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Depression and Suicide in Teenagers and Children

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Title: Depression and Suicide in Teenagers and Children


1
Depression and Suicide in Teenagers and Children
  • Dr. J. Sean McKay
  • Family Psychology Associates
  • April 2006

2
Symptoms of depression
  • Depressed mood
  • Sleep Disturbance
  • Appetite/weight disturbance
  • Concentration problems
  • Loss of interest
  • Withdrawal
  • Feelings of hopelessness, worthlessness, guilt
  • Recurrent thoughts of death/suicide

3
Can depression look different in children?
  • Anger / Irritability
  • Behavior Problems
  • Substance abuse
  • Academic problems
  • Preoccupation with morbid themes
  • Heightened expressions of boredom
  • Frequent vague, nonspecific physical complaints

4
What is suicide?
5
What is suicide?
  • An act resulting from when a person chooses to
    end their own life to end some sort of suffering
    or pain existing in their current circumstances.

6
What is suicide?
  • An act resulting from when a person chooses to
    end their own life to end some sort of suffering
    or pain existing in their current circumstances.
  • Contrary to what most may think, suicide is not a
    desire to die

7
What is suicide?
  • An act resulting from when a person chooses to
    end their own life to end some sort of suffering
    or pain existing in their current circumstances.
  • Contrary to what most may think, suicide is not a
    desire to die but rather a desire to end of
    feelings of pain (and death is seen as the only
    way)

8
Permanent solution to a temporary problem
  • Our perception of temporary problems is that they
    seem permanent
  • Use your own example of a permanent problem
  • Is it still a problem?
  • Is it still unmanageable and unbearable?

9
Permanent solution to a temporary problem
  • At times a person can become so overwhelmed they
    begin to feel there is no solution
  • ENDING THE PAIN BY ANY MEANS NECESSARY begins to
    look appealing, often leading to suicidal thoughts

10
A Trivia Quiz
  • All suicidal teenagers are seriously mentally ill.

11
A Trivia Quiz
  • All suicidal teenagers are seriously mentally ill.
  • False.

12
A Trivia Quiz
  • All suicidal teenagers are seriously mentally ill.
  • False.
  • Although extremely unhappy about some life
    circumstance, they are not necessarily mentally
    ill.

13
A Trivia Quiz
  • Suicide runs in the family.

14
A Trivia Quiz
  • Suicide runs in the family.
  • False.

15
A Trivia Quiz
  • Suicide runs in the family.
  • False.
  • It follows an individualized, unique pattern.

16
A Trivia Quiz
  • Once suicidal, an adolescent will be suicidal
    forever.

17
A Trivia Quiz
  • Once suicidal, an adolescent will be suicidal
    forever.
  • False.

18
A Trivia Quiz
  • Once suicidal, an adolescent will be suicidal
    forever.
  • False.
  • Suicidal risk is typically only for a limited
    period of time.

19
A Trivia Quiz
  • Teenagers always commit suicide without warning.

20
A Trivia Quiz
  • Teenagers always commit suicide without warning.
  • False.

21
A Trivia Quiz
  • Teenagers always commit suicide without warning.
  • False.
  • Studies show that people give many clues and
    warnings before committing suicide.

22
A Trivia Quiz
  • Teenagers who talk about suicide dont commit
    suicide.

23
A Trivia Quiz
  • Teenagers who talk about suicide dont commit
    suicide.
  • False.

24
A Trivia Quiz
  • Teenagers who talk about suicide dont commit
    suicide.
  • False.
  • Eight of ten suicide cases gave warnings before
    attempting or completing suicide.

25
A Trivia Quiz
  • Suicide strikes most often the very rich or the
    very poor teenager.

26
A Trivia Quiz
  • Suicide strikes most often the very rich or the
    very poor teenager.
  • False.

27
A Trivia Quiz
  • Suicide strikes most often the very rich or the
    very poor teenager.
  • False.
  • Suicide is represented equally among all levels
    of society.

28
A Trivia Quiz
  • There is a suicide type of personality who is
    more apt to commit suicide.

29
A Trivia Quiz
  • There is a suicide type of personality who is
    more apt to commit suicide.
  • False.

30
A Trivia Quiz
  • There is a suicide type of personality who is
    more apt to commit suicide.
  • False.
  • All appear vulnerable depending on the stresses
    they are experiencing.

31
A Trivia Quiz
  • When a teenager talks about suicide, change the
    topic and try to get his mind off it.

32
A Trivia Quiz
  • When a teenager talks about suicide, change the
    topic and try to get his mind off it.
  • False.

33
A Trivia Quiz
  • When a teenager talks about suicide, change the
    topic and try to get his mind off it.
  • False.
  • Take them seriously. Give them the chance to
    express their feelings. Let them know you are
    concerned and want to help.

