All too often, these adolescents end up taking their own lives when their depression gets too painful for them and they have not received the help that they need. Even the medications that are designed to help them get through the depression can sometimes make things worse, as various medications for depression and anxiety carry a risk of suicide when people are just starting or just getting off of the medication.
Reviewing the literature about how to deal with depression in adolescents is very important, as treatment is needed in many cases. The first important concern for treatment is the psychodynamic approaches that are used. Psychodynamic approaches, or psychosocial approaches, generally translate in lay terms to counseling or therapy of some kind. This can be in a group or individually, depending on which way the therapist feels will be more effective, and the recent evidence into this issue shows that adolescents that are dealing with depression may find that this kind of intervention is often very effective in alleviating their depression (Lewinsohn & Clarke, 1999; Clarke, Rohde, Lewinsohn, Hops, & Seeley, 1999). One of the main reasons that a treatment approach is so important for these people is that around 15% of adolescents are viewed as being clinically depressed at some time in their teenage years (Montgomery, Beekman, & Sadavoy, 2000).
One study that was conducted by NIMH in 1997 indicated that adolescents that suffered from depression and were treated by therapists had a 65% remission rate and responded to treatment much more rapidly than adolescents that were treated with support and concern from their families only, instead of professional intervention (Brent, Holder, Kolko, Birmaher, Baugher, Roth, Iyengar, & Johnson, 1997).
This does not mean, however, that family therapy or intervention in the life of a troubled individual has no merit. Even those that did not have one-on-one counseling or therapy found that there was improvement when they were involved in a program that dealt with family therapy and coping skills. Not only did depressive symptoms show a decrease, but there was also significant improvement in problem-solving skills, interacting with family and friends, and overall social functioning in general (Mufson, Weissman, Moreau, & Garfinkle, 1999).
Adolescents clearly need support and help when they are depressed, just as individuals of any age group do. However, finding that help and support can be very difficult, because adolescents often do not know how to go about asking for help, or who to turn to. Often, they are not even aware that they are depressed. Instead, they just think that everyone feels this way, or that it 'will not happen to them.' Parents, siblings, friends, other family members, and teachers can compound the problem if they look the other way and insist that everything is fine when it is really not.
Sometimes, when an adolescent commits suicide, the parents insist that they never knew that their child was depressed, or that they never saw any signs that there was a problem. Usually, though, there are signs, and others either ignore these signs or they do not recognize them for what they are and therefore do not do anything about them. People obviously want to think that everything is all right. No one likes to acknowledge that they or someone they love has a problem. Despite this, though, the recognizing of and admitting to a problem with depression can save lives.
No parent should have to go through the pain of burying their child. When parents know that there is something that they could have done but they did nothing, that pain is magnified and intensified. An adolescent suicide can not only take the life of the young person but can ruin or severely damage the lives of the family members and friends, as well. This destruction damages society in that economic and social issues and affected, and people's lives are disrupted while they struggle to cope with the loss of a loved one.
Losing someone that was loved, especially if the loss is sudden or deliberate, can cause ripples that last in other people's lives for many years to come. Someone who commits suicide is often said to be selfish, because he or she did not think about or did not care enough about the pain that would be caused to others. This sounds relatively harsh, but it is also accurate. Most individuals that take their own lives do not spend much time thinking about how deeply their parents and friends will be hurt by it. Also possible is that they just assume that no one will actually care anyway, because they are so depressed that they cannot see past the pain that they are in to the grief that they will cause for others.
Risk Factors for Adolescent Suicide
Risk factors for adolescent suicide are many and various (Rubenstein, Heeren, Housman, Rubin, & Stechler, 1989). If an adolescent realizes that he or she is homosexual, that particular adolescent will have a higher suicide risk (Rubenstein, Heeren, Housman, Rubin, & Stechler, 1989). Homosexual adolescents are not the only ones that have this increased risk, however (Rubenstein, Heeren, Housman, Rubin, & Stechler, 1989).
Another risk factor for adolescents is having someone close to them commit suicide (Rubenstein, Heeren, Housman, Rubin, & Stechler, 1989). If the adolescent has been exposed to suicide early in life, they often have a stronger risk of committing that act themselves (Rubenstein, Heeren, Housman, Rubin, & Stechler, 1989). It would seem like an early exposure to a suicide early in life would frighten an adolescent badly and stop them from ever committing such as act, but it appears instead that there is a fascination with suicide at that point.
The highest, risk, however, is from adolescents that already have a mental disorder. Approximately 90% of the adolescents that commit suicide are found to have some kind of mental disorder (Shaffer & Craft, 1999). Twenty-one percent of those adolescents who actually did commit suicide has been to a mental health professional within three months of their death (Shaffer, Gould, Fisher, Trautment, Moreau, Kleinman, & Flory, 1996). This is indicative of the fact that they had a problem, but apparently did not receive proper treatment or enough treatment to prevent them from their suicide attempt. The most common diagnosis is usually a mood disorder, either with or without substance abuse and anxiety (Stanard, 2000). Having a major depressive disorder increases the suicide risk 12 times, and attempting suicide at least once before increases the risk by three times (Stanard, 2000).
There are few ways that suicide can be prevented in the adolescent population, but watching for warning signs and ensuring that interventions are begun early are the best ways to help as many individuals as possible. Even this will not help everyone, and adolescents with serious problems can still slip through the cracks. However, many adolescents can be saved if parents and others are paying attention to their children and what kinds of changes that they may see in their children.
When intervention is needed, there are several specific things that should be done. These include: ensuring that there is a clinical interview with the adolescent in question, observing the behavior of the adolescent, getting other information from significant others in the adolescent's life such as teachers, friends, and parents, assessing the risk factors and support levels that the adolescent has, and assessing the suicidal intent and reasons for living exhibited by the adolescent (Stanard, 2000). When all of these things are studied together, they help to create a much clearer picture of whether the adolescent is actually depressed and suicidal, and whether treatment is necessary.
This does not provide all of the answers, because there is actually no way to answer the question completely. There is no way that all suicides by children and adolescents can completely be prevented, but most of them could be prevented if parents and others around them were willing to recognize the signs and symptoms and speak up about them. Noticing the depression and not saying anything about it, or refusing to see it for what it is will not help the adolescent's struggle and may result in a suicide attempt if not treated. Parents and others who have frequent contact with adolescents must be watchful and mindful of the problems that many of these individuals face so that they can be protected and cared for as much as possible. This is the only way to lower the rate of adolescent depression and suicide.
Determining why children and the elderly (the two groups with the highest numbers) commit suicide is another concern that many individuals in the helping professions face. Obviously, they commit suicide because they are depressed in many instances, but it is also accurate to say that there are other reasons why many of these the elderly choose to take their own lives. Some of them are involved in substance abuse and other issues that cause them to…