Melvin Konner M.D. Ph.D.

The Official Website of Melvin Konner, M.D, Ph.D.

...Since the causes of human nature are not a one-way street, I also want to know how changes in our environment make their impact on us--how advances in biology and medicine change how we think about our lives. My knowledge and experience have often led me to comment publicly on medical ethics, health care reform, child care, child welfare, and other policy questions, and I will do that here as well.
You are here: Home Teen Suicide: Can It Always Be Stopped?

Teen Suicide: Can It Always Be Stopped?

January 4th, 2011

An American between 15 and 24 commits suicide every two hours.

teen1My last posting about the tragic and very public suicide of a sixteen-year-old boy on the grounds of my niece’s Charleston school, produced two anonymous comments (on the Psychology Today website):

CALL ME A PESSIMIST BUT-
I see first all those who failed Aaron, and a group being sad and responding after a tragedy, yes, but also acts that are self preserving of the remaining group, and few answers.

What was his private hell?

What failure of parents and school and friends occurred?

How can we fix all of it?

Hard questions.
Not just symbolic gestures are what the situation requires IMHO.

And:

Its the usual thing… We show compassion on a certain individual when they die. I think the life of Aaron calls the attention of every one of us to show compassion for others…

My reaction is to ask, “How do you know that anyone failed Aaron?” Because he took his own life? Because he did it in a public way that seemed as if it could have be vengeful? Because you believe that every suicide can be prevented by compassion?

There was not the slightest evidence that Aaron’s fellow students lacked compassion for him while he was alive among them, much less that there had been any bullying. His schoolmates tolerated his moods and eccentricities, which included playing his boombox loudly on his shoulder between classes, for which he was affectionately nicknamed “Boombox Kid.”

As for the adults around him-parents, teachers, counselors-there is every indication that his “private hell” was recognized and that many were trying to help him. And the fact is that no, not every suicide can be prevented by compassion, or psychotherapy, or medication, or all of them put together.

Someone between fifteen and twenty-four commits suicide roughly once every two hours in the U.S., and although some well-publicized and especially tragic cases have been associated with bullying, most are not. Many are associated with depression, but although girls are three times as likely as boys to be depressed-and even twice as likely to attempt suicide-boys are four to five times more likely to actually kill themselves.

Should we look for warning signs-depression, isolation, substance abuse, suicidal ideation, attempts at self-harm, and so on? Of course we should, and we should intervene when we see them. For a young person especially, “It gets better” is a true and helpful message. Limiting access to firearms and drugs is surely a plus.

But the tools of prediction are far from perfect. We can’t keep every moody teen on suicide watch, and there is so far no form of compassion guaranteed to prevent an impulsive youngster from taking his own life. The teenage years are characterized by unprecedented hormonal surges that take place years earlier in a child’s life than they did in centuries past.

Equally important, we have learned in the past decade or two that myelination and neurotransmitter development in the parts of the frontal lobes that help us inhibit impulses do not reach mature status until after age twenty. Adolescents are impulsive and their inhibitory abilities are weak.

Of the thousands who take their own lives each year, many can surely be prevented from doing so. Children are bullied, warning signs go unheeded, mental illnesses are often not recognized or treated until it is too late. But all these problems have been known for many years. They are not solved of course, and we need to do better, but they have gotten attention, and all our collective efforts have reduced the suicide rate-a little bit.

Meanwhile, there are many puzzles. The huge gender disparity tells us that girls are not always worse off than boys, and underscores the relationship between successful suicide and aggression. We could no doubt figure out how to do more with this information.

Perhaps the greatest paradox is that African-Americans and Hispanic-Americans, both disadvantaged minority groups, who are in a sense constantly bullied by society, have much lower suicide rates at all ages than Non-Hispanic Whites do. Only the Native American/Alaskan Native minority exceeds the dominant white majority in this tragic way of ending human life. If we understand the first things about suicide, why can’t we explain why some oppressed minorities are so much less likely to do it than the dominant majority?

To point, in complete ignorance, to a “failure” or lack of “compassion” on the part of Aaron’s relatives, teachers and friends is to blame the other victims of his suicide. I wrote about their reactions because his action threatened to damage hundreds of others along with himself. Their response, far from being “just symbolic gestures,” exemplified the best things about the human spirit-which incidentally include, in every culture, symbols and rituals that express sadness and compassion and that knit a torn community together after a tragedy.

In fact, it is one of the most distinctively human of all expressions, and since the dawn of culture it has helped us to go on in the face of tragedy and loss. “How can we fix all of it?” is indeed a “hard question”, and it will be a welcome day when we can. Meanwhile, let’s show some compassion for the survivors, and admire their twin human abilities to grieve together and go on.

Note: By invitation, I’ve started a blog on the Psychology Today website, and my latest post can be read there or here, although different comments may be  posted there.

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