A short while ago, like many others, I received the horrific news that a young adolescent boy took his life in his parents’ home during the early hours of the morning while everyone slept. Even I, with so many years of experience in medical and psychiatric medicine, still find it difficult to accept such actions. The degree of trauma and pain suffered by the parents and the immediate family was, as to be expected, enormous and unbearable. The shock and loss experienced by his peers and associates, as judged by their reaction and their comments in the social media sites, was cataclysmic. Everyone searched for answers, and as happens in these situations, there was no shortage of answers. But all of them were merely the result of speculation and guessing, and there were no, and quite likely, there will never be any definitive reason for the tragedy. In the end a young man with so many reasons to live, was lost forever.
To God-fearing societies, Suicide is considered to be an abomination against God and except in the most extreme, radical societies, the action is considered to be illegal or taboo. Yet despite every effort to control it, each year over a million people the world succeed in killing themselves. This statistic is even more frightening when you consider that for every successful attempt there are many more who have either attempted and failed, or seriously considered the possibility but never took any action. Sometimes I wonder whether there is some truth in the statement made by a collegue of mine during a discussion on the subject; “We humans are all born with the instinct to take our lives at any time, and for any reason, and except for the grace of God and a little luck, we often do.”
Suicide is a worldwide scourge which, despite intensive attention, continues to increase at an alarming rate. The World Health Organization estimates that by the year 2020 there will be more than 1.5 million successful suicides and between 15 – 30 million unsuccessful attempts occurring annually. Each year it ranks in the top ten causes of death among adults and among the top three causes of death among adolescents. Further, although the records are not complete, the evidence points to the fact that the incidence of suicide in the Caribbean is surprisingly high and getting higher. This is a state of affairs that is unacceptable and demands the concerted efforts and understanding of everyone including parents, politicians, teachers and trained professionals as a matter of urgency.
Apart from the tragic consequences to the victim, Suicide is a very serious public health issue that has lasting, harmful effects on the family, the associates, and the community, which can persist for generations. Unlike other events, this is further aggravated because of the unfortunate nature of the deed and the resulting ongoing “embarrassment”. The action invariably leads to a sense of shame and withdrawal, and a genuine reluctance to seek appropriate help. When this is compounded with the inevitable feelings of responsibility and guilt experienced by the surviving family, the result is a further disintegration within the family structure leading to ongoing pain and suffering.
Suicide is a highly complex phenomenon, which despite extensive research, is still not clearly understood and unfortunately, not adequately managed. It is a behavioral action that involves poorly understood interactions between genetic, biochemical, psychological, societal, and cultural factors. Research shows that, especially in regard to adult victims, there are most often diagnosable underlying psychological conditions such as depressive illnesses, behavioral or personality disorders or substance abuse. This would suggest that, at least in regard to adult population, much more aggressive attention should be paid to the identification of early symptoms, the use of public education and the easy availability of competent resources including trained personnel, will have some effect on reducing the rising incidence of suicide.
Contrary to prevailing views, the problem of Adolescent Suicide is, in my view, somewhat different from Adult Suicide, and should be approached differently. Although depression is frequently mentioned as a risk factor in its causation and some sources suggest that this may as high as 75% of cases, I believe that the real causes are much more complex, and relate to the underlying demands of process of adolescence itself. At best, these years are an anxious and unsettling period for teenagers as they face the difficulties of transition into adulthood. It is the period in life where on the one hand much is expected from them, but also one during which they undergo tumultuous changes physically, sexually and emotionally. They experience strong feelings of doubt, inadequacy, gender uncertainty and orientation and have deep seated fears of facing the future and expectations of adulthood, while they deal with the competitive demands of the present. It is a period that is often confusing and intimidating, causing some of them to feel isolated from family or authority, reluctant to seek guidance from them and unfortunately, turning to their peers for help. This is a formula for tragedy!
Compounding this situation, is the very real social and environmental risk factors which we, as adults, do not understand and tend to take for granted. We assume that “they will learn as we did when we were their age” and make little or no effort to really understand our children. We tend to conveniently forget our own period of uncertainty and feelings of inadequacy which we experienced or witnessed in our time, and we try not to recall the names of our friends or contemporaries who fell by the wayside, or chose the ultimate solution because “they could not take it anymore”. I have no doubt that any one of us will have no difficulty to remember several examples among our own peers in our day.