34
A Trivia Quiz
  • Suicide ranks as the third leading cause of death
    among teenagers in the U.S.

35
A Trivia Quiz
  • Suicide ranks as the third leading cause of death
    among teenagers in the U.S.
  • True.

36
A Trivia Quiz
  • Suicide ranks as the third leading cause of death
    among teenagers in the U.S.
  • True.
  • Shocking, isnt it? Suicide lags only behind
    accidental injuries and homicides in number of
    deaths nationally.

37
A Trivia Quiz
  • Usually linked with a teenage suicide (or an
    attempt) is a history of failed communication.

38
A Trivia Quiz
  • Usually linked with a teenage suicide (or an
    attempt) is a history of failed communication.
  • True.

39
A Trivia Quiz
  • Usually linked with a teenage suicide (or an
    attempt) is a history of failed communication.
  • True.
  • If a suicidal teenager feels unable or unsafe
    expressing his feelings to others, it only
    worsens feelings of isolation and helplessness.

40
A Trivia Quiz
  • A teenager will provide clues to those close to
    him prior to the attempting of taking his life.

41
A Trivia Quiz
  • A teenager will provide clues to those close to
    him prior to the attempting of taking his life.
  • True.

42
A Trivia Quiz
  • A teenager will provide clues to those close to
    him prior to the attempting of taking his life.
  • True.
  • We have to be very observant, however, since
    these clues can often be indirect and subtle.

43
A Trivia Quiz
  • There is no reason for a person to beat around
    the bush when a teenager verbally indicates a
    desire to commit suicide.

44
A Trivia Quiz
  • There is no reason for a person to beat around
    the bush when a teenager verbally indicates a
    desire to commit suicide.
  • True.

45
A Trivia Quiz
  • There is no reason for a person to beat around
    the bush when a teenager verbally indicates a
    desire to commit suicide.
  • True.
  • In fact, the teenager will probably welcome an
    open and honest conversation.

46
Suicide by the numbers
  • 2003 national data
  • 31,484 deaths by suicide (all ages)

47
Suicide by the numbers
  • 2003 national data
  • 31,484 deaths by suicide (all ages)
  • 4,238 of these deaths were age 24 or younger

48
Suicide by the numbers
  • 2003 national data
  • 31,484 deaths by suicide (all ages)
  • 4,238 of these deaths were age 24 or younger
  • Mortality rankings
  • Sixth among 5-14 year olds

49
Suicide by the numbers
  • 2003 national data
  • 31,484 deaths by suicide (all ages)
  • 4,238 of these deaths were age 24 or younger
  • Mortality rankings
  • Sixth among 5-14 year olds
  • Third leading cause of death for ages 15-24

50
Suicide by the numbers
  • 2003 national data
  • 31,484 deaths by suicide (all ages)
  • 4,238 of these deaths were age 24 or younger
  • Mortality rankings
  • Sixth among 5-14 year olds
  • Third leading cause of death for ages 15-24
  • Second among 25-34 year olds

51
Suicide by the numbers
  • In the past 6 months, about 3 of teenagers have
    attempted suicide

52
Suicide by the numbers
  • In the past 6 months, about 3 of teenagers have
    attempted suicide
  • Within the past 6 months, up to 6 of teenagers
    have considered suicide

53
Suicide by the numbers
  • In the past 6 months, about 3 of teenagers have
    attempted suicide
  • Within the past 6 months, up to 6 of teenagers
    have considered suicide
  • By the end of high school, as many as 10 of
    students have made a suicide attempt

54
Georgia Suicide Rankings
  • Age 10-14
  • Males 4th
  • Females (not in top 10 causes)
  • Combined - 5th

55
Georgia Suicide Rankings
  • Age 10-14
  • Males 4th
  • Females (not in top 10 causes)
  • Combined - 5th
  • Age 15-19
  • Males - 3rd
  • Females - 7th
  • Combined - 4th

56
Georgia Suicide Rankings
  • Age 20-24
  • Males - 3rd
  • Females - 3rd
  • Combined - 3rd

57
Gender Differences in Teen Suicidality
  • Suicidal thoughts
  • 33 of females
  • 20 of males
  • Suicide attempts
  • 14 of females
  • 7 of males

58
Gender Differences in Teen Suicidality
  • One-half of girls who have attempted suicide have
    mothers who have also made attempts in the past
  • Most completed suicides are made by boys WHY?
    the lethality of the attempt
  • Girls pills
  • Boys firearms

59
The Impulsive Nature of Suicide
  • 80 of suicides are considered to be impulsive
    acts
  • Though the person may have been considering
    suicide for some time, they spend an average of
    only 25 minutes thinking about the act before
    making the attempt

60
Correlates of Suicide
  • 99 of attempters experience some level of
    depression severity / rates
  • Mild 8
  • Moderate 14
  • Severe 40

