THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Tuesday, November 7, 1995 TAG: 9511070046
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: By DEBRA GORDON, STAFF WRITER
LENGTH: Long : 268 lines
EVERY DAY of my life, suicide passes through my mind. Some days more than others, but nonetheless I think of it. My troubles are slowly eating me from the inside out, and I cannot for the life of me get them out of my head.
- from a letter written by ``Susie,'' a 17-year-old high school senior in Virginia Beach
She wants to remain anonymous. Doesn't want her parents knowing what she's done, what she thinks about. Still, she sent a letter to The Virginian-Pilot detailing her thoughts.
``If adults read this with an open mind,'' she wrote, ``then just maybe I can get through to them. I hope to touch teenagers through this and possibly encourage parents to help them.''
Her own parents, she said in an interview, haven't helped her much - even though her mother saw her through one suicide attempt and a junior high school guidance counselor alerted her parents to Susie's suicidal thoughts.
Susie, who says she has tried to kill herself three times in the past five years, is not the only adolescent having, and acting on, suicidal thoughts.
From 1980 to 1992, the suicide rate among teenagers 15 to 19 increased 28.3 percent. Among kids 10 to 14 the rate jumped 120 percent.
``Although suicide among children is a rare event, the dramatic increase in the suicide rate . . . underscores the urgent need for intensifying efforts to prevent suicide . . . in this age group,'' said the Centers for Disease Control and Prevention when it released these statistics last spring.
Mary Herbert Daly, a social work manager at Children's Hospital of The King's Daughters, has seen the numbers firsthand. About a dozen kids a month wind up in the hospital's emergency room after attempting suicide.
``There are more and more of them, and they're getting younger and younger,'' she said.
In February, King's Daughters, in conjunction with the Barry Robinson Center and Eastern Virginia Medical School, began the Child Mental Health Program to provide immediate referral and counseling when these children come into the emergency room.
Daly is dismayed that such a program is even necessary. But the numbers don't lie.
Statewide, suicides among children mirror the national rates. The numbers jumped 175 percent among children ages 10 to 14 between 1990 and 1993, and 24 percent among children 15 to 19, says the Virginia Department of Health.
And those numbers only include children who managed to kill themselves. For every completed suicide, says author B.D. Garfinkel in his 1986 book, ``The Medical Basis of Psychiatry,'' there are 300 to 350 serious attempts.
It started when I got into junior high. It seems to me that most girls get into the depression stage then. There were a lot of us like that. It's like a lost feeling. Abandoned. My parents still argued all the time. My grades dropped from As and Bs to Cs and Ds. I couldn't talk to my mom and dad about anything because I was always afraid. Afraid that my dad was going to hit us.
- from an interview with Susie
Why is life so awful for so many young people?
You have only to pick up the newspaper, as Susie did. A front-page article in The Virginian-Pilot about a 10-year national study on adolescents prompted ``Susie's'' letter and paints a grim picture of teenagers' lives. The study concluded that adolescents are neglected, misunderstood and in high peril of ``seriously damaging their life chances'' through drug abuse, pregnancy, antisocial behavior and deficient education.
The article was very true, Susie said, but what it didn't address was the reasons kids find themselves spiraling downward.
Dr. Charles K. Devitt, medical director at Barry Robinson, knows those reasons well, reeling them off with ease:
Chaotic family lives.
Schools that are large and often impersonal.
Pressures, both internal and external, to succeed.
Demands on kids to mature at earlier ages.
Sexual abuse.
Substance abuse: either their own or a family member's.
``Some live in homes where chaos and unpredictability are the norm,'' Devitt said. ``They have a sense that adults are insensitive to their plight, that no one else has been in this kind of predicament before, that there's no way out. And that the pain of living is too great and the rewards are beyond the horizon and insubstantial for the current suffering.''
A combination of factors led to Susie's three suicide attempts.
The first time, she was 12 and in the seventh grade.
Her relationship with her father was disintegrating. He is a violent man, she said, prone to hitting his children and verbally belittling them when they don't meet his expectations.
