DEAR READERS: Recently I had a young patient who had just suffered the loss of a dear friend through suicide. She was upset and distraught over how such a "neat person" could feel so overwhelmingly sad that he ended his life.
As we processed her feelings, the idea of what his family must be going through and how to move forward, she said to me, "You have to write a column about this. I wish every teenager just sat in our session. Teenagers need to know that suicide is not the answer."
She was right. So this week's column will be a little different than usual because I want to address an issue that needs to be talked about. If this column helps just one teenager who is struggling, then it has served its purpose.
The numbers are sobering
According to the American Foundation for Prevention of Suicide, more than 36,000 people in the United States die by suicide every year. Suicide is the third-leading cause of death in people between age 15 and 24.
In a survey of high school students, the National Youth Violence Prevention Resource Center found that almost one in five teens had thought about suicide, about one in six teens had made plans for suicide and more than 1 in 12 teens had attempted suicide in the past year.
Teen girls and boys are both at risk for suicide. Teen girls are more likely to attempt suicide, but teenage boys are four to five times more likely to die by suicide.
Those eye-opening statistics show how important it is to talk with teenagers about suicide. Many people avoid talking about it because they "don't want to put any ideas in their heads."
Research has shown discussion of suicide with teens does not lead to any increased thinking about suicide or to suicidal behaviors.
Not talking about it is being in denial of a real issue teenagers face. The best approach is a straightforward and fact-based perspective that emphasizes causes and consequences. Young people need to hear that while the feelings of sadness, disparity or hopelessness may arise, they have so many other options or choices to help with those feelings besides harming themselves.
Almost every adult can recount moments in their teenage years that seemed so upsetting that they wondered, "Why am I even here? No one would really care if I was no longer here."
Moments that hurt
Whether it was breaking up with someone who they thought was the love of their life, feeling they had no friends, watching their parents struggle, feelings of failure, experiencing the loss of someone they loved such as a parent or grandparent, feeling overwhelmingly embarrassed over something or even just having an argument with someone that hurt so bad that they questioned their value, there are many ways kids can feel hurt.
Those moments, as painful as they are, are normal. They are part of our growing process and it is through those moments that we form coping skills to help us move into adulthood.
What we tend to forget is that young people need to hear from us that we have all experienced these distressed moments and that we understand how difficult it can be in that moment.
We need to emphasize, as I did with my patient, these are merely moments. Teenagers need to hear from us that the hard times will go away and they will experience happiness and joy again. These moments of sadness or embarrassment or loneliness will not last forever.
They need to know that what feels overwhelmingly sad one day will not always hurt the same way in days or months to come. They need to expect bad days but know that there will be good days as well. Something that feels so big one day will only be a blip in our life in a few months.
They need to hear that suicide is not an option and that help is always available.
People who have attempted suicide say they did it because they were trying to escape a problem that seemed impossible to get relief from or escape the bad feelings that surround it.
Many suicide attempts are unplanned and impulsive reactions to feeling desperately upset. Teens need to be reminded often that there is no problem too big for them to handle, no place where they are completely alone.
Someone to turn to
Teenagers need to know all the options available if they are troubled, depressed or overwhelmed. Every teenager should have three numbers in their cellphones of trusted adults besides their parents whom they can call anytime for support. Have them put their three names on their "favorites list" so they can easily access that number if they are distressed or upset.
They need to know that they can reach out to their teachers, school counselor or nurse, coach, youth pastor, family doctor, friends' parents or family members.
At the very least, every teenager should be told that there are crisis lines they can call such as (800) 784-2433 if they need to speak with someone immediately or privately.
Teens also need to be told the symptoms of depression so they are aware that when things don't feel right, they need to ask for help. These may include feelings of sadness, excessive sleep or inability to sleep, weight loss or gain, physical and emotional fatigue, continuing anxiety, social withdrawal from friends or school, misuse of drugs or alcohol and related symptoms.
They need to know that asking for help is not a sign of weakness but shows a great deal of maturity and internal strength. One of the most important things we can pass along to teens is that they are not alone, ever. There are always adults who are prepared to help and can work with them at helping them to feel better.
Dialogue, not a lecture
Parents need to also provide an open door to talk with teenagers if they are upset. Notice the word "with" and not "at." Talking at your teenagers will make them feel you are lecturing them, talking with them opens a dialogue and makes them feel safe in sharing their feelings. Don't be critical of their feelings or minimize their problems; be open and supportive.
Work together to decide what is the right direction for them once you determine what is causing the painful emotions.
Suicide is a permanent answer to a temporary feeling. Being an adolescent or teenager means you are constantly changing, evolving and growing. With growing comes a variety of emotions. Some emotions will be wonderful and others will hurt like there is no tomorrow. But there is a tomorrow and there always will be.
Look to tomorrow
I remember being so upset in high school (and I can't even remember why now), and I talked to my mom about thinking of wanting to "just go away because no one really cares." She told me that no matter how bad today was, tomorrow will always be better. If the next day doesn't seem to get better, the day after that will be better.
She said that if I told myself that every time I felt upset or sad, I would be OK. And she was right.
"Tomorrow will be better" should be shared with every young person so they are prepared to handle the sadness of today, but to know that it won't last forever.
After every storm, the sun does rise.