CDC's Youth Risk Behavioral Survey reports that suicide is the third leading cause of death for 15-24 year olds. It is the sixth leading cause of death for 5-14 year olds. Statistics indicate:

• Nine percent of 12th grade students reported attempting suicide in the past year.
• Twenty-four percent of 12th grade students reported considering suicide in the past year.

Risk Factors and Warning Signs

A variety of factors have been identified as possible risk factors for suicide. For any one person, the greater the number of risk factors, the greater the suicide risk. Risk factors for suicide include

• certain personality traits
• family stresses
• prior suicidal behavior
• biochemical and genetic factors
• stressful life events
• social and cultural factors
• psychiatric disorders
• behavioral factors
• exposure to attempted or completed suicides

It is difficult both to predict and to prevent many suicides; however, in 80 percent of cases, young people committing suicide have expressed their intent prior to the actual act. The duration and intensity of, as well as changes in, behavior are important indicators. Observable signs of suicide risk include:

• marked decline in school performance, skipping classes, dropping out of activities
• death themes in art or written work
• giving away prized possessions
• sudden changes in relationships, withdrawing from friends
• apathy
• risk-taking behavior
• statements such as "I wish I were dead" or "No one cares"
• loss or disappointment
• stressful episode or chronic stressful life situation at home, with peers
• signs of mental illness

Causes of Suicide

Causes of suicide are not clearly understood, but there are two general models for thinking about the causes:

• depression model-requiring mental health interventions
• stress model-requiring social intervention

Causes of suicide also focus on motives such as revenge (desiring to create guilt in those left behind), loss or perceived loss, failure or depression.

Signs of Depression and Mental Illness

Depression alone or in combination with aggressive behavior and substance abuse or anxiety is found in more than 50 percent of all suicides. Psychiatric diagnoses are present in 90 percent of suicides.

Signs of depression include:

• depressed mood
• change in eating and sleeping patterns
• loss of interest or pleasure in usual activities
• fatigue or loss of energy
• feelings of worthlessness, self-reproach or guilt
• diminished ability to think or concentrate, indecisiveness
• thoughts of death, suicide or wishes to be dead
• extreme anxiety, agitation or enraged behavior
• isolation
• excessive drug and/or alcohol use or abuse
• history of physical or emotional illness
• feelings of hopelessness or desperation

Influence of Alcohol and Other Drugs on Depression and Suicide

Alcohol use or cocaine use is present in two-thirds of suicides among males ages 18-19, but neither is commonly associated with female teens or younger male teen suicides.

Research reported in the journal Drug and Alcohol Dependence (December 2, 1996) indicates that major depression does not cause alcohol abuse; rather, shared genes and shared family experiences cause both depression and alcohol abuse. Alcohol, acting as a depressant, worsens the depression.

Getting Help

A variety of health-care professionals can help deal with thoughts of depression and suicide, including doctors, psychologists, counselors, therapists and psychiatrists. Many communities have Suicide Hot-lines, which may be called 24 hours a day.

"QPR" may be thought of as an alternative "CPR," another life-saving measure. QPR stands for three things to do if you suspect someone is thinking about committing suicide:

• Question-Ask if the person is thinking about suicide. This awareness in itself may have a calming effect.
• Persuade-Talk with the person about the problem, the permanency of death or anything that will get him or her off the edge of the cliff.
• Refer or Report-Young people should immediately tell a trusted adult of their suspicion. Threats of suicide should never be ignored.