctional family dynamic, and the presence of firearms in the home.
The causes of suicide, whether attempted or successful, may be indicative of an underlying mental or personality disorder, which is worsened by life stressors, which can trigger a suicide. The patient may have feelings of being isolated without lack of family or social support, leading to feelings of hopelessness. The act of suicide may even be designed to punish loved ones, or as a result of rage of frustration. As such, any talk of suicide should be taken seriously and not just dismissed as “just seeking attention.”