61
Correlates of Suicide
  • 99 of attempters experience some level of
    depression severity / rates
  • Mild 8
  • Moderate 14
  • Severe 40
  • Suffering depression makes a person 27 times more
    likely to attempt suicide

62
Correlates of Suicide (cont.)
  • History of child abuse makes a person 30 times
    more likely to attempt suicide

63
Correlates of Suicide (cont.)
  • History of child abuse makes a person 30 times
    more likely to attempt suicide
  • Substance abuse
  • Intoxication associated with as much as 50 of
    all suicides why?
  • Poor judgment
  • Impulsiveness
  • Aggressiveness

64
More scary numbers
  • 90 of suicide attempts go unrecognized by
    significant others
  • 10-20 of all attempters eventually complete
    suicide
  • 30-40 of those who complete suicide have made
    previous attempts that go unrecognized
  • Still, nearly 50 have no previous suicide history

65
Protective Factors
  • Religion / spirituality
  • Sobriety
  • Best friends
  • Pet
  • Compliance with medication
  • Support of significant others
  • Counselor / therapist
  • Duties to others
  • Fear of death
  • Positive self-esteem
  • Good health

66
What are we supposed to look for?
67
Warning Signs of Suicidality
  • Tendency toward isolation
  • Substance abuse
  • Low self-esteem
  • Sense of powerlessness
  • Guilt
  • Emotional / psychological pain
  • Withdrawal from others / activities / items
  • Sexual identity crisis
  • Anger / rebelliousness
  • DEPRESSION
  • Sudden / unusual changes in behavior
  • Obsession with death
  • Direct or indirect threats
  • Giving away items
  • Previous attempts
  • Poor impulse control
  • Conflict with authority
  • Sudden improvement in mood sense of peace

68
Classroom warning signs
  • Abrupt changes in attendance
  • Dwindling academic performance
  • Sudden failure to complete assignments
  • Lack of interest in activities and surroundings
  • Changed relationships with friends and classmates
  • Increased irritability, moodiness, or
    aggressiveness
  • Withdrawal and displays of sadness
  • Death and suicidal themes evident in reading
    selections, written essays

69
Extracurricular warning signs
  • Overhearing remarks indicating profound
    unhappiness or despair
  • Observing prized possessions being given away
  • Loss of interest in extracurricular activities
  • Dropping out of sports and club activities
  • Direct suicide threats or attempts
  • Marked emotional instability
  • Recent suicide in family (watch for anniversary
    dates)
  • Heavy use of alcohol or drugs

70
So what can we do?
  • Know the warning signs!

71
So what can we do?
  • Know the warning signs!
  • Find out the severity of the threat
  • Death wish?
  • Plan?
  • Planned method?
  • Environmental risk factors?
  • Recent substance abuse?
  • Medical illnesses?
  • Psychiatric diagnoses?
  • Family history of suicide?
  • History of impulsivity?
  • Has a will been made?
  • Any talk of plans for future?
  • Social support system present?
  • Any recent significant losses?

72
So what can we do? (cont.)
  • Call suicide by its name
  • Absolutely horrible
  • nasty
  • Hurts a lot of people
  • Helps nobody
  • Totally selfish
  • Final theres no second chance
  • (Be sure that it is the ACT of suicide referred
    to, NOT the person)

73
So what can we do? (cont.)
  • Educate them about suicide share the
    information you have about it

74
So what can we do? (cont.)
  • Educate them about suicide share the
    information you have about it
  • Help the person toward professional care
  • DONT keep it a secret
  • DONT think it is just a threat take all
    threats seriously
  • Listen to them but DONT DARE THEM

75
LISTEN!
  • DO
  • Take seriously anyone who talks about suicide
  • Trust your instincts that your friend may be
    hurting and thinking of suicide
  • Listen carefully, especially to the feelings
    behind the words
  • Encourage expression of feelings is a socially
    appropriate way
  • DONT
  • Be judgmental
  • Give advice
  • Try to call a bluff, daring them to do it

76
BE HONEST!
  • DO
  • Offer to go with your friend to get help
  • DONT
  • Keep a suicide plan a secret
  • Wait to notify the appropriate adult better
    to risk a friendship than a life
  • Encourage the blaming of others inhibits
    problem solving

77
SHARE YOUR FEELINGS!
  • DO
  • Tell your friend how you feel about their choice
  • Be non-judgmental, use calm reassuring voice
  • Focus on concrete actions rather than vague plans
  • DONT
  • Be a cheerful phony do not give the person
    false reassurances

78
GET HELP!
  • DO
  • Get help, even if your friend is reluctant to
    accept it or tells you not to
  • Try to understand a friends reluctance to accept
    adult help (shows your caring concern)
  • Help them identify support systems
  • Identify other resources available to them,
    including counselors and clergy
  • Ask for help for yourself when you dont know
    what to do for your friend or child
  • DONT
  • Delay if the situation is an emergency get help
    as fast as possible
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