Ask Dr. Barb: Teen's death raises suicide concerns

Dr. Barbara RosenbergDear Dr. Barb: A close friend of my 13-year-old niece  died suddenly. The girl hadn’t been ill, and some suspect suicide. The school sent suggestions on how to help grieving teens, but I don’t think it’s enough. Some parents haven’t been discreet in mentioning the suspected suicide. My niece and her classmates know their friend’s parents were in the middle of a bitter divorce. I don’t want them to think suicide is an answer to despair or any teen problem. What can I do to help?

Dear Reader,

Losing a friend or family member in sudden death is extremely upsetting in and of itself; however, losing someone close due to a possible suicide is one of the most devastating losses a person will ever experience. In this case, the lack of clarity about the classmate’s death can only intensify the feelings of grief.

Grief is a natural response to losing someone to whom you are close. This internal pain can affect an individual emotionally, physically, mentally and even spiritually. Grief can be experienced as feelings of numbness, sadness, confusion, anxiety, despair, shame, guilt or anger. Such feelings may progress in stages, and there is no exact timeline. How one grieves usually depends on the nature of the loss as well as one’s personality, coping style, religion and life experience.

Teens may grieve differently than adults or even younger siblings. The teenage years have their own challenges pertaining to identity formation and the need to become more independent from parents. The sudden death of a loved one can greatly disrupt a teen’s sense of security, stability and safety. With a possible suicide, the experience can be terrifying.

A 13-year-old might feel very anxious as to why someone would commit suicide. She might worry that it could happen to her. Of course, as you mentioned, you do not want your niece and her classmates to think that suicide is the answer to any teenage problem.

A common question anyone asks after a suicide is why did this happen? Every suicide has different causes, but studies link suicide  to intense psychological pain, including depression and hopelessness. Such feelings can be caused by mental illness or by some personal problem that seems unsolvable.

For example, a teen may be subject to family dysfunction, sexual trauma or social stress like bullying or difficulty forming friendships. Some who lack coping skills or the self-esteem to reasonably address these problems might resort to drug or alcohol abuse. Unfortunately, reckless behavior can increase feelings of depression and negate the ability to problem-solve. With impaired judgment and poor impulse control, problems start to seem worse than they really are, and, for some, death seems like the only way to end the pain.

Unfortunately, many suicidal teens are unlikely to seek help. Some find it difficult to ask for help because they don’t want to burden others, or they are ashamed to admit their problems. Also, suicidal thoughts can be related to chemical changes in the brain that can block an individual’s ability to reach out.

With the suspected suicide of your niece’s friend, her group might be wondering if she was suffering and why she didn’t tell them. They may feel guilty about not being there for her if she needed them. 

If you niece’s friend did commit suicide, she may have been so caught up in her suffering that she was unable to realize how much others cared for her. If she was unable to share her anguish, her friends should know it does not mean she didn’t care about them.

Suicide is the second leading cause of death among school-age youth. The reason is not always known, but please advise your niece and her friends that suicide is preventable. Tell them that suicide threats must always be taken seriously. Immediate action must be taken to keep a suicidal person safe. Tell them to never keep a friend or anyone else’s suicidal thoughts a secret. They must tell a care-giving adult such as a parent, teacher or school psychologist as soon as possible.

Warning signs can be direct or indirect statements about killing oneself, prior suicide attempts, or a dramatic change in behavior, such as preoccupation with death. More obvious risks are suicide notes or online postings.

Anyone who has such concerns about a loved one should calmly ask the person if he or she is considering suicide. Listen carefully and focus on their well-being without being accusatory or judgmental. Reassure them that there is help and that they won’t always feel this way. Don’t leave him or her alone, and remove any means for self-harm.

In moments of stress and normal moodiness, an adolescent might say “I wish I were dead” with no real suicide plans. Nevertheless, a parent or teacher should still be informed. This will create an opportunity to check in with the student. If necessary, a next step could be a referral to a psychologist or a psychiatrist to more thoroughly assess the problem and provide treatments. Various therapies can help explore painful or troubling events and feelings, teach coping skills, change negative thought and behavioral patterns, and encourage the development of healthier home and school relationships. In some instances, symptoms of depression might also require medication to be carefully prescribed and monitored by a psychiatrist.

Every community must make suicide prevention a priority. Of utmost importance is providing easy access to effective medical and mental health resources. Together, schools and families can work to build resiliency in individuals and lessen suicide risk factors.

For anyone in crisis, there are 24-hour hotlines such as National Hopeline Network (1-800-SUICIDE or Hopeline.com) and the National Suicide Prevention Helpline (1-800-273-TALK); online, see SuicideHotlines.com.

Barbara L. Rosenberg, Ph.D, is a licensed psychologist whose Summit practice serves individuals of all ages, as well as couples and families. She previously chaired educational and social programs for the Essex-Union County Association of Psychologists. Contact her through BarbaraRosenberg.com.