Adolescent Suicide – Developmental Factors and Influences

Adolescent suicide is a significant problem.  The teen years typically are a time of awakening, of sudden maturation and the precipitous acquisition of new thoughts and ways of being.  This can lead to pathologies all the way from mild identity crises to full-blown schizophrenia.  Statistics from the National Institute of Mental Health show that in 2006 suicide was the third leading cause of death for young people ages 15 to 24.  Of every 100,000 adolescents ages 15 to 19, 8.2 per 100,000 died by suicide; this increased to 12.5 per 100,000 for young adults ages 20 to 24.

There are many developmental factors and influences, which make suicide and attempted suicide more common in adolescence.  They are devious and intermingled, which makes isolating them more difficult.  I doubt there is a single case of adolescent suicide where one proximate cause can be assigned as precipitating; more likely several are substantial factors.  These include, at a minimum: hormonal development during adolescence, which can lead to sudden and unpredictable mood swings and susceptibility to depression; changes in brain neurochemistry and even brain anatomy (the stabilization of neuronal growth); a predisposition towards riskier behavior given relatively more freedom and relatively fewer constraints; dramatically greater cognitive development and learning new skills, ways of thinking and problem-solving techniques; concern over performance at school or in connection with after-school activities such as sports; the creation of an identity (or even an “identity crisis) that may diverge from one’s parents, culture and social precepts; the emergence of sexuality and sexual preference, with concomitant fears of peer-group acceptance or social rejection; changing or inadequate relationships with one’s parents or other significant care-givers; what we characterized in class as “frameworklessness,” a state of instability and anxiety unique to adolescence; media images and impressions that create a false world-view about consumer culture and increase emphasis on extraneous factors such as body image; and an enhanced appreciation for moral judgment, including emotions such as guilt and idealization of role models.  The National Institute of Mental Health estimates that as many as 25 adolescent suicides are attempted for each one that is successful.  This naturally raises the question, why did the attempts fail?

The most likely answer to this problem is the adolescent has reached impasse in her/his personal life and is attempting to make a dramatic statement as to the condition of her/his psyche.  The motivations for doing so could run the gamut from simply calling attention to oneself to a genuine “cry for help.”  If an adolescent is “on the fence” about whether to commit suicide or not there are several interventions she/he might consider.  These include peer-group or school-counseling support, “suicide hotlines” or even pastoral counseling (if religious).

The effect on family members (siblings, parents) and on the family system of a successful adolescent suicide is disastrous.  The first question that arises is “why” with attendant feelings of guilt, blame and shame.  While some allowance might be made for precipitating factors, by far and away the most likely parental response is “what could we have done that we didn’t do,” “why didn’t we recognize what was going on” or “why is this happening to us?”.  It is unlikely this trauma will dissipate shortly and well could last over a lifetime.  As a result the family unit might tend to disintegrate with individual members assigning fault to others.  This leads to a high rate of post-suicide divorce.

Another prospect is that family members simply dissociate and the integral bonds that kept the family together loosen and then dissolve.  Parents may take up risky activities such as drinking, gambling or infidelity.  Having lost a loved one in such an unpredictable and catastrophic way they simply may no longer care about maintenance of the family unit.

Conversely the family unit may grow more insular; suspicious of outsiders, restricting of its activities, and focusing inward on sheer maintenance of a façade or veneer of normalcy.  This in turn could result to fractured sibling identities as brothers and sisters abandon the “self that was the sibling of the one who killed herself/himself” and evolve an entirely new, less guilt-ridden personality.

David Kronemyer