It is this perceived apparent inadequacy or inability of parents and other people in authority to display the appropriate interest or worse, ignore the developing signs on the horizon, that in my mind give rise to some, if not all, the risk factors. As parents and adults, our expectations are directed to personal success and advancement for our children, and we give little attention to storm raging within and around them. To make matters worse, the current adolescent population has the added impact of the internet, and in particular such media sites as Facebook, to influence and further aggravate their conflicts. Not the least of which is the lingering fear of exposure, or ridicule or humiliation that, unlike previous generations, could occur and spread rapidly and lead to devastating consequences. Parents must recognize this very real possibility at all times and must take every opportunity to maintain open communication, flexibilty and willingness to understand their children.
Suicide among adolescents very rarely occurs on a planned, premeditated program. Rather it is much more an impulsive response to an unacceptable situation occurring in the individual’s life, whether that be a failed romance, bullying, criticism, sexual orientation or any of the many variations that has the potential of causing pain and embarassment, especially when the victim feels unable to deal with it. I recall the response of a young girl after a failed attempt:
“I did it on a sudden impulse, when I could not bear the thought that everybody will soon know about me. It seemed that this was the right thing to do especially since none of my family or friends really understood.”
Much has been written on this subject, but the following observation from Social Science department of the University of Amsterdam, Holland, is impressive:
“Suicidal feelings should not be underestimated, they are real and powerful and immediate. The victims are driven by pain not choice. Suicide isn’t chosen – it happens when pain exceeds the resources for coping with pain. But we do know that suicide is often a permanent solution to a temporary problem. And we also know that most people who once thought about killing themselves are now glad to be alive. They did not want to end their lives – they just wanted to stop the pain.”
Suicide is clearly a serious concern which is crying out for serious and concerted action from all the relevant members of society. The only way we can hope to reduce the incidence of attempted and completed episodes in our community is by establishing comprehensive programs involving all members of society. In situations where meaningful efforts in education, sensitization and improved communications among all groups have occurred there has been significant improvement both in the reduction of events and in the general welfare of our teenage population. But if we hope to be successful we must include everyone involved in the care and concern of our adolescents;
-Health authorities must provide adequate professional support such as Social and Psychological personnel to deal with the very real adolescent problems of adjustment and orientation and to identify and correct the symptoms of depression so common at that age. We cannot allow the present pattern of leaving them to their own resources and expected increasing disasters.
-Families must be educated to their responsibility in the welfare of their children. Negative family functioning is undoubtedly a strong risk factor. There is a very strong association of suicidal and other emotional ideation among teenagers with a family history of suicide, substance abuse, marital conflict, physical violence and marital conflict including divorce, neglect or abandonment. Studies suggest that family conflicts precipitate at least 20% of completed suicides and 50% of attempted. Successful family interactions result in providing the necessary protective factor, secure safety net and open communications that are needed to help overcome any challenge or conflict.
-School personnel play an equally vital role in the lives of their students. The ongoing contact in the classroom and in the hallways may provide an opportunity for early identification and effective prevention of potential behavior. Any change in academic performance or behavior or emotional response may herald an early sign of trouble. This is even more important since students are more willing to confide in their teacher than their parents. But for this to take place, teachers must make the effort be alert and proactive in the school.
In the end, the only chance we have to try to curb this scourge in society, and to protect our children from impulsively destroying their sacred and God-given life lies in our willingness, as parents, teachers, professionals or support personnel to recognize our individual and group responsibilities and to take steps to familiarize ourselves with appropriate knowledge. Normal, healthy adolescent development occurs in the context of a loving, secure, mutually respectful setting where there are responsible and mature relationships. Until they are comfortable to express their concerns, positive or negative, to parents and teachers and not be afraid of ridicule or embarrassment they are likely to keep them to themselves or worse, seek out the advice of their peers.
…………This is the challenge we face as we continue to witness the senseless loss or destruction of our children.
< >
No one ever lacks a good reason for suicide.
……Cesare Pavese
Suicide is not a remedy.
…..James A. Garfield There is something great and terrible about suicide.
