PREVENTING TEENAGE SUICIDE

Nothing is so tragic as the life of a young person, who has not yet really or fully lived, to be cut short. And there is a certain horrific stigma when it becomes public knowledge that a premature death was from suicide. Suicide conjures up all the negative connotations of mental illness in the family, the 'dysfunctional' family, and sin. It is often considered to be an act of cowardice, escaping life or 'copping-out'. Such attitudes show a lack of understanding, a lack of empathy. A person with adequate self-esteem and self-confidence, a positive and outgoing attitude, can hardly realize the suffering of a teenager with severe depression. The most severe depression is due to a double jeopardy, a negative psychology coupled with a genetic biochemical imbalance.

The individual who is doubly handicapped suffers great anguish and despair within. I say, 'within' advisedly, as many afflicted with depression learn to put on a happy face and seem perfectly normal. They are often considered to be the 'nicest' people, as they have learned how to say what people want to hear and show what people want to see. But they contain their demons in a box that is like a coffin, and when alone they are haunted by horrible jack-in-the-boxes, dark feelings and impulses they can share with no one, and so they feel isolated, alienated, not belonging to the rest of humanity, which seems to be going along with gaiety and confidence.

Often these severely depressed individuals become addicted to substances such as alcohol and cocaine, and there is the ever-present consolation of marijuana. These are self-medications for feelings that are experienced as intolerable. If not for the substance, life feels like it is not worth living. As addicts, there is yet another stigma, that of the 'junkie'. Their reputations fall with the lowest of the low, even though the habit may be relatively mild. But in self-medicating, the teenager removes himself from the professional help he or she greatly needs.

In order to prevent suicide, early intervention for depression is adviseable, and a psychiatrist is best suited to help the family evaluate which of the many treatment possibilities would be most helpful. He or she can provide prescription medications and a variety of psychotherapy and counselling approaches, from individual and group psychotherapy to family counselling. The psychiatrist may also refer to Alcoholics Anonymous or other self-help groups for alcohol and other drug dependencies and addictions. AA and other self-help programs are very effective for some and totally ineffective for others, and yet the cost is minimal and the resources great, over time. Then there are the twenty or thirty day rehabilitation and detox programs, which are helpful to a few more. There are also residential treatment centers where patients would be inmates for months at a time, with comprehensive programs of individual and group therapy, and rehabilitation resources.

Psychotherapy may be short or longterm, supportive or intensive. Supportive therapies aim to maintain the status quo, and usually consist of short sessions once a week or less or even less often. Intensive psychotherapy, for those who have the motivation and capacity for it, seek more profound changes in the personality, which work to prevent recurrences of depression or relapses into addiction. This means more than one long session per week, sometimes extending for a period of years. It aims to resolution of unconscious unresolved conflicts. Its basis is an evolved working relationship which seeks to restore trust and interpersonal skills, which are necessary to self-esteem and social functioning.

When resolution is effected and insight obtained, the person regains self-esteem and self-confidence and his or her unique creativity is released. Oftentimes the teenager is a frustrated writer, artist, musician or actor. The person will find a constructive niche in society and become a productive citizen. This is a better choice than a premature interruption of life, but involves a considerable investment of time and energy, and persistence in a painful, difficult and protracted process. But depression itself is a signal of struggle, and that struggle can be resolved by either life or death. Most of us would say, difficult as it is, life is the answer.