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Articles by Dr. Dubey on mental health.

Parenting in midlife: Understanding Teenage Suicide

Parenting in midlife: Understanding teenage suicide.

“I will kill myself and blame it on you,” said one upset teenager to another. The other responded, “You wait and see, I will kill myself before that and blame it on you.” She then actually carried out the threat. This conversation is not from a soap opera on television. A parent’s worst nightmare – this is a true incident that happened between two school friends in rural India. And the girls were not on Blue Whale or any such app.

Luckily, medical professionals were able to save the girl’s life. But the school authorities asked her to stop coming to school. They did not want to deal with liability issues. The same school had lost a male student to suicide in the previous year. The rumour was that the boy had consumed pesticide because he was infatuated with a girl and there were some problems because of that. The same boy had lost his young male cousin to suicide a few years earlier. The reason for that suicide was apparently the same – love life issues. Infatuations and love affairs are highly disapproved of in rural Indian society. None of these kids showed any signs of clinical depression.

But this is not a scary scenario that only rural parents deal with. Over the past year, coincidentally, I worked with two 16 year old girls – both of whom had attempted suicide. One has a history of cutting, while the other has attempted suicide before. For both, the recent episode was triggered by a fight with other kids in school. The girls belong to families that are on opposite ends of the socio-economic spectrum. One studies at a well known, high end, private boarding school. The other studies at a rural, government school. Both seem to have concerned, caring parents. And both seem to have a decent relationship with their parents.

For parents of teenagers, this brings up many questions. Why do some teenagers play these life and death games? How does the thought of killing themselves as a way of proving a point, making a statement, or scoring one on the other, enter their minds? Teenagers have their entire lives ahead of them, why then do some feel that they have nothing to live for? Or, why do they believe that their current situation will never change and their problems will never be solved?

Parents often wish to think of childhood and youth as a care-free time. By the time their children are in their teenage years, most parents have hit midlife. In midlife, it is often difficult for parents to remember what their own teenage years were like. In addition, midlife typically brings its own specific stresses and strains. In the midst of dealing with their own midlife issues, most middle aged parents tend to look back at their own teenage years with nostalgia. But the fact is that teenage years are not an easy time for most young people. They go through as much anxiety and stress as adults do, albeit of a different kind. And they often deal with these stresses without the needed coping skills and support systems. Some facts to consider are:

Intense emotions
Parents often complain about their teenaged children blowing hot and cold, emotionally. The reason for their confusing behaviour is that teenagers experience their emotions more strongly than adults do. Hormonal fluctuations and a still developing brain are most often blamed for this phenomenon. Whatever be the exact reasons, most teenagers feel happiness with as great an intensity as sadness, disappointment, anger, and so on. As a parent it is important to understand that young people often get so deeply immersed in their feelings that it is difficult for them to take perspective. At such times, it is difficult for them to believe that there can be an end to their anger or sorrow.

Impulse control issues
Everyone – parents, schools, and teenagers, themselves – expects teenagers to behave very maturely. But the fact is that while they may have achieved their full height, their brain still has catching up to do. One of the biggest challenges for teenagers is learning to control their impulses. This challenge often infuriates and frustrates parents. Research has shown that young people usually know what is good for them and what is not. However, when faced with tempting but harmful choices, such as, drug/alcohol use or premature sexual behaviour, they are unable to make the right decision. So, knowledge and information often falls short in keeping them safe.

Inadequate coping ability
We, as parents, spend years figuring our what is the best way to cope with situations and build relationships that we can lean on in times of trouble. Despite that, we get into trouble – often relying on excess food and/or alcohol to help us feel better, even in midlife. Adolescents are just starting out on this journey of figuring out how to cope with the myriad situations that life can throw one’s way. They obviously have a long way to go. A lot of young people do not have role models or parents/other adults who can model healthy behaviours. More importantly, many young people do not have the kind of relationship with one or more adults that they need to be able to seek out or accept the adult’s help. This leaves them to their own devices, especially when they are confused about how to handle situations, stressed or in trouble. If they are able to find their path, they are lucky. If not, they are lost.

Negative peer influences
Like young birds learning to fly, teenagers have to make their tentative leaps at independent decision making. During this time they often rely on others of their age for guidance and support. One’s friends can, therefore, be a very big source of influence and determine whether one choses to act in ways that are harmful or beneficial for oneself. The good thing is that nature has made us all developmentally unequal – we learn to walk, talk and become capable of mature decisions at different ages. While we all catch up and eventually learn to walk – this inequality means that an immature 16 year old may become friends with a more emotionally mature 16 year old and learn from them. However, the reverse also happens or a bunch of equally immature kids become friends, leading themselves and each other into trouble.

Thinking in extremes and catastrophizing
While the teenage years are romanticized, they are often the most anxiety driven years of a person’s life. The rat race starts young. Teenagers experience pressure from parents, school, friends and themselves. They experience performance pressures, social pressures and the overwhelming belief that it has to all work out now, or never. Thinking is in black and white and all mistakes, shortcomings, flaws, failures, including failed romances, are catastrophized. Doom and gloom is predicted whether one loses a percentage point or gets a pimple on one’s face. Many young people believe that if they do not get a specific percentage in the board exams or do not get admitted to a specific college, they are doomed. If they are not clear about their career goals right now and have not charted an educational path right now, they will be career-less.

Instead of helping them moderate this tendency to think in extremes, most parents and teachers reinforce it. For example, parents often hold the mistaken belief that scaring teenagers with dire consequences will motivate them to study harder. In addition, teenagers go through peer pressure to conform. To be considered “popular” or worthy of being admitted to a group ruled by “popular” kids, makes many a teenager’s life miserable. No wonder then that this pressure cooker like atmosphere makes it difficult for some to live.

Societal contribution
The idea of suicide often comes from external sources. For most kids, unfortunately, the sources are many. These include apps/games like the blue whale app, reading or hearing about suicides through the media, and having a family member, classmate or known person commit suicide. Children who grow up in rural areas in India are often surrounded by stories of suicides committed by grown-ups known to them. The reasons reported may include shame, financial difficulties, loss of any kind, failed love relationship, etc. A young girl recently told me that whenever her parents get into an argument with each other, one or the other threatens to kill himself/herself. If we, as adults, portray suicide as a way of dealing with various situations, it is no surprise then that young people also resort to thinking about, threatening, or attempting suicide as a way of dealing with their problems.

Not just depression
These days, most people, including the media, seem to think that all people who commit suicide are depressed. It is a fact that people diagnosed with psychiatric disorders, such as, moderate to severe clinical depression, bipolar disorder or schizophrenia are vulnerable to suicide. However, all people who commit suicide do not meet the criteria for a mental illness. Often, teenagers carry out suicidal acts on an impulse when under severe emotional stress. Such kids feel extreme emotional pain and just want to stop feeling the way they do at the moment. If they survive the suicide attempt they often state that they did not actually want to kill themselves. They only wanted to put an end to their emotional distress.

Physical, sexual or emotional abuse can place a young person under great emotional stress. But even if a teenager was saved from traumatic experiences, the reasons given above may place some teenagers in an emotionally vulnerable state. A state or point in time when suicide seems to be the only option available. Because it is nearly impossible to guess or predict someone else’s state of mind, even if it is your own child, parents need to think of prevention.

Watch out for the next blog post on teenage suicide prevention.

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