……..Honore De Balzac
Suicide is the remedy of pain
…..Matt Hartman
More than one soul dies in a suicide
…..Author Unknown
When people kill themselves, they think they're ending the pain,
but all they're doing is passing it on to those they leave behind ……Jeannette Walls
Sometimes I wonder if Suicides aren’t in fact,
Sad guardians of the meaning of life
…..Vaclav Havel
I’ll show you a young man with so many reasons why,
there but for fortune, go you or I.
.….Joan Baez (“there but for fortune”)
To God-fearing societies, Suicide is considered to be an abomination against God and except in the most extreme, radical societies, the action is considered to be illegal or taboo. Yet despite every effort to control it, each year over a million people the world succeed in killing themselves. This statistic is even more frightening when you consider that for every successful attempt there are many more who have either attempted and failed, or seriously considered the possibility but never took any action. Sometimes I wonder whether there is some truth in the statement made by a collegue of mine during a discussion on the subject; “We humans are all born with the instinct to take our lives at any time, and for any reason, and except for the grace of God and a little luck, we often do.”
Suicide is a worldwide scourge which, despite intensive attention, continues to increase at an alarming rate. The World Health Organization estimates that by the year 2020 there will be more than 1.5 million successful suicides and between 15 – 30 million unsuccessful attempts occurring annually. Each year it ranks in the top ten causes of death among adults and among the top three causes of death among adolescents. Further, although the records are not complete, the evidence points to the fact that the incidence of suicide in the Caribbean is surprisingly high and getting higher. This is a state of affairs that is unacceptable and demands the concerted efforts and understanding of everyone including parents, politicians, teachers and trained professionals as a matter of urgency.
Apart from the tragic consequences to the victim, Suicide is a very serious public health issue that has lasting, harmful effects on the family, the associates, and the community, which can persist for generations. Unlike other events, this is further aggravated because of the unfortunate nature of the deed and the resulting ongoing “embarrassment”. The action invariably leads to a sense of shame and withdrawal, and a genuine reluctance to seek appropriate help. When this is compounded with the inevitable feelings of responsibility and guilt experienced by the surviving family, the result is a further disintegration within the family structure leading to ongoing pain and suffering.
Suicide is a highly complex phenomenon, which despite extensive research, is still not clearly understood and unfortunately, not adequately managed. It is a behavioral action that involves poorly understood interactions between genetic, biochemical, psychological, societal, and cultural factors. Research shows that, especially in regard to adult victims, there are most often diagnosable underlying psychological conditions such as depressive illnesses, behavioral or personality disorders or substance abuse. This would suggest that, at least in regard to adult population, much more aggressive attention should be paid to the identification of early symptoms, the use of public education and the easy availability of competent resources including trained personnel, will have some effect on reducing the rising incidence of suicide.
Contrary to prevailing views, the problem of Adolescent Suicide is, in my view, somewhat different from Adult Suicide, and should be approached differently. Although depression is frequently mentioned as a risk factor in its causation and some sources suggest that this may as high as 75% of cases, I believe that the real causes are much more complex, and relate to the underlying demands of process of adolescence itself. At best, these years are an anxious and unsettling period for teenagers as they face the difficulties of transition into adulthood. It is the period in life where on the one hand much is expected from them, but also one during which they undergo tumultuous changes physically, sexually and emotionally. They experience strong feelings of doubt, inadequacy, gender uncertainty and orientation and have deep seated fears of facing the future and expectations of adulthood, while they deal with the competitive demands of the present. It is a period that is often confusing and intimidating, causing some of them to feel isolated from family or authority, reluctant to seek guidance from them and unfortunately, turning to their peers for help. This is a formula for tragedy!
Compounding this situation, is the very real social and environmental risk factors which we, as adults, do not understand and tend to take for granted. We assume that “they will learn as we did when we were their age” and make little or no effort to really understand our children. We tend to conveniently forget our own period of uncertainty and feelings of inadequacy which we experienced or witnessed in our time, and we try not to recall the names of our friends or contemporaries who fell by the wayside, or chose the ultimate solution because “they could not take it anymore”. I have no doubt that any one of us will have no difficulty to remember several examples among our own peers in our day.
