By Steven T. Padgitt, Ph.D.

As the third largest cause of death between the ages of 15 and 24, the adolescent suicide rate has tripled since 1960. This is the only age group in which an increase has occurred over the last three decades. While there are approximately 10,000 reported teen suicides annually, it is estimated that the number of teen suicides is actually three to four times that number when unreported deaths and "suicide equivalents" are added. Lastly, there between 100,000 and 200,000 adolescent suicide attempts and gestures each year.

Depressed adolescents frequently communicate their despair before they act out in this final act of desparation. Teens tend to reflect their dysphoria with action rather than words. For example, they are inclined to withdraw from others, complain of boredom and have an increasingly difficult time concentrating. School performance tends to suffer and changes in personality may include increased aggression.

Clues as to impending suicide like, "I won't be around to bother anyone any more", are often given by troubled adolescents in an attempt to communicate a need for help. A pre-occupation with death also suggest serious disturbance. Some teens will attempt to straighten out their affairs, exemplified by returning long overdue library books or by giving away prized possessions, before acting out.

Common motivational factors that play into teen suicide are self punishment and retaliatory abandonment. In both cases emotional pain and resultant anger are clear contributors. The young suicide victim may have felt such an intense need for self punishment that this self inflicted murder appears to be the only recourse. For the individual who feels the pain of chronic emotional abandonment by his/her parents the act of suicide may be the only way the teen knows to convey his/her pain. This act of self inflicted aggression, aimed at the parent(s), truly makes this a family affair.

Prevention is the key to teen suicide reduction. While "hot lines" and attempts to keep such lethal instruments as fire arms and drugs out of the hands of children and adolescents are a good start, these measures don't prevent the truly suicidal teen from acting out self destructively. True prevention begins with eliminating the causative factors such as family disturbance. Recognizing the signs of depression and the clues expressed by the suicidal person are also essential. Early identification and treatment are the best approaches to slow this national epidemic. The parent, sibling or friend who recognizes the warning signs can help by taking action that will assist the adolescent change the direction of the developing or existing crisis.

The intervention can take the form of first acknowledging the messages received from the teen, no matter how covert they are. Next, the adolescent and the family must be encouraged to seek the assistance of an expert. The irreversibility of suicide demands immediate action. Anyone who receives information that suggests a teen is in danger of suicide can assist in diverting the deadly crisis. A caring response that both shows support for the adolescent and direction toward appropriate professional assistance can make a difference.