It is estimated that 9% of all teenage deaths in South Africa, are the result of suicide. It is also the fourth leading cause of death among 15 to 19 year-olds globally. Teen suicide has been named a silent epidemic, since the warning signs are often subtle and frequently missed. With this in mind, it is imperative that parents, guardians, teachers and every adult involved in the lives of young people, make sure that they know how to recognise teens who are suffering and offer the support that they need.
This is according to Justine Lacy, Clinical Executive at Profmed Medical Scheme, who says that this is a serious issue that seems to be on the rise. “During 2020 and 2021, Profmed Medical Scheme experienced a 30% increase in hospital admissions for suicide attempts for children and teenagers between the age of 11-18 years and 6.1% in adolescents/adults between the ages of 19-25 years. While one could note that admissions related to a mental health disorder, including depression have also been increasing year on year since 2019, this isn’t the only link to suicide. Many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses.”
In light of this, Lacy says that fighting this silent epidemic starts with recognising the warning signs. “The South African Depression and Anxiety Group (SADAG) has in fact done a lot to educate people on how to identify individuals who are at risk of suicide. Suicide risk factors amongst young people are often related to depression (which is present in an estimated 60% of people who commit suicide. However, in males this relationship is often lacking. What is increasingly recognised, is that depression in males takes many guises, and it might become evident as uncharacteristic aggression, risk-taking, or alcohol- or drug-dependence Studies have found that, the lower the reported rates of depression, the higher were the suicide rates in both males and females. This means that it is imperative that depression is diagnosed and acknowledged in order to decrease someone’s suicide risk.”
She says that teens who attempt suicide will often talk about it whether this be directly or indirectly. “Triggers for suicide in teens results from a depressed mood which manifests in sleeping pattern change and poor appetite, low energy levels, feelings of worthlessness, self-reproach or guilt. If this goes unchecked, it may result in suicidal thoughts. Additional factors which could increase the risk for suicide in depressed individuals are extreme anxiety, agitation or enraged behaviour, excessive drug and/or alcohol use. Recent bereavement is a risk factor for suicide, as is a sense of alienation.”
Dr. Wilhemina Erasmus, Clinical psychiatrist and Profmed member, adds that recently, many teenagers have been struggling to adjust to the online system of schooling and academic problems. “A sense of loss in the experience of certain life events have often been reported by my depressed teenage patients. It has been concerning that the amount of time spent on social media seems to be increasing, which may lead to depression, according to a few new studies. Social media tends to create a false glamour and a false sense of reality which leads to unrealistic expectations.”
According to Dr. Erasmus, teenagers often experience irritability rather than sadness when they are depressed. “They may be grumpy, easily frustrated, or prone to anger outbursts. Their pain may also be experienced in more concrete ways with unexplained physical symptoms like headaches and stomach pain. As they may experience decreased self-esteem, teenagers with depression are prone to be extremely sensitive to criticism. While depressed adults tend to isolate themselves from everyone, teenagers may withdraw only from some people, often their parents, and might even start to hang out with different crowds.”
She adds that parents often ask how they should distinguish between depression and “just moodiness” of a typical teenager. “If the symptoms persists for a long time, is very intense or very different from their usual nature, it may point towards depression. Depressed teenagers also tend to sleep a lot, have low energy levels and have great difficulties with concentrating on their school work.”
Unfortunately, Dr. Erasmus notes that accurate prediction of suicide unfortunately still remains difficult. “Suicide is seldom the result of a single stressor, but rather results from a combination of a desire to end one’s own life as well as the means to do it. A human’s brain is only fully developed around 25 years of age, and it is specifically the part that helps to inhibit impulses which is still growing in adolescence. When a teenager who experiences suicidal ideation starts taking an antidepressant there might be a short period after they have started to feel better, where they may have more energy to act on suicidal thoughts impulsively. It is extremely important to monitor adolescents closely when medication is started.”
To this, Lacy adds that there is help available for those who are at risk of suicide. “If you, as a parent or a teen, needs help, SADAG has a helpline to well-trained people who are always ready to help. Dialing their 24 hour Helpline at 0800 456 789 is the first step towards getting the help that you need. Teachers and educators should also learn to recognise the warning signs of depression and potential suicide in learners. A teacher who is concerned about a learner should facilitate referral to a counsellor, and notify their parents as well as providing access to resources and support,” she concludes.