It is this perceived apparent inadequacy or inability of parents and other people in authority to display the appropriate interest or worse, ignore the developing signs on the horizon, that in my mind give rise to some, if not all, the risk factors. As parents and adults, our expectations are directed to personal success and advancement for our children, and we give little attention to storm raging within and around them. To make matters worse, the current adolescent population has the added impact of the internet, and in particular such media sites as Facebook, to influence and further aggravate their conflicts. Not the least of which is the lingering fear of exposure, or ridicule or humiliation that, unlike previous generations, could occur and spread rapidly and lead to devastating consequences. Parents must recognize this very real possibility at all times and must take every opportunity to maintain open communication, flexibilty and willingness to understand their children.
Suicide among adolescents very rarely occurs on a planned, premeditated program. Rather it is much more an impulsive response to an unacceptable situation occurring in the individual’s life, whether that be a failed romance, bullying, criticism, sexual orientation or any of the many variations that has the potential of causing pain and embarassment, especially when the victim feels unable to deal with it. I recall the response of a young girl after a failed attempt:
“I did it on a sudden impulse, when I could not bear the thought that everybody will soon know about me. It seemed that this was the right thing to do especially since none of my family or friends really understood.”
Much has been written on this subject, but the following observation from Social Science department of the University of Amsterdam, Holland, is impressive:
“Suicidal feelings should not be underestimated, they are real and powerful and immediate. The victims are driven by pain not choice. Suicide isn’t chosen – it happens when pain exceeds the resources for coping with pain. But we do know that suicide is often a permanent solution to a temporary problem. And we also know that most people who once thought about killing themselves are now glad to be alive. They did not want to end their lives – they just wanted to stop the pain.”
Suicide is clearly a serious concern which is crying out for serious and concerted action from all the relevant members of society. The only way we can hope to reduce the incidence of attempted and completed episodes in our community is by establishing comprehensive programs involving all members of society. In situations where meaningful efforts in education, sensitization and improved communications among all groups have occurred there has been significant improvement both in the reduction of events and in the general welfare of our teenage population. But if we hope to be successful we must include everyone involved in the care and concern of our adolescents;
-Health authorities must provide adequate professional support such as Social and Psychological personnel to deal with the very real adolescent problems of adjustment and orientation and to identify and correct the symptoms of depression so common at that age. We cannot allow the present pattern of leaving them to their own resources and expected increasing disasters.
-Families must be educated to their responsibility in the welfare of their children. Negative family functioning is undoubtedly a strong risk factor. There is a very strong association of suicidal and other emotional ideation among teenagers with a family history of suicide, substance abuse, marital conflict, physical violence and marital conflict including divorce, neglect or abandonment. Studies suggest that family conflicts precipitate at least 20% of completed suicides and 50% of attempted. Successful family interactions result in providing the necessary protective factor, secure safety net and open communications that are needed to help overcome any challenge or conflict.
-School personnel play an equally vital role in the lives of their students. The ongoing contact in the classroom and in the hallways may provide an opportunity for early identification and effective prevention of potential behavior. Any change in academic performance or behavior or emotional response may herald an early sign of trouble. This is even more important since students are more willing to confide in their teacher than their parents. But for this to take place, teachers must make the effort be alert and proactive in the school.
In the end, the only chance we have to try to curb this scourge in society, and to protect our children from impulsively destroying their sacred and God-given life lies in our willingness, as parents, teachers, professionals or support personnel to recognize our individual and group responsibilities and to take steps to familiarize ourselves with appropriate knowledge. Normal, healthy adolescent development occurs in the context of a loving, secure, mutually respectful setting where there are responsible and mature relationships. Until they are comfortable to express their concerns, positive or negative, to parents and teachers and not be afraid of ridicule or embarrassment they are likely to keep them to themselves or worse, seek out the advice of their peers.
…………This is the challenge we face as we continue to witness the senseless loss or destruction of our children.
< >
No one ever lacks a good reason for suicide.
……Cesare Pavese
Suicide is not a remedy.
…..James A. Garfield There is something great and terrible about suicide.
……..Honore De Balzac
Suicide is the remedy of pain
…..Matt Hartman
More than one soul dies in a suicide
…..Author Unknown
When people kill themselves, they think they're ending the pain,
but all they're doing is passing it on to those they leave behind ……Jeannette Walls
Sometimes I wonder if Suicides aren’t in fact,
Sad guardians of the meaning of life
…..Vaclav Havel
I’ll show you a young man with so many reasons why,
there but for fortune, go you or I.
.….Joan Baez (“there but for fortune”)
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