The Missing Variable Nobody Talks About When It Comes To Teen Suicide
Dr. Patricia O'Gorman on an often-overlooked contributor to suicide and what parents can do immediately.
Alexander Grey | Unsplash, Sandy Torchon, hamzaturkkol | Canva A few years ago, I evaluated a 12-year-old teen* who was being admitted to the adolescent drug rehabilitation center where I consult. In addition to addiction, his accompanying medical information indicated he had recently been admitted to a hospital for an overdose.
Small, bright, and round-faced, he looked more like an 8- or 9-year-old. He spoke freely about his intense LSD and cannabis use spiked by occasional pill use of a wide variety of “whatever I can get.” When I asked about what he recently overdosed on, he offered a shy smile, looked up from under impossibly thick eyelashes, and said, “Tylenol.”
This, among other conversations, led me to wonder how many crises labeled as overdoses were, in actuality, suicide or suicide attempts. This may be a variable too many authorities are missing.
Suicide by Intentional Overdose in Children
“You overdosed on Tylenol?” I asked the 12-year-old in front of me.
He shook his head yes. “Look, I’ve been using pot since I was 6. I knew pot and LSD wouldn’t do it. So I took a bottle of Tylenol.”
The catalyst was abuse: Ongoing physical and sexual abuse by his stepfather.
“We’ve been in lockdown together," he told me. "There was only one way I could get out. I took it.”
In the years since the pandemic began, I have noticed an increasing number of teens sharing that their overdoses were suicide attempts. Some were pleased they were rescued; others, whose depression was so deep, wished they had been allowed to die.
Even now that lockdown is well behind us, children who experienced abuse, like my 12-year-old patient, may still be experiencing the fallout.
Increasing Teen Mental Health Problems
Our youth are experiencing an increasingly wide variety of stressors: lack of education tailored to their needs, insufficient mental health support, food shortages, and a dearth of supportive adults. Many youth are also living with increasingly stressed adults who may have once been able to offer support but who are now using alcohol and drugs to soothe their despair.
Too many of these stressed-out adults model escape through anesthetizing their feelings. Just one indicator of this is online alcohol sales, which have increased 262% from 2019 for the week ending March 21, 2020 [Pollard et al, 2020]).
It is no wonder that many children consider the use of substances not only to soothe themselves — but to rescue them permanently from lives they feel they can no longer manage.
Dr. Christina Rodriquez, a psychologist researching child abuse during the pandemic, concluded:
The most frequent reporters of child maltreatment—teachers, doctors, and mental health professionals—suddenly lost access to children during this pandemic. Official reports of child welfare in many states plummeted (Jonson-Reid et al., 2020) even while news reports described increases in hospital visits and hospitalizations from child abuse (Da Silva, 2020; Woodall, 2020).
Teen Suicide and Childhood Maltreatment
“Childhood maltreatment constitutes experiences of any sexual, physical, and emotional abuse and/or neglect that result in substantiated or possible harm that affects the individual’s physical and mental health” (Angelakis et al, 2020).
Evidence suggests that childhood maltreatment results in youth fantasizing about their death, even mentally rehearsing suicide scenarios.
Photo: Ranta Images via Shuttertock
Suicide Risk Factors and Signs
Recently, reporters began exploring whether school closures have resulted in increased childhood maltreatment, as well as the overall impact of school closures on the mental health of our children, including its link to suicides. While increasing numbers of “adolescent suicides during the pandemic cannot conclusively be linked to school closures and national data on suicides in 2020 have yet to be compiled, there is mounting concern” (Tingley, 2021).
The Role of Impulsivity In Suicide Attempts
Dr. Paul Nestadt, a psychiatrist at the Johns Hopkins School of Medicine, observed that “Suicide is also surprisingly impulsive. A majority who decide to do it act within an hour … nearly a quarter act within five minutes. Not having access to a lethal weapon during that time greatly reduces the risk of death (Tingley, 2021).”
The lethal weapons to which our youth have immediate access are drugs. Unfortunately, many are using them.
Teens Today Have Wide Access to Drugs
Our youth have access to drugs from a variety of sources: on the street, through friends, and from doctors who prescribe them based on increasingly time-limited office visits. The most commonly abused of these being stimulant medication.
Youth require, at the very least, thorough screenings to see if their symptoms are the result of ADD or ADHD, and not the result of other mental health concerns such as trauma, depression, or anxiety, all of which share the same cluster of symptoms: struggles with concentration, difficulty in focusing, forgetfulness, fidgeting, impulsiveness, problems sleeping, angry outbursts, boredom, mood swings, or poor decision-making.
Prescribing the wrong medication opens a pathway for youth to trade this highly valued street commodity.
According to Dr. Caleb Alexander, co-director of the Center for Drug Safety and Effectiveness at Johns Hopkins, “Unfortunately, just as with opioids, these medicines are far too accessible in bathrooms and bedrooms and kitchen cabinets all over the country”(Lieber, 2018).
Risk Factors for Adolescent Suicide Risk:
The standard list of risk factors for suicide needs to be expanded from warning signs, such as those indicated by Stanford Children’s Health:
Noticeable changes in eating or sleeping habits
Unexplained or unusually severe, violent, or rebellious behavior
Withdrawal from family or friends
Sexual promiscuity, truancy, and vandalism
Drastic personality change
Agitation, restlessness, distress, or panicky behavior
Talking or writing about committing suicide, even jokingly
Giving away prized possessions
Doing worse in school
To also include:
Substance use
Access to drugs and or alcohol
Access to any prescription medication, including those prescribed for their parents or themselves
Access to OTC medications such as Tylenol, and cough syrups containing dextromethorphan
Isolation
Enduring emotional, physical, or sexual abuse
Witnessing domestic violence
Being isolated from a known abuser
A known abuser having access to this youth
article continues after the advertisement
What parents can do, today:
What we can do to help combat this epidemic within a pandemic is relatively simple: ask youth about their drug use. Be curious, compassionate, and direct.
Keep lines of communication open between yourself and your children and let them know you are available to support them. Remind them that nothing could make you stop loving them and that you can solve problems together. Then, be sure you listen attentively when they do open up to you.
After all, the link between the addiction epidemic and the rise in suicide rates is clear.
*Some identifying details may have been changed to protect patient privacy
If you are experiencing suicidal thoughts or feelings of hopelessness about the future, please know that healing is possible. Talk to someone you trust and reach out to a mental health professional for support. You can also dial 988 anytime, day or night, for additional support or visit the 988 Suicide & Crisis Hotline site.
Patricia O’Gorman, Ph.D., psychologist and life coach, is a best-selling author of nine books on trauma, resilience, women, and self-parenting. Find her work on Substack.