Families: Catching Teens in Time

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Moody. Difficult. Distant. Teenagers can be all these things and more. Most of the time such behavior means little--just adolescents going through the motions of growing up. But for more than 2,000 American teenagers who end their lives each year, these are the signs of impending disaster. The suicide rate for adolescents has more than doubled since the 1960s. So the challenge for parents is to be able to tell the difference between normal teen angst and terminal despair.

Solving that puzzle is even more imperative at this time of year. Late spring and early summer are the most common seasons for teens to make suicide attempts, say experts. "Lots of things change," explains psychologist Herbert Nieburg, director of behavioral medicine at Four Winds Hospital in Katonah, N.Y. "They may be leaving school and going off to college. They may be moving. There may be a breakup of a romantic relationship." Ohio State University psychologist Carl Tishler concurs. "Parents and teachers need to recognize that sometimes it's a very, very sad experience for kids to graduate from high school." At times this sadness is expressed in recklessness, Tishler says. "It may not be that someone says, 'I'm going to go out and kill myself.' But there are so many unconscious bad feelings. They get drunk, they slam into a bridge abutment, and they die."

Luckily, there are recognizable warning signs, many experts agree. Ninety percent of suicidal teens are depressed, and depression tends to cause certain types of behavioral changes. "There's no one symptom that's going to leap out to a parent," says Kay Redfield Jamison, professor of psychiatry at the Johns Hopkins School of Medicine and the author of Night Falls Fast: Understanding Suicide. "It's rather a whole cluster of changes in behavior and mood and sleep and eating patterns and energy levels." Professionals tell parents to look for dramatic changes in behavior or appearance, changes in weight, changes in performance in school. Any talk about wanting to die or commit suicide should make a parent go on red alert.

Another strong signal is continuing alcohol or drug use. "Substance abuse is very significant," says Nieburg. "One of the first things kids will do to try to make their pain go away is to try and medicate it. They don't go to the doctor and get Prozac or Zoloft. They use marijuana, cocaine, amphetamines, ecstasy, PCP, LSD. They want to get away from the pain."

Be aware that certain kids are more at risk. A teen with a family history of suicide or depression is more likely to make an attempt. So is someone who has already made an attempt. A teen with a life-threatening illness like HIV infection or a history of physical, emotional or sexual abuse is a prime suicide candidate. Several studies have shown that gay teens are significantly more likely to try to take their own lives. A teen in a home with firearms is at greater risk, as shooting is the most frequent method chosen by adolescents to kill themselves. (Experts suggest keeping guns locked up or out of the house altogether.)