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Sometimes you might see a big neon billboard amid a teen's chaotic emotional life that announces things are going poorly: Changes in eating and sleeping habits. Substance abuse. A waning interest in social activities. Withdrawal from friends and family members. Difficulty getting along with others. A decline in grades or a sudden generosity with possessions. An experience of negative setbacks or overreaction to relatively minor setbacks.
But sometimes not. "Suicide is not what people think -- there often are no warning signs," says Michael Bradley, psychologist and author of Yes! Your Teen Is Crazy and Yes! Your Parents Are Crazy . "An increasing number of suicides appear to be 'out-of-the-blue' suicides where they simply could not find any indications." He says 15 to 25 percent of adolescent suicides are without obvious warnings, but others put the figure as high as 50 percent. A child can look fine, can be president of the student council or a high-achieving athlete, can appear contented and well-adjusted, in a way that gives no indication of their inner turmoil.
"Adolescents are not small adults, they're large children, and we forget that," he says. "Ages 13-18 is where the real game of creating the adult is afoot, for this is when humans can actually begin to develop real values, beliefs, and codes of conduct. Consequently I argue that the most vital parenting years are not the first five, but the last."
Dr. David Shaffer, MD, professor of Psychiatry and Pediatrics at Columbia College of Physicians and Surgeons, says this doesn't suggest that such suicides are nothing more than regrettable spontaneous acts. Usually, he says, an underlying -- but undetected -- psychiatric disorder was at play, whether it be anxiety disorder or other relatively common afflictions of adolescents, particularly what is being called "perfectionism," the excessive desire of the child to do well and please others.
Dr. Gordon Flett, PhD, psychology professor at York University in Canada and author of a number of studies on the dangers of perfectionism, identifies four types of perfectionism:
"One of the problems is that even when the perfectionist is highly accomplished, he or she may not have any satisfaction with the accomplishments because the standards for self-evaluation are grossly inflated," Flett says. "We are quite concerned that some adolescents if they are perfectionistic and suicidal may 'put on a happy face' and never let down their guard, so the people around them may think that everything is fine when it is just the opposite."
The phenomenon is so common, Flett explains, that it has a name: Richard Cory Suicides, named for the famous poem about a man who seemed perfectly contented until the night he took his own life.
As a result, some experts are suggesting new things to look for -- much more subtle signs that might suggest a child is prone to depression or suicide -- and things we can do to help defuse those triggers.
One suggestion, according to Dr. Shaffer, will benefit the kid who is obviously overworked but has rejected a parent's suggestion to relax. "When you see that the balance of a child's life is out, that they seem to be getting excessively worked up about this kind of thing, this is usually an indication of needing to get checked out," he says.
Bradley offers his own tips for what to do next: "If the kid is noncommunicative, try to get them to see a counselor. First, offer that option; if they refuse, softly start to turn up the pressure. Say, 'Go one time and I'll stop bugging you.' Third, bribe them, offer an incentive -- 'I tell you what, see the shrink a couple of times and I'll get you those concert tickets' -- because sometimes that's what they need to get past their own resistance. Giving them a bribe may give them an excuse to go see the shrink. Sometimes they'll tell us things they won't tell the parents. The worst thing that happens is you waste a couple of sessions and a couple of fees, but it can be a lifesaver."
Another suggestion is to openly discuss suicide with your kids, just as we teach kids about drug use or sexual activity. "It's exactly the same drill," says Bradley. "You're equipping the child to handle something they might encounter in the future." He advises seizing the opportunity of a celebrity's suicide attempt or a relevant local news story as a natural motive for discussing it. If that fails, he says, just "take your kid out for coffee and say, 'Have you ever thought about killing yourself?' Raise that question... Get her to talk as much as she's willing on the subject with additional questions about her views and beliefs, and don't shut her up by preaching about your own."
One final suggestion Bradley offers has to do with failure, which he says has taken on a gravity in today's children that is inappropriate and unforgiving. Failure is okay, says Bradley, because it teaches resilience. "It's important that parents talk to their kids about expecting them to fail and talking about their own failures. Some kids think parents can't handle it when their children fail. Those kids become so ashamed -- they think their worth to their parent is their achievement level."
Originally published on LHJ.com, March 2008.