Teen suicide is contagious. Small communities, because of the close knit relationships and limited number of resources, are particularly susceptible. Adolescents are building relationships with their friends as a link to the world outside the family. Relationships with parents are strained in this process, whether parents notice or not.

The loss of a friend can shatter the teen's developing worldview and his/her hope for the future. As the teenager reaches for support from his/her peers, the sadness and loss can spiral in intensity within the peer group. The strength of the family bond is the only lifeline that the adolescent can count on at this point. If anything blocks that link, the risk of contagion becomes real.

Statistics about teen suicide are astonishing:

For every two homicides in the U.S. there are three suicides.

Every hour and forty-five minutes another young person commits suicide.

Suicide is the 2nd leading cause of death among college students and the third-leading cause of death among youth overall (ages 15-24).

Teen/youth suicide rates have tripled since 1970.

Mental Illness: Ninety percent of adolescent suicide victims have at least one diagnosable, active psychiatric illness at the time of death most often depression, substance abuse, and conduct disorders. Only 15% of suicide victims were in treatment at the time of death.

Previous Attempts: Between 26% and 33% of adolescent suicide victims have made a previous suicide attempt.

Stressors: Suicide in youth often occurs after the victim has gotten into some sort of trouble or has experienced a recent disappointment or rejection.

Firearms: Having a firearm in the home greatly increases the risk of youth suicide. Sixty-four percent of suicide victims 10-24 years old use a firearm to complete the act.

Contrary to common belief, asking your child about suicidal feelings does not increase the risk of suicide. In fact, the silence may well increase the risk of suicide. Without support, a depressed teen may conclude that their plight is hopeless.

Asking teenagers about suicide won't make them more likely to contemplate it, as some parents and school officials fear, a study suggests. In fact, the study found that simply asking troubled students about any suicidal impulses appears to ease their distress and might make some of them less likely to try killing themselves.

The results confirm what many mental health experts already believe and should alleviate fears among some parents and schools that just mentioning suicide might plant the idea in teens' minds, said study author Madelyn Gould, a researcher at Columbia University and New York Psychiatric Institute.

National data suggest that each year more than 3 million youngsters ages 15 to 19 think seriously about committing suicide. About 1.7 million try it, with more than half of the attempts requiring medical attention; and about 1,600 succeed.

"Without asking a kid directly, it's sometimes hard to pick up," Gould said.

On March 22, 2005, a disturbed 16 year old Native American teen with a history of being teased by his peers killed 9 and then himself.

The shooter had a history of posting to a Neo-Nazi website. His comments give some hints about why it happened.

As a result of cultural dominance and interracial mixing, there is barely any full-blooded Natives left. Where I live, less than 1 percent of all the people on the reservation can speak their own language.

Under a National Socialist government, things for us would improve vastly," it said. "That is why I am pro-Nazi. It's hard though, being a Native American National Socialist, people are so misinformed, ignorant and close minded, it makes your life a living hell.

This boy was profoundly alienated. His link to his parents was broken, and what little support he had from his grandfather led to grandfather being the first victim.

Rural Native American reservations are isolated, sparcely populated and close knit. Relationships are fractured by poverty, drug and alcohol abuse, and profound alienation leads to the highest rate of suicide among teens.

Experts say teen suicide is an epidemic on Indian reservations across the country. Some of the highest teen suicide rates are on Indian reservations in the Upper Midwest.
[...]
American Indian teen suicide is a complex problem with no easy solution, says McDonald. Poverty, substance abuse, and cultural issues all play a role.

There are barely enough mental health providers to respond to crisis situations on most reservations. There's rarely the time for prevention or long-term counseling. Efforts to help are often stymied by a lack of resources. A successful suicide intervention project on the White Earth reservation recently shut down. The project coordinator says the volunteers who ran it simply burned out. Doug McDonald says American Indians have been left behind even in the area of psychiatric research. He contends there's less mental health research about American Indians than any other ethnic minority in the United States. That means mental health professionals often don't have critical information about the culture and values of the people they care for.

Attempting suicide has become an acceptable response to a desperate life for American Indian teens, according to Doug McDonald.
[...]
McDonald thinks part of the problem is that some Indian kids don't have healthy role models. He says there are many great role models for Indian teens to emulate, but too often when they look to the adults in their life, they see them deal with problems by turning to alcohol, drugs and violence. Many Indian families lost the ability to parent when a generation grew up in government boarding schools had no parental role models, says McDonald.

Indian communities must come together to lead the effort to save Indian children, McDonald believes, and he's hopeful getting the attention of the U.S. Senate will bring more mental health resources to Indian Country. "If nothing is done, then look out. Because these children are crying out, they're screaming at the top of their lungs at this point, giving their lives, saying, 'I am miserable, and I am miserable to the point I'd just as soon not be around anymore.' If we don't listen to that, the problem is only going to get worse," says McDonald.

Nothing less than a rapid, sustained response will solve the crisis, McDonald says, because the problem has been building for many years, and can't be fixed by sending a few crisis counseling teams to reservations.

Nothing short of major social policy changes will make a difference for adolescents in America.

Nice touch CBS! Thanks!

There is lots more at the link.

CBS.com

“...there's nothing, repeat, nothing to be ashamed of when you're going through a depression. If you get help, the chances of your licking it are really good. But, you have to get yourself onto a safe path.” - Mike Wallace, Co-Editor of 60 Minutes in an interview with CBS Cares on his personal journey through depression

Enlightenment Bulletin Board :: Electroshock therapy may have side benefit

People with depression have high concentrations of norepinephrine, a nervous system hormone that signals blood vessels to constrict and ratchets up blood pressure, researchers report. Treating these individuals with electroshock therapy lowers their norepinephrine concentrations—and their heart rate and blood pressure too, scientists find.

