From the Fall 2000
Issue
REAL
LIFE
When
Friends Want to Die:
How To Help
Teen Suicide: Raising Awareness
For A Growing Epidemic
By Dorothy Ratusny, B.Sc., M.A., (C).
OACCPP
Images by Linsai O (age 17)
Chances
are that you will know of at least two people who will commit
suicide during their teen years. These may or not be
people who are in your circle of friends. But what if they were
- would you know the signs and how to help?
My
first exposure to suicide was in Grade 9 when I had heard about
a girl in my high school that had killed herself. I remember thinking,
"why in the world would she have done this?" She was so pretty,
and she was popular with the 'in' crowd. Furthermore, she seemed
to have it all, intelligence, friends, and a cute boyfriend who
seemed to be madly in love with her. "What could possibly be so
wrong with her life that she felt she had no other choice?" I
also remember to this day how she did it. I heard from friends
at school that she lived with her family out in the country. I
was told that she used her father's hunting rifle and somehow
propped it up against a chair in her bedroom, and aimed at her
head. It killed her instantly. I also remember wondering about
how her family, her steady boyfriend of three years, and her friends
were dealing with this.
Often
the biggest obstacle that family and friends have to 'work through'
when someone commits suicide is the feeling of helplessness and
guilt for what they were unable to prevent. Yet, a teen thinking
about suicide actually puts out several signs or indicators letting
certain people know what they are planning. The greater question
is how to notice these signs and how to intervene successfully.
Teens
who are seriously thinking and perhaps planning to commit suicide
are often feeling depressed. An important element to their depression
is the feeling of hopelessness. While it is common for teens to
experience temporary periods of sadness or mild depression depending
on their life situation, prolonged depression (lasting several
weeks or months) with elements of hopelessness is an important
predictor of suicide. One of the best ways that you can intervene
if someone is feeling hopeless about their life, or about the
problems they are experiencing in their life, is to help them
reduce or decrease their feelings of hopelessness.
You
can do this by listening to them, being empathetic, and also letting
them know that you do not see their problems as hopeless. Pointing
out some concrete examples of the 'positives' in their life -
the potential reasons for living, and for problem solving with
them around their 'options' is crucial in helping them begin to
'think' differently about their situation. The next step is to
provide your ongoing support while encouraging them to get help.
There are many trained professionals both in the school and community,
who can provide supportive and effective counselling interventions
that can help resolve some of the underlying problems that create
a feeling of hopelessness.
Since
it is often extremely difficult for someone to feel hopeful when
they are in the middle of a distressing or traumatic situation,
this article is aimed at raising awareness about suicide; what
to do if you find yourself in a situation where someone you know
is talking about it and; how to help.
Some
stats:
*Compared
with other industrialized countries, Canada has the third highest
rate of suicide among teens.
*In 1997, Statistics Canada reports 261 suicides between the
ages of 15 & 19.
*The current rate of 13 suicides per 100,000 remains twice the
1970 rate.
*male teens are more than 4 times more likely to commit suicide
than females.
Still,
these figures do not include unreported deaths and 'suicide
equivalents', which could easily increase these statistics threefold.
It is estimated that thousands of teens try to kill themselves
every year.
In the vast majority of cases, someone who attempts suicide would
choose differently if they were not in great distress, and felt
they had the resources to evaluate their options objectively.
Most suicidal teens give warning signs in the hope that they will
be rescued, because they are intent on stopping their emotional
pain, not on dying. In fact, many teens send out several 'warning
signs' for weeks, possibly months before they actually make plans
and attempt to kill themselves.
One
of my colleagues remembers a schoolmate who committed suicide
at age 17. She was a talented dancer who studied at a Performing
Arts School. Although this was an attractive girl, who excelled
in her studies; she developed anorexia nervosa as she continued
to believe she was ugly and overweight. My colleague remembers
hearing that this girl's friends began to distance themselves,
and eventually alienated her as she became more and more negative
in her thinking of herself. Her self-loathing eventually turned
fatal as she wrote 'good bye' notes to her parents, her siblings,
and her dog.and took an overdose of pills before bed one night.
