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Dr. Ally

Let's Talk about 13 Reasons Why and Teen Suicide


Image source: www.weheartit.com @helenacff

Suicide has been called a national epidemic. Whether you agree or not we can all identify that suicides are increasing in frequency and visibility. It is currently the third leading cause of death among people ages 10-24 according to the US Centers for Disease Control and Prevention, with numbers increasing fastest in girls between the ages of 10 and 14. They may not make up a large segment of people who complete suicide but suicides in this age range are becoming more frequent even tripling over the past 15 years. In our state, California, suicide is the 11th leading cause of death overall and is the second leading cause of death for people between the ages of 25 and 34.

Suicide rates were decreasing after 1989 then made an about face and rose by a quarter between 1999 and 2014. You have to wonder why, in the last 15 years have we begun seeing changes in suicide, particularly among the young? There is obviously no one phenomena to pin this change on but changes in socialization may be partly implicated. When we look at the evolutionary purpose of socialization we see that we have socialized for millions of years with the intent of increasing our chances of survival. We evolved to need physical contact to release oxytocin, eye contact to indicate attention, and groups to assure safety. At a time when technology is pushing socialization faster than we can evolve it may be impacting how we feel. The University of Pittsburgh even conducted a study focused on how long hours on Facebook can impact levels of depression and lead to jealous feelings.

If that’s not enough to keep you up at night there are also neurological reasons why adolescents may be experiencing the distress they report. Partly, the frontal-limbic system; this system is the connection between the limbic system, emotional center of the brain, and the frontal lobe, the problem-solving center. These two areas of the brain work hand in hand to help us experience, process and come up with solutions to situations we experience even very emotionally triggering ones. The issue is that this brain region begins developing in late childhood and is not fully complete until the mid to late 20’s. Studies have also shown that some people who attempt suicide have less density in white matter and decreased activity in these brain areas. Possibly leading to difficulties generating alternate solutions, increased emotional pain, and acting on impulses. I know when I was an adolescent break-ups seemed bleaker and arguments more dyer. Whereas now I am able to take stock of the good, the bad and the ugly of a situation and most often identify that I'm better off without the toxic relationship anyway.

What are the Symptoms?

There are a number of symptoms health and mental health providers look for and it may help you know if a loved one is experiencing some depression or suicidal thinking. Hopelessness (feeling like nothing will ever change) is a key feature of depression and often present in people that attempt suicide. People also report feeling increased loneliness, feeling separated from others, or like a burden. In people thinking about suicide you can often see an increase in impulsive behaviors and an increase in risky behaviors, but don't rule out that when someone wants to complete suicide they may also engage in a lot of planning. You also want to be aware of any large changes in behavior. Changes in things like appetite (eating more or less than usual), changes in sleep patterns (too much or too little), or changes in mood like brightening. Occasionally, when someone has decided to attempt suicide they feel better and will begin to look happier even sometimes optimistic.

13 Reasons Why

Image source: www.weheartit.com @sofiemk

I watched the show 13 Reasons Why and I was torn. On one hand, I believe suicide is an issue that must be discussed in open forum with honesty, non-judgement, and love. But on the other hand, I feel that the social contagion of suicide is a very real issue and must also be considered when having these public discussions. In my very humble opinion, this show highlighted some poignant issues faced by many middle-class American adolescents and validated many of their feelings of rejection, alienation, and discrimination. It also may have glorified the attention the protagonist received for completing a suicide and making her now infamous 13 tapes.

Studies have shown that suicides have a contagious element, particularly among “vulnerable” individuals. When I say contagious I am referring to an increase in suicide rates, or the development of "clusters" of suicides after exposure to a suicide or hearing about a completed suicide in media. The suicide of a family member of loved one have the highest relationship to contagion followed by media reports of suicides then scripted shows. The Canadian Medical Association Journal (2013) studies children between 12 and 13 and found that “being exposed to the suicide of a classmate was associated with being five times more likely to have suicidal thoughts.” Other studies identified that adolescents are more vulnerable to media influences, particularly those between the ages of 15 and 19. I will reinforce, children that are not thinking about attempting suicide and are not considered “vulnerable” will most likely not be triggered by shows or conversations about suicide. However, children that have already made attempts, are considering suicide, or are considered “vulnerable” will need additional conversations and support surrounding this content. The discourse is necessary and meaningful, particularly for children in vulnerable states. Since I’ve now successfully petrified every parent out there and I’m all about solutions. What is a parent or loved one to do? Monitor, support creative endeavors, encourage positive coping, learn positive coping for yourself and teach it to the children around you, and keep an eye on your children"s friends. So, don't be afraid to start these conversations just keep them open, honest, and nonjudgmental.

This article covered a lot of topics. If you are or know of anyone thinking about suicide please contact some of the resources listed below. If you are at imminent risk of suicide, which means thinking seriously about it right now, contact 911 or head to a local emergency room.

National Suicide Prevention Lifeline 1-800-273-TALK (8255)

Trevor Lifeline 1-866-488-7386

Trans Lifeline US: 1-877-565-8860 Canada: 1-877-330-6366

Crisis Text Line Text "741741"

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