In many countries in the western world, suicide rates in older teenage and young adult males have tripled in the past twenty years! International research has repeatedly shown that the vast majority of people who die from suicide have had depressive illness at the time, and it is very likely that adequate treatment of the illness would have prevented death in the vast majority of these cases. It is therefore very important not to miss the diagnosis of depressive illness in this group, especially if they indicate in any way that they wish they were not alive, or regard their own lives as meaningless.
We all know the mood swings of normal teenage development are frequent and intense, and this makes diagnosing an emotional illness affecting a teenager particularly difficult. However, typically these mood swings are relatively brief, lasting hours or days. If a teenager is continuously miserable or withdrawn for two weeks or more at a time, there needs to be increasing concern about the possible development of depressive illness. You may find it useful to complete the questionnaire on depressive illness on this site, and more than five ‘yes’ answers over a consistent period of time indicate the need for further specialised assessment, or at least a discussion with your family doctor if possible.
It is also worth reading the Section on this site which discusses the differences between depressive illnesses and unhappiness. Certainly, if a teenager or young adult has continuous low mood, or has trouble concentrating or remembering, the chances are much higher that that person is suffering from depressive illness, not just teenage mood swings or temporary unhappiness.
Some doctors are very reluctant to diagnose depressive illness unless the biological drives of sleep, appetite or sexual interest are affected. In my opinion, teenagers and young adults have such powerfully driven biological drives that they can often have depressive illness despite having ongoing normal sleep, appetite and sexual interest.
Many people express disbelief that teenagers and young adults, in the prime of their lives, and with a lifetime of possibilities ahead of them, could possibly develop depressive illness. However, the reality is that the pressures and expectations on teenagers and young adults have escalated hugely compared with a generation previously. Young people are now expected to be socially skilled and confident, be verbally well equipped, and be able in many cases to initiate and maintain a demanding psychosexual relationship, and at the same time be able to be academically or occupationally successful. In contrast, it is not that long ago that such expectations were only placed on those in their mid- twenties and older. Furthermore, there is far more intake of alcohol, marijuana and other substances among young people compared with some years ago, and these substances significantly increase the risk of depressive illness and suicide when consumed in excessive amounts. Research shows that depressive illness is starting earlier with each generation.
As indicated above, suicide rates have escalated dramatically in young males, and to a lesser extent in young women, in many countries in the western world over the past ten to twenty years. Increasing pressures, and higher intake of alcohol, marijuana and other substances, and the increasing prevalence of depressive illness in all age groups in society are likely to be the major explanations.
Furthermore, the risk of suicide is increased when an individual feels that he or she is NOT NEEDED. Against the background of normal parent – teenager friction and power struggles, young adults may be lead to believe they are nothing but a burden on their families and society, as they are obliged to spend many years dependent on their parents while gaining qualifications for the increasingly sophisticated occupational roles required in today’s society.
Features considered particularly indicative of an increased risk of suicide among teenagers and young adults are
- the presence of depressive illness; having problems with memory or concentration is a strong indicator of depressive illness, not just being unhappy.
- heavy intake of alcohol, marijuana or other substances;
- confiding in friends about thoughts of suicide;
- a sense of hopelessness about the future;
- a sense of not being needed or of use to anyone;
- parting with important personal possessions;
- episodes of SELF-INFLICTED harm, such as burns or cuts, or attempts at suicide, no matter how insignificant they may appear. (Psychologically, they are indicators or a sense of desperation; the single factor most often found in those who commit suicide is a previous failed attempt).
What can be done?
Ideally, an unhappy teenager or young adult can be brought along to see a doctor or counsellor. However, the reality is that very many teenagers and young adults would refuse to do this, or would not confide in the person they were brought to see. If any self- destructive behaviour has occurred, or has been threatened, it is advisable to involve professionals, regardless of the temptation to cover over the event, and/or to accept the young person’s explanations and promises that the behaviour will not be repeated.
Hopefully, the young person will read the information on this site, or in other reference sources, and understand that it is not surprising that the most sophisticated part of our body, being our brain, is at risk of developing the most subtle and sophisticated illnesses. It is not surprising that this complex of chemical and electrical energy goes off the tracks at times, and this illness is very common and usually very easy to treat with modern antidepressants.
In dealing with teenagers under stress, some of the following general reminders may be useful.
Firstly, a useful rule of thumb is to remember that your teenage children are 2 to 3 years older than their chronological age! The trick therefore is to make the transition as smoothly as possible from telling a child what to do, into a situation where you discuss the options in a situation and your own beliefs and advice. Reserve the laying down of the law to as infrequent a role as possible.
Secondly, it is useful to try to understand the viewpoints of the younger generation as much as possible, to the stage where you can accurately summarise his or her views, and the reasons for them. This does not mean you have to agree with each other, but it does mean you are able to understand each other’s viewpoint, and accept the theory that all viewpoints have some greater or lesser degree of validity. Indeed, it is often a useful way of avoiding arguing with another human being to suggest that each party understands the others viewpoint, and will think about it, without necessarily having been converted on the spot.
Thirdly, it is important to let the teenage and young adults about whom you are concerned know that they are emotionally needed, and are important to you, even despite their inability to be financially independent at this point in time, and despite the inevitable arguments and power struggles inherent in teenagers growing to be independent adults.
Fourthly, seek advice from friends and relatives, and be prepared to consider their opinions. Also, do seek advice from counsellors and doctors, even if the young person involved refuses to go with you. You may find it useful to complete the questionnaire on depressive illness on this site, and, either on your own behalf if you are reading this site, or in the way you think it would be answered by the young person about whom you are concerned, and bring it with you when seeing the doctor or counsellor.
Important Disclaimer: This site is medical information only, and is not to be taken as diagnosis, advice or treatment, which can only be decided by your own doctor.