THE
SIGNALS
What Are the Signs that Someone may be Contemplating Suicide?:
1)
Withdrawal / isolating self from friends and family
2)
Depression, broadly speaking, not necessarily clinical depression
but indicated by signs such as:
- showing
signs of sadness, hopelessness, irritability
-
loss of interest in usual activities
-
changes in weight, appetite, behavior, sleep patterns, level
of activity which does not seem characteristic
-
loss of energy
-
making negative comments about self
-
recurring thoughts of death/suicide a. sudden change from
extreme depression to being 'at peace' which may indicate
that they have made a decision to attempt suicide
3)
Talking, writing, or hinting about suicide 4) Previous attempts
/ history of suicidal behavior 5. Purposefully putting personal
affairs in order / giving away possessions / 'clearing the air'
over personal incidents from the past
This
list is not exhaustive. Signs and symptoms also depend on the
personality traits of the individual, your relationship with that
person, and their ability to cope. The best thing you can do to
help if you suspect someone is thinking or contemplating suicide
is to ask. Be caring yet to the point. Ask them outright if they
are having difficulty coping. You may want to let them know you
are concerned and want to help.
Questions
to Ask:
1)
Have you been feeling sad or unhappy? A 'yes' will confirm that
he or she has been feeling some depression.
2)
Do you ever feel hopeless? Does it seem as if things can never
get better? Over half the people with depression feel hopeless.
Feelings of hopelessness are often associated with suicidal
thoughts.
3)
Do you have thoughts of death? Do you ever think you'd be better
off dead? A 'yes' indicates suicidal wishes but not necessarily
suicidal plans. Many depressed people say they think they'd
would be better off dead and wish they'd die in their sleep
or get killed in an accident. However, most of them say they
have no intention of actually killing themselves.
4)
Do you have any actual plans to kill yourself? If the answer
is 'yes' ask about their plans. If specific plans are made,
and if they have the means to carry out these plans the danger
is much greater.
The
answers to these questions will give you an idea of how severe
the problem is. In my experience, people who feel suicidal are
usually quite honest. Ask if they would be willing to get some
help or to talk to someone? If the person who feels suicidal is
cooperative and has a clear plan to reach out for help, the danger
is less than if they are stubborn, secretive, hostile, and unwilling
to ask for help. The key here is prevention.
Educating
yourself on what signs to look for, and being brave enough to
ask questions is the first step in intervening. Providing your
support and helping that person to get help is the next step.
Help
can begin by speaking to a Guidance Counsellor or a Staff Psychologist
at your school. You may choose to accompany your friend to the
appointment. Encourage them to be open and honest about how they
are really feeling. I also think that there needs to be a level
of open communication with the parents of the teen. While all
parents may not be able to provide the kind of support and love
that their teen needs, many can. It is important that parents
know how their child is feeling. It also becomes far easier for
a teen contemplating suicide to get help, if those who can help
know exactly what is going on.
Finally,
if you discover that a friend or a loved one is actively suicidal,
and is in need of immediate emergency intervention, bring them
to the emergency room of a local hospital. If they refuse, and
you feel they are in danger of harming themselves, you can call
the police and ask for help. They can bring the suicidal person
to the hospital, or in some cases, to an emergency mental health
facility where the person is assessed and placed under care. If
the person continues to threaten suicide, he or she may be committed
involuntarily for a three-day evaluation in most provinces. Doing
this will often anger the person who feels suicidal. However,
by bringing attention to the individual and their situation, there
is a better chance that they can receive help.
Many
depressed people say they think they'd be better off dead, however,
most of them have no intention of actually killing themselves.
Often the biggest obstacle that family and friends have to 'work
through' when someone does commit suicide is the feeling of helplessness.
Prepare yourself to help.
Dorothy
is a certified Psychotherapist specialising in Cognitive Therapy
and in private practice in Toronto, Ontario. She can be reached
at (416) 490-9970 or dratusny@idirect.ca
Sources:
Statistics
Canada Advisory Services Ontario Region
Burns,
D. (1989). The Feeling Good Handbook, Penguin Books Canada Ltd.,
Toronto, ON.