``I just couldn't take it anymore,'' Susie said of that first attempt. ``I was like, maybe if I weren't here, I wouldn't have to worry about it.''
One night she went into the kitchen and cut her wrist with a knife. Then she thought of her younger brother. ``I can't do this to my brother,'' she remembered thinking, ``because we're so close, and if he were to lose me, he's going to have it really, really bad.''
So she bandaged her wrist and hid it under long-sleeved shirts for a couple of weeks until it healed.
The second attempt came, she said, when she was 16. A close friend had killed himself three weeks earlier. That, combined with the continued tense relationship with her father, drove her to the medicine cabinet and a handful of pills.
``It seemed like every day something bad would happen,'' she said. ``I'd get in trouble for something.'' Once her friend died, she said, ``I couldn't take it any longer.''
Susie realized as soon as she had swallowed the pills that she really didn't want to die. She called her best friend, who rushed over, determined to get her to the hospital. Then Susie's mom came home from work and made her daughter throw up the pills.
She and her mom talked after that incident, Susie said, but her depression continued.
The third attempt was at the end of school last year, she said.
Susie took pills again and, this time, passed out. But they weren't enough to kill her, and she awoke the next morning throwing up. That's when she decided that no matter how bad things got, she wouldn't try to kill herself again, because she didn't want to leave her brother and friends.
But her depression continues. Susie said she doesn't sleep well at night, often lying awake for hours listening to the radio.
She said she's very quiet in school and wishes her friends would just pick up on her mood and ask how she's feeling. ``You don't just come out and say, `I don't feel good. Will you please talk to me?' '' she said. ``You're just silent, but no one seems to be able to pick it up. Even my best friend doesn't understand. She talks to me everyday - she's my best friend - it's not hard to figure out what's going on.''
Her best friend, who also asked not to be identified in this story, said she knows Susie is unhappy. ``But I don't know what to do,'' she said. ``I just listen to her. The only thing I can do is be there with her.''
Susie admitted that she's good at hiding the depression. ``I've been doing it so long,'' she said. Sometimes she hides from the sadness with a combination of drugs and alcohol. ``They help for the short term, while you're on it,'' she said, ``but then once it's gone, you're back in the same place as before.''
She's not alone in her feelings.
Norfolk public schools senior guidance coordinator Pamela Kloeppel also has seen more depression in kids - especially younger children.
``The students most at risk are those that have suffered a multiple set of losses: death of someone close to them, separation of a family through divorce, movement away from someone, a remarriage in a family, reversals of finances. It can be so many things. Loss is all over the place. Child abuse is considered a loss,'' Kloeppel said.
But why do these children turn to death as the answer?
``It's a quick kind of solution,'' said Dr. Suzanne Boulter, a New Hampshire pediatrician who serves on the American Academy of Pediatrics' Committee on Adolescence. ``Teens don't have the ability to take the long view. For them, a small problem in life, like a bad grade in school, a bad report card, not meeting their own expectations, having their boyfriend or girlfriend break up with them, is so important that they can't look beyond that. It's just the worst thing that could ever have happened, and they don't see how to live another day.''
Many adolescents use drugs or alcohol right before they attempt suicide, Boulter said, so their level of judgment is lowered.
She is most concerned about the availability of guns. It's a major reason, she said, that suicide rates are increasing among children.
The Centers for Disease Control agree with Boulter's assessment, noting that almost the entire increase in suicide rates can be attributed to firearms. Males ages 15 to 19 are more likely to kill themselves, even though more girls try, research shows, because females tend to use pills or other less painful methods (alcohol, carbon monoxide) while males tend to use guns.
If someone was to be aged on their experience and mentality, I would be well over the hill. Parents, teachers, counselors, etc., just do not understand what it is like to be a teenager in this decade. Instead of scrutinizing and scolding us, they should offer us help. We may not think that it is what we want, but it is for our own good. I, like many others, have learned to realize that I'm alone.
- From ``Susie's'' letter
The world in which she lives, Susie said, is vastly different from the one in which her parents grew up. Violence, drugs, sex - especially sex - are an integral part.
