Youth

depression and
suicide.

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CONTENT PAGE

• Topic: Youth depression and suicide

• Roll No. 2020/BALLB/75
• Semester: 1st
• Name of Subject: Sociology
• Total No. of Pages attached in the project: 17
• Date: 27.12.2020

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 INDEX

Sr. No. Name of the chapter Page no.

1 ABSTRACT 4

2 SIGNS AND SYMPTOMS OF DEPRESSION 5-7

3 ADOLSCENT DEPRESSION 8

4 TEEN SUICIDE 9-10

5 CAUSES OF SUICIDE 11

6 STATISTICS – WHAT DATA SAYS? 12-14

7 SUICIDE PREVENTION 15-16

8 CONCLUSION 17

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 Abstract

Suicide is both a public and mental health problem, and is a leading cause of deaths,
especially among adolescents. Two factors that contribute to the decision of adolescents to
commit suicide are having a primary mood disorder and/or substance use. In the Indian
culture, the family unit has both a positive and negative impact on suicide.

The family serves as a protective factor that provides a strong support for the individual, but
alternately creates an inseparable individual when seeking mental health care, which often
complicates the situation. Due to the stigma, Indians typically perceive having a mental
illness as shameful. Religion is integral to the Indian culture so much so that individuals often
use herbal remedies, seek help from religious leaders, and attend religious establishments
prior to obtaining a mental health evaluation in those that are subsequently deemed as
mentally ill. Despite the fact that suicides are underreported and misdiagnosed in India, it is
known that the highest rates are among those <30 years old.

The methods most commonly used to commit suicide in India include the ingestion of poison
(often pesticides), hanging, burning, and drowning. When immigrating, Indians tend to
switch the methods they use to commit suicide from ingestion of poison to hanging, which
may reflect a lack of available poisonous substances or the influence of the host culture.
Considering the high suicide rates in adolescents, the importance of providing
psychoeducation, restricting access to lethal means, and promoting social integration in
immigrants are various ways by which suicides in Indian adolescents can be avoided.

This project aims to study the signs and symptoms of depression, adolescent depression,
teen suicide, causes of suicide, Indian statistics on suicide rates and suicide prevention in
detail.

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 Signs and symptoms

At some point, most of us have, or will experience sadness. However, sadness is usually
short-lived. When a person suffers with depression, it can affect work, school, eating, and the
ability to enjoy life over an extended period. It is imperative to make the distinction between
sadness and clinical depression; when depression is recognized, needed treatment can be
obtained.
Depression can affect one's ability to do the simplest things, such as waking up in the
morning, brushing your teeth, going to school or work, and eating a meal. Depressed feelings
make it hard to function normally, focus, and participate in once-enjoyable activities.
Depressed feelings result in little to no motivation or energy, making it hard to get through
each day.
Symptoms of depression range from feeling sad, empty, hopeless, angry, cranky, or
frustrated; to weight loss or gain; to thinking about dying and/or having suicidal thoughts. A
more exhaustive list of depressive symptoms is provided in the table1 below. In addition to
recognizing symptoms of depression, it is important to acknowledge that each person
experiences depression in his own way. Even though someone may not have all the classic
symptoms of depression, he or she may still be clinically depressed.

1
Source
Teen Depression and Suicide: A Silent Crisis

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What causes depression?

Heredity plays a significant role, accounting for half of the etiology behind depression.
Depressed individuals often are direct family members of others who suffer from depression.
Depressed individuals may not have the same thoughts as healthy persons, due to
neurotransmitter imbalances in the brain.

Specifically, depressed individuals experience abnormal regulation of cholinergic,

catecholaminergic (noradrenergic or dopaminergic), and serotonergic (5-hydroxytryptamine)
neurotransmission . The neurotransmitter imbalances can prevent someone from recognizing
that he or she could find help. Many depressed individuals cannot imagine being happy again.
They feel unbearable emotional, and sometimes physical, pain that seems to have only two
options: dying or living with pain.

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Neuroendocrine dysregulation may relate to problems of the hypothalamic-pituitary-adrenal,
hypothalamic-pituitary-thyroid, or growth hormone systems, areas that can be treated.
Psychosocial factors also play a role in depression. Major life stressors can
precipitate depression but normally do not cause clinical depression, except in people
predisposed to depression. Once someone has been clinically depressed, she is at higher risk
for depression. Women are at higher risk, possibly related to heightened response to daily
stressors (emotional sensitivity), higher levels of monoamine oxidase enzyme responsible for
degrading neurotransmitters, higher rates of thyroid dysfunction, and the endocrine changes
of menstruation and at menopause .

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 Adolescent depression

In the past, people believed children could not suffer with depression. When teens showed
signs of depression, it could be mistaken for the moodiness of puberty. Research today
reveals that teens may be clinically depressed.

How prevalent is depression among adolescents?

