January 2, 2007
A University of Michigan Health Minute update on important health issues.
Don't let 20/20 hindsight happen to you:
Everyone needs to be on the lookout for warning signs of teen suicide, say grieving parents and a U-M psychologist
ANN ARBOR, MI – Right about now, Chase Edwards should have been starting to think about where he wanted to go to college. Or maybe he would have been filling a portfolio with creative sketches to help him apply to art school.
But instead, his parents are bracing for the fourth anniversary of the day they said goodbye to their son forever. Chase was just a few weeks away from his 13th birthday when he committed suicide – an act that seemed to come from out of the blue.
Looking back, though, his parents Jeff and Laura Edwards say the signs were all around. They just hadn’t known what those signs meant.
Normally a happy and quick-witted kid, Chase had become irritable and apathetic. He had trouble sleeping. He had complained of frequent stomachaches. He had cleaned his room thoroughly, and sorted his Detroit Red Wings and Simpsons collectibles. He dropped out of sports and school government. His parents didn't know it, but his drawings and a school essay hinted at the despair that was eating him up from the inside.
Still, no one – not his parents, his sister, his friends, his teachers, his coaches – put the clues together while Chase was still alive. But it all became clear after he died.
“I never thought Chase was depressed, and the reason I didn’t is because I had no idea of what depression was,” says Jeff. “Kids don’t come with instructions, and there are some things you don’t know. But what’s worse is that there are some things you don’t know that you don’t know about.”
That’s why he and Laura have spent the past four years trying to spread the word about the warning signs of suicide to teens and anyone who works with them. They even worked for the passage of a Michigan law that urges schools to teach about it.
The Edwards family is far from alone. A kind of 20/20 hindsight plagues thousands of parents a year, as they grieve the loss of children, teenagers or young adults who take their own lives, says Cheryl King, Ph.D., the director of the Youth Depression and Suicide Prevention Program at the University of Michigan Depression Center.
A child psychologist and suicide researcher, King says the warning signs of suicidal thoughts in young people are often confused with the “normal” experiences of the teen years. But it is possible to learn to identify the signs of risk.
“Everyone knows teens get moody, but in truth there are two easy ways to see the difference,” she says. “One is to have our eyes out for changes, marked changes, in a young person’s personality and behaviors, whether that’s at school, in their spare time, or in their eating and sleeping habits or their use of alcohol and drugs. The other is to look for the typical signs of depression, either a sad mood or an angry, irritable, aggressive mood, especially if these persist for two weeks or more.”
One in four young women and one in seven young men have had a bout with depression by the time they enter adulthood, she says. Depression and its cousin, bipolar disorder, are two of the main risk factors for teen suicides and suicide attempts. Alcohol and drug abuse, and a pattern of aggressive or antisocial behavior, are also major risk factors. When these conditions or problems occur together, a teen’s risk of committing suicide is generally higher. However, any one of these problems can lead to suicidal behavior in a teen who is experiencing severe hopelessness or acting aggressively and impulsively.
Both teens and adults need to understand that depression and bipolar disorder are real diseases rooted in brain chemistry and genetics, King says, not personal failings or weaknesses. They’re not the result of something they did or didn’t do – and they’re not something to be ashamed of. Moreover, all of these problems or conditions can be treated, with good results, if teens get professional help as early as possible.
“What they are experiencing is treatable, just like a bad back or heart disease or diabetes, might be,” King says. “A number of studies have shown that a combination of antidepressant medication and psychotherapy, or talk therapy, can be effective in treating depressive disorders in many teenagers, but the biggest challenge is finding those who need treatment and getting them the help they need.”
Whatever the underlying cause, suicidal thoughts and attempts are more common than most people realize, she says. One in six high school students in anonymous surveys say they have thought seriously about committing suicide, and one in 12 have actually tried to kill themselves. In fact, suicide is the third leading cause of death among young people, after accidents and homicides. But because of the stigma against talking about it, many young people go without help.
That’s why parents and others need to trust their gut feeling, King explains, and not be afraid to tell a child or teen that they’ve been noticing changes — that something’s not quite right and they’re worried. That can open up the dialogue that can help families seek professional help.
But, King says, it’s not just parents who should be on the lookout. “I really believe that as a community we can’t rely solely on parents to recognize depression in teenagers,” she says. “It’s very important that we work with our front-line people who work with young people to know how to recognize depression or signs of suicide risk.”
These “gatekeepers” who work with kids and teens all the time develop a good sense of which ones have been acting differently, King says. They might include teachers, coaches, clergy and school counselors but also the doctors and nurses who regularly take care of a child or teen, friends of the family, aunts and uncles, grandparents, and even law enforcement and justice system officials.
That’s why Jeff and Laura Edwards worked with their state legislator and King to prepare Chase’s Law, which was enacted in the summer of 2006. It encourages schools to teach students, teachers and all school personnel about the risk factors for suicide and depression, and the factors that help prevent suicide. The bill also calls for schools to inform parents about these efforts.
“Chase’s Law is important because it’s going to give an opportunity not only for the teachers, the counselors and the principals to feel comfortable talking about depression and suicide prevention, but it’s also going to involve the parents,” says Laura Edwards. “It will save lives.”
King says this kind of education is a key part of Michigan’s suicide prevention plan, which she helped develop as part of a statewide coalition. Many other states, school districts and cities around the nation have also started to implement their own suicide-prevention programs, and a growing number of resources are available online to help these programs get going.
The Edwardses hope that their efforts to raise awareness can keep other families from experiencing the overwhelming grief that Chase’s suicide brought them. “This can happen to anybody, regardless of age, gender, economic status, race, et cetera,” says Jeff. “It’s an abduction of your child from the inside out. And I hope that what people can take away from our experience is that it absolutely can happen to you, because it very much happened to us, and we had no reason to think that it would.”
Anyone who is considering suicide, or knows someone who may be considering suicide, may call 1-800-273-8255 at any time to be routed to the closest possible crisis center.
Facts about teen depression, bipolar disorder and suicide:
- One in every 11 high school students in Michigan reported in the 2005 Michigan Youth Risk Behavior Survey that they had attempted suicide one or more times in the past year; three percent of those who had made an attempt needed medical attention afterward.
- In the same survey, 26 percent of students reported symptoms of depression, and 16 percent had seriously considered suicide in the last year. Those who had symptoms of depression were far more likely to have attempted suicide during the previous year.
- Suicide is the third leading cause of death among teens and young adults, taking nearly 4,000 lives each year. In 2003, 244 suicides occurred among children aged 10 to 14.
Warning signs that a young person might be considering suicide:
- Threatening to hurt or kill oneself, or talking about wanting to hurt or kill oneself.
- Looking for ways to kill themselves by seeking firearms, available pills, or other means.
- Talking or writing about death, dying, or suicide.
- Feeling hopeless.
- Feeling rage or uncontrolled anger or seeking revenge.
- Acting reckless or engaging in risky activities, seemingly without thinking.
- Feeling trapped – like there’s no way out.
- Increasing alcohol or drug use.
- Withdrawing from friends, family, and society.
- Feeling anxious, agitated, or unable to sleep, or sleeping all the time.
- Experiencing dramatic mood changes.
- Seeing no reason for living or having no sense of purpose in life.
Find more on the Web at:
U-M Depression Center:
(free online depression test)
Chase Edwards memorial web site
Michigan Legislature: Chase’s Law
American Association of Suicidology
Suicide Prevention Resource Center
(Offers resources for parents, teachers, school health providers, and teens)
American Foundation for Suicide Prevention
Note to editors: For tips on reporting on suicide without creating unintended consequences, follow this link.
Written by Kara Gavin
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