Northern Virginia has recently experienced several teen suicides. Last month, two Langley High School students took their own lives just a day apart from one another, and this month it appears two students at Woodson High School also committed suicide. Fairfax County alone has had 15 suicides over the past 3 years, and the surrounding counties, including Loudoun County, have also had a number of teen suicides in recent years.

Suicide is tragic, and it seems to be even more so when it involves our young. As the director of a private mental health practice, I can report first hand that the recent suicides in Fairfax County have had a profound impact on parents across Northern Virginia. Over the past month, I have received a number of calls from upset and worried parents, with the majority of them asking the same question, “How do I know if my teen is suicidal?”

According to the Centers for Disease Control and Prevention, suicide is currently the third leading cause of death among young adults and adolescents 10 to 24 years of age, following unintentional injuries and homicide. And, according to the National Institute of Mental Health, scientific evidence has shown that almost all people who take their own lives have a diagnosable mental or substance abuse disorder. This makes sense if you consider that those who suffer from depression and/or other mental health disorders would be less capable of coping with difficult situations or strong, negative feelings than those who are free of such problems.

But not all suicidal teens are depressed. Teens in crisis, for instance, may impulsively act-out and some might even go to the extreme of suicide with several factors contributing to that final decision — personality style, identity struggles, access to external resources and relationships (perceived or real) and developmental immaturity to name a few of the important ones. Research on the teen brain, specifically the prefrontal cortex, in recent years has led to some interesting findings on teen risk taking and impulsiveness. The general conclusion being that teens do not possess the cognitive maturity of adults and thus are vulnerable to exercising extremely poor judgment and poor impulse control at times and especially when emotions are strong.

Recent research on the topic of teen suicide has also found that teens that are exposed to a peer who has committed suicide are significantly more likely to think about or attempt suicide. “Suicide contagion” is the term for this phenomenon. Suicides can also then occur and spread (e.g., throughout a school system), and this is termed, “suicide cluster.” Interestingly, this latter phenomenon is known to occur in response to celebrity suicides. For example, the number of suicides reportedly skyrocketed nationally in the month of August following the suicide of Marilyn Monroe in 1962.

Researchers have estimated that there are between 8-25 attempted suicides for each teen suicide death and that four out of five teens who attempt suicide have given clear warnings. While knowing if a teen is truly suicidal is not always simple to determine, there are many factors and behavioral indicators that can help parents or friends recognize the threat of suicide in a loved one. Since mental and substance-related disorders so frequently accompany suicidal behavior, many of the cues to look for are the actual symptoms associated with such disorders as depression, bipolar disorder, anxiety disorders, alcohol and/or drug use, disruptive behavior disorders, borderline personality disorder, and schizophrenia.

Some common signs or symptoms of these disorders include:

Extreme personality changes

Loss of interest in activities that used to be enjoyable

Significant loss or gain in appetite

Difficulty falling asleep or wanting to sleep all day

Fatigue or loss of energy

Feelings of worthlessness or guilt

Withdrawal from family and friends

Neglect of personal appearance or hygiene

Sadness, irritability, or indifference

Extreme anxiety or panic

Self-destructive behavior (e.g., drinking alcohol, taking drugs or cutting)

Poor school performance

Difficulty paying attention and concentrating

Other factors to consider include:

Having a history of abuse

Having a close family member who has tried or committed suicide

Having access to guns

Having significant relationship or social problems

Tragically, many of these signs and/or factors can go unrecognized, and while suffering from one of these symptoms certainly does not necessarily mean that one is suicidal, it is always best to communicate openly with a loved one who has one or more of these problems, especially if the problems are unusual for that person.

There are also more obvious signs indicating a higher potential for committing suicide. Putting one’s affairs in order, such as giving or throwing away favorite belongings, is a strong clue. And it cannot be stressed more strongly that any talk of death or suicide should be taken seriously and paid close attention to. It is a sad fact that while many of those who commit suicide talked about it beforehand, only 33 percent to 50 percent were identified by their doctors as having a mental illness at the time of their death, and only 15 percent of suicide victims were in treatment at the time of their death, according to the National Institute for Mental Health. Moreover, approximately one-third of teens who die by suicide have made a previous suicide attempt, so a history of suicide attempts is a cause for careful monitoring of behavior.

While these most recent teen suicides are tragedies in our community, it is important to keep things in perspective. Yes, suicide rates have increased in Virginia in recent years, however, statistics show that Virginia’s suicide rate is only slightly above the national average, and Northern Virginia reportedly has the lowest suicide rate in the State.

If you, or is someone you know, exhibits any of the warning signs listed above, please get help right away. Talk to someone you trust as soon as you can, such as a parent, teacher or school counselor. If you are uncomfortable talking about your feelings with someone you know, please call a suicide crisis line (such as: 1-800-273-TALK (8255) or 911. Most toll-free lines are staffed 24 hours a day, 7 days a week by trained professionals who offer confidential support to help you work through tough situations. Lastly, Northern Virginia has many well trained mental health professionals for your teen to meet with privately should you have concerns regarding your teen’s safety and well being.

Michael Oberschneider, Psy.D.

Ashburn Psychological and Psychiatric Services

Published: Ashburn Patch and Leesburg Patch, 03/26/2014