``I know teen pregnancy is a big thing now, and it scares a lot of girls,'' Susie said. ``So in that way, they think about suicide because they don't want to be pregnant, they don't want to tell their parents, but they still feel they have to have sex with their boyfriends. It's like it's a must. An understood thing. It's sad.''
What's missing, says Barry Robinson's Devitt, is what he calls a ``holding environment,'' the kind of community support that was available in earlier times.
And the institutions that once helped look after children - churches, community groups - have been devalued, he said. ``These were points of support that provided strict oversight and additional role models for kids,'' Devitt said.
So these days, when kids are depressed or overwhelmed, many don't have a support system in place, he said.
``Teachers nowadays, they don't care,'' Susie said. ``They sit in the class and are just waiting the last 10 minutes until the next class.''
She admitted there are some good teachers at her school; her writing teacher, she said, pulls out her feelings. And she said that some of the older teachers still care.
As for guidance counselors, Susie said, ``they think of us as numbers, not individuals.''
It's a result of the larger, more anonymous schools that most kids attend these days, particularly in high school, Devitt said. ``Many kids I meet with don't know the name of their counselor,'' he said. ``They've never met them.''
Virginia Beach schools spokesperson Bonnie Fischer said the system has no formal suicide prevention plan, although suicide, along with other mental health problems, is discussed in 10th-grade health classes. Each school, she said, does have a crisis intervention team that would come together if a child needed help.
Norfolk's public schools have had a suicide prevention program since 1989. Prevention is taught through the regular curriculum, intervention is provided when a child threatens suicide, and a ``postvention'' plan is immediately instituted if a child does commit suicide.
``We take it very seriously,'' Kloeppel said. ``Our job is to educate, but we must be on the lookout for children who need support.''
All the experts point to parents and the family as the first line of defense in preventing suicide.
Susie agreed, saying: ``If families were being more close and understanding, it would help. Family life is a major thing. I need my family and friends. And if they could understand and help you from the very beginning, then everything wouldn't snowball.'
But therapists and doctors also recommend that parents find other relationships for children. ``Make sure they have a relationship with another adult professional, like a pediatrician or counselor or even a non-relative adult outside the family unit,'' Boulter said, ``so that confidential things can be discussed and chewed out. Because it's hard to discuss this with their own parents.'' MEMO: After her interview with reporter Debra Gordon, Susie decided to see a
therapist. She is now in therapy, with her younger brother, trying to
resolve her depression and other problems.
ILLUSTRATION: SAM HUNDLEY
The Virginian-Pilot
Illustration
WARNING SIGNS
In 1991, more teenagers and young adults died from suicide than
died from cancer, heart disease, HIV infection or AIDS, birth
defects, pneumonia and flu, stroke and chronic lung disease
combined. Suicide is the third leading cause of death, behind
unintentional injury and homicide, among those 15 to 24.
-- Centers for Disease Control
Many symptoms of suicidal feelings are similar to those of
depression. Parents should be aware of warning signs in adolescents
who may try to kill themselves. Child and adolescent psychiatrists
recommend that if one or more of these signs occurs, parents need to
talk to their child about their concerns and seek professional help
if the concerns persist:
Change in eating or sleeping habits
Withdrawal from friends and family and regular activities.
Violent actions, rebellious behavior or running away.
Drug and alcohol use.
Unusual neglect of personal appearance.
Marked personality change.
Persistent boredom, difficulty concentrating or a decline in the
quality of schoolwork.
Frequent complaints about physical symptoms, often related to
emotions, such as stomachaches, headaches, fatigue, etc.
Loss of interest in pleasurable activities.
Not tolerating praise or rewards.
A child who is planning to commit suicide may also:
Complain of being ``rotten inside.''
Give verbal hints with statements such as: ``I won't be a problem
for you much longer,'' ``Nothing matters,'' ``It's no use,'' ``I
won't see you again.''
Put their affairs in order - give away favorite possessions,
clean their room, throw away important belongings, etc.
Become suddenly cheerful after a period of depression.
- Source: American Academy of Child and Adolescent Psychiatry.
by CNB