This article is of particular interest to me because of a recent article written by a person recovering from depression who made some claims about a long-term strategy in correcting a depressive lifestyle. I posted the article here with a caveat that I didn't endorse his statements and wondered aloud if his assertions in particular about norepinephrine were true. Today I find this article about a researcher finding high levels of norepinephrine in depressed people. Interestingly enough, they found shock treatments (ECT) lowered norepinephrine levels in the brain. They speculated some anti-depressant medications may do so also but noted there was very little research on the topic. The authors talk primarily about the danger to heart health that norepinephrine posed due to higher blood pressure.

I'm wondering if there is a reader who could direct me to some resources about norepinephrine and depression. Please email me.

ECT is a controversial treatment for most everyone. The literature supports using ECT as a last recourse for a suicidal depression after both medication and therapy fail. However, the thought of sending an electrical shock through someone's brain is enough to give most people a chill.

I've seen a lot of people benefit from ECT, some people who got relief no other way. And I've seen a few people who felt a certain level of trauma from the experience including some who reported long-term memory loss. I've also seem a disturbing pattern of in a few patients who showed some beginning signs of dementia. After a series of ECT, they showed increased disorientation. Some were so disoriented for long enough to required a nursing home placement. I can't say I saw these patients long enough to know whether this disorientation persisted. But it's enough to make me think more than twice about suggesting ECT to anyone, especially the elderly.

Then I recalled another article I read recently about a new technique that seemed to have promise as an alternative to ECT. This technique involves using a specialized MRI to create an electromagnetic field inside the brain that has had "anti-depressant effects" in animal studies. Somehow an MRI seems much less invasive and focused than a global electrical shock. It will also be interesting to see if this technique also decreases norepinephrine.

Enlightenment Bulletin Board ::'Complicated Grief' Goes Beyond Depression

Researchers estimate that 10 percent to 15 percent of the surviving relatives of people who die naturally experience complicated grief, Prigerson said. She said people who lose someone they were emotionally dependent on are at greatest risk.

She is working to get the disorder recognized in the American Psychiatric Association's next edition of the Diagnostic and Statistical Manual of Mental Disorders. The next DSM-V will be published in 2012. Dr. Michael First, a Columbia University psychiatry professor and member of a committee that will decide what goes into the DSM, said the panel will consider whether complicated grief merits its own designation. "From what I've seen so far, it's certainly not an off-the-wall suggestion," First said. He said doctors see patients all the time, especially the elderly, who never get over the death of a loved one.

Dr. Richard Glass, a psychiatry professor at the University of Chicago and deputy editor of the Journal of the American Medical Association, said studies have shown that people suffering from complicated grief do not meet the criteria for depression or post-traumatic stress, although some of the symptoms overlap. "The evidence so far indicates that there really is something different here," Glass said.

The most recent study, published Tuesday in JAMA by Shear and her colleagues at the University of Pittsburgh, examined different ways to treat complicated grief. Researchers found that 51 percent of patients treated with a therapy developed just for the symptoms of complicated grief showed improvement. So did 28 percent of complicated grief sufferers who underwent a treatment commonly used for depression.

Golebiewski, 56, of North Fayette, was given the therapy for complicated grief as part of the study. It included being tape-recorded while he talked about his daughter's life and death, then listening to those recordings. He said after listening to the tapes repeatedly, he developed ways of dealing with those feelings. "I was able to visualize her again in life and as happy as she was and the cheerful person that she was," he said. "I was able to see her there in that context."

Out standing research has documented our innate ability to help ourselves recover from grief. I believe people have the ability to facilitate recovery from many mental health disorders. The problem is that we create many obstacles that prevent our natural ability to recover from working as it should.

For many years, grief groups have shown their effectiveness. One of the natural processes that emerge from these groups is that each member to review their thoughts and feelings about their losses repeatedly throughout their treatment. The group, with the help of a therapist, helps the member identify recurrent themes in their stories that suggest strategies to better cope with their feelings. This emotional process facilitates changing the memories about the loss, so that when inevitably, the survivor remembers their loss again, they remember the healing thoughts and feelings as well.

A similar process may be helpful recovery from memories caused by singular traumatic events. However, there are other issues in post-traumatic stress that need attention as well.

The biggest obstacle to recovery from grief is denying or avoiding the thoughts and feelings that come with the memories. It is not possible to just forget something so emotionally important to us. Sometimes our lives interfere and limit the time we have to grieve. At other times, some believe it's best not to think about it.

It's very important that we set aside a significant amount of time, preferably daily to devote to recoverying from grief. A photo album, sorting through the belongings of our loved one, as painful as it is, can be very helpful. If such efforts are not helpful, the help of a qualified mental health professional may be necessary.

Good advice for an aging population:

Enlightenment Bulletin Board :: APA Says Older Adults: Beware Memory Scams; Get It in Writing First

Especially if you’re older, get everything in writing, from estimates to receipts. Psychologists at Washington University report that the memory function of people in their mid-60s and up is easily swayed by the power of suggestion, making them more vulnerable to memory-related scams. A full report appears in the May issue of the Journal of Experimental Psychology (JEP): General, which is published by the American Psychological Association.

For example, an unscrupulous contractor can tell an older customer, “I told you it would cost [a much higher price than was originally quoted] and you agreed to pay!” Without a written estimate, the customer is likely to “remember” it that way, too, and be overcharged. Another scam, “you forgot to pay me,” also underscores the need for written receipts. Some con artists even run their own rudimentary memory tests on the elderly, checking to see if their memory is bad enough to make them good victims.

The article emphasizes that there is great variation between older adults in their ability to be scammed in this way, however, here is one more reason to do business in what has always been the best method. Get it in writing first!