Depression and suicide
Suicide is the third leading cause of death in the U.S. among those ages 10-24. Roughly 157,000 people per year within this age group receive treatment for self-inflicted injuries in the emergency room*. Many people we talked with had suicidal thoughts, and a few had attempted suicide.
If you currently feel suicidal or know someone who is feeling suicidal, please call 911 or the National Suicide Prevention Lifeline, 1 (800) 273-8255.
Suicide as a sign of the seriousness of depression
For many people in our study suicidal thoughts were a sign that they needed to get help. Crystal says she experimented with actively attempting suicide, and ‘after a couple incidents that’s when it was noticed and I had to get help’. Marty says he let his depression control him, and this led to his depression becoming more serious. He warns others that, ‘depression might be overlooked by some doctors, but it’s a serious illness it’s easy to overlook what can happen’.
Destructive thoughts and thoughts of death
People often had destructive thoughts or thoughts of death when their depression was severe. Teddy says he, ‘slipped into this really deep dark depression, where I wanted to die’. A few started having suicidal feelings in middle school, while most expressed first having thoughts in high school or college. Leanna says she ‘would take my mom’s sleeping pills in hopes that I wouldn’t wake up at a really young age’. Crystal says her thoughts of suicide increased when she started college. She ‘realized at that point that I have suicidal thoughts every day and they haven’t gone away. Beginning of college I started having them constantly, I remember that a little bit in high school but in college I really realized that every moment that I’m not actively engaging my mind in something else I go back to my original thought process and it quickly spirals into feelings of erasing myself’. Maya describes her thoughts as ‘being intellectually suicidal’ but did not have any concrete plans to follow through with them.
Brendan describes having suicidal thoughts at a young age.
Reasons for feeling suicidal
The people we interviewed gave many reasons for feeling suicidal. They felt suicidal because life did not feel worth living or because they felt hopeless in particular situations, such as coping with family or a relationship. Elizabeth attributed her suicidal thoughts to her ‘lack of coping skills… It felt like any little hurdle that I came to, I just couldn’t face it’.
Teddy started feeling suicidal when his relationship with his girlfriend ended. He says, ‘she found another guy and I found out just by putting all the pieces together she was trying to make me into the guy that she was really going after. And after that like, I was going in and out of mental hospitals trying to you know, just end it because there was nothing else I could do’.
For more about relationships, see ‘Depression and relationships‘.
Jackson, a man who identifies as transgender, said his feelings of being different made him feel more isolated. He watched a friend who had come out become ‘a target for ridicule and physical abuse’. This led Jackson to become ‘invisible and suicidal for many years’. For more about feeling different see ‘Depression and feeling different when young‘. Others, like Myra and Brendan, also talked about being a target of bullying and abuse and related these experiences to their suicidal thoughts (see ‘Depression and abuse‘).
Some people felt a more general hopelessness about the world or a lack of reason to live. Sierra Rose says her thoughts were telling her, ‘look at the world we live in, the crap world and blah blah blah all of those negative voices talking in the back of your head, convincing you that life isn’t worth living.’ She also expresses that she didn’t have a choice in terms of being born and and couldn’t understand ‘why can’t I make the decision to just leave’. Similarly, Colin says he ‘would just wake up and just couldn’t find any reason or purpose in the day whatsoever’ and ‘felt so guilty for it because… I had good parents, good family’. For Colin, his suicidal thoughts were connected with his struggle with OCD. For more about OCD, see ‘Depression and obsessive compulsive disorder (OCD)‘.
Colin describes his experience in the hospital after attempting suicide.
Crystal discusses the pressure she feels and how it relates to her suicidal thoughts.
A few people talked about how being on medication or not being on medication influenced their thoughts of suicide. Sierra Rose described how a medication, ‘made me feel so much more suicidal. I couldn’t even cross the street without thinking about jumping in front of the next car I see which was you know really bad because I lived along a highway and had to cross the highway to get to work. So, you know, you’ve got semi’s rushing by you at 40 miles per hour it’s really hard to avoid the thoughts in your head saying, ‘Jump, just do it, just step out in front of them.’ Colin experienced a similar increase in suicidal thoughts when on a medication and said he ‘became twice as suicidal as I was before.’
Although increase in suicidal thoughts is an uncommon side effect of antidepressants, it is serious and needs immediate help. The FDA has placed a ‘black box’ warning label on antidepressants to alert people up through age 24 about this rare but serious possibility.
If you or someone you know is considering harming themselves, please call 911 or The National Suicide Prevention Lifeline, 1-800-273-8255.
Others, like Ben, said he would have suicidal thoughts when he wasn’t taking medication.
(For more information about taking medication for depression, see ‘Depression, medication, and treatment choices‘.)
Asking for help
Several people we talked to described realizing they needed to ask for help from family or friends when feeling suicidal or as part of a suicide attempt. Some felt their suicide attempts were a sign they needed help from others. Marty said, ‘I understand how they were just cries for help, because if I wanted to die I would be dead right now’. Sierra Rose described feeling desperate and how she ‘had to call my mom to talk me down’, even though she felt their relationship was strained at time and they had not talked for over a year. Whitney said she was committed by her father after her second suicide attempt and was not given a choice about hospitalization.
A few people discussed reaching out via suicide helplines. Crystal said she, ‘called suicide hotlines daily’ when she needed ‘short term solutions to help get me out of a panic attack or some sort of crash’.
Devin describes telling his parents about needing help before he attempted suicide.
People we talked with reported a range of things that contributed to their decision to live. Most were concerns related to a greater sense of purpose, but a few worried about the ‘shock’ their death would be to people they cared about. For many, a greater sense of purpose included wanting to be there for family or friends. Crystal felt she had a ‘duty’ to finish school and take care of her family. Teddy and Sierra Rose felt a similar sense of responsibility, but for their pets. (See ‘Depression and pets‘.)
Sierra Rose talks about her difficult living situation and being scared to live with her mother’s boyfriend, but realizing that she did not want to die and wanted to be there for her brother.
Sierra Rose who was experiencing abuse from her mother’s boyfriend describes telling her brother about her suicide attempt.
Crystal describes how she uses self talk to prevent suicide.
For others, seeing a family member or a friend attempt or commit suicide prevented their own attempts. One participant says after her friend attempted suicide ‘that was really the turning point for me, when I realized I could end up like that too’.
A few people said finding distractions or something to occupy their mind helped prevent thoughts of suicide. Crystal used goal setting, which helped her occupy herself ‘until that next discrete point’.
Despite difficult circumstances, a few participants still felt hope for the future. Jackson said that although he ‘didn’t feel like I had anything to look forward to’ after his mother was sent to prison and his father died unexpectedly, he felt that ‘anything could happen’. Although his circumstances changed negatively, he thought there could also be a positive spin and that ‘things can get better’. He says, ‘I had the adulthood to look forward to, where I was like, oh, maybe I can finally be free of these horrible people and make my own choices. So, maybe it will be better’. Brendan realized that ‘periods of hopelessness are temporary’ and still feels positive for the future, despite having bad days.
After experiencing cycles of depression, Brendan feels hopeful about the future.
References
*’Suicide Prevention’. Injury Prevention and Control: Division of Violence Prevention (Centers for Disease Control), 10 March 2015, Web. 7 February 2016.
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