Data from the 2013 national Youth Risk Behaviour Surveillance Survey (YRBSS) showed
that 29.9% or three out of 10 U.S. high school students expressed feeling sad or hopeless
almost daily for two or more weeks2. Data also revealed that adolescent females feel sad or
hopeless, seriously consider attempting suicide, and attempt suicide at almost twice the rate
of males. Furthermore, Hispanic teens report feeling sad or hopeless, seriously consider
attempting suicide, make a suicide plan, and attempt suicide more than Black or White teens.
The ongoing YRBSS results give strong evidence that depression and suicidal thinking are
fairly common among youth.

Teenagers may show indicators of depression that are different from adults. Depressed teens
may sulk, act out, get in trouble at school, express negativity, and feel misunderstood by
others. One study suggests that as many as six students in a classroom may be struggling with
depression at any given time. Teens struggle with school, grades, family, friends, and their
identity. Bullying is a serious problem, contributing to teen depression. In 2013, 19.6% of
U.S. high school students reported being bullied on school property, whereas 14.8% reported
bullying electronically by email, chat rooms, instant messaging, websites, or texting. Sadly,
family members, friends, and school personnel may not notice teens who are sad, lonely, and
distressed, as they can be invisible or try not to be noticed.

Many depressed adolescents are not properly diagnosed. Some mistakenly look at depressed
teens as being difficult or blame the teen for feeling the way they do. Alternatively, depressed
teens may appear mentally healthy, forcing a smile so others will not worry. However,
eventually the signs of depression will become evident. It can be difficult to tell whether
adolescents with behaviour changes are going through a temporary phase or are suffering
from depression.

2
Centres for Disease Control and Prevention. (2015). Youth risk behaviour surveillance survey (YRBSS)
results. Retrieved from http://www.cdc.gov/healthyyouth/data/yrbs/results.htm

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 Teen Suicide

What is teen suicide?

Suicide is when a teen causes his or her own death on purpose. Before trying to take their
own life, a teen may have thoughts of wanting to die. This is called suicidal ideation. He or
she may also have suicidal behaviour. That’s when a teen is focused on doing things that
cause his or her own death.

Suicide is the third leading cause of death in young people ages 15 to 24. The CDC reports
that:
▪ Boys are 4 times more likely to die from suicide than girls.

▪ Girls are more likely to try to commit suicide than boys.

▪ Guns are used in more than half of all youth suicides.

The first step to preventing teen suicide is recognizing and treating depression. Effective,
early intervention will help reduce the burden and disability of depression. A combination of
proactive support, mood elevating medications, and psychotherapy such as Cognitive
Behavioural Therapy, can effectively treat teen depression. The earlier treatment is started,
the better the response to treatment.

Young people with mental health problems — such as anxiety, depression, bipolar disorder,
or insomnia — are at higher risk for suicidal thoughts. Teens going through major life
changes (parents' divorce, moving, a parent leaving home due to military service or parental
separation, financial changes) and those who are bullied are at greater risk of suicidal
thoughts.

Things that increase the risk of suicide among teens include:

• a psychological disorder, especially depression, bipolar disorder, and alcohol and drug
use (in fact, about 95% of people who die by suicide have a psychological disorder at
the time of death)
• feelings of distress, irritability, or agitation
• feelings of hopelessness and worthlessness that often come with depression
• a previous suicide attempt

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 • a family history of depression or suicide
• emotional, physical, or sexual abuse
• lack of a support network, poor relationships with parents or peers, and feelings of
social isolation
• struggling with their gender identity and/or sexuality in an unsupportive family or
community

Critical protective factors for suicide include support from families, friends, and others, such
as the school or faith community (Substance Abuse and Mental Health Services
Administration [SAMHSA], 2012). Faith-based organizations, such as Young Life (2015), a
Christian organization, provide teenagers with adult leaders who provide time, energy, and
guidance to direct teenagers on the “path to fulfilling lives.” Specific protective factors
against adolescent suicidal behaviour, many of which can be influenced, include self-esteem,
self-discovery, defence mechanisms, productive coping strategies (i.e., focusing on the
positive), spirituality and religion, reasons for living, caring by family and other adults,
parental involvement, family connectedness, school and neighbourhood safety, and
pharmacotherapy.

Depressed teens need to be assessed for how they respond to life, especially stressful
situations. Negative thinking patterns and behaviours can be replaced with effective coping
strategies, such as good problem solving, helping with motivation to change, building self-
esteem, resolving relationship problems, and learning stress management techniques. If
chronic pain is a variable, management of pain is important. Other studies additionally
support the importance of religion and increased frequency of attendance at religious services
as protective factors for depression and suicidal ideation in adolescents. According to the
NIMH3, helping teens recognize that they are not alone, that there are people who want to
help them, and that depression is a real, treatable brain illness can help teens receive the care
they need.

3
National Institute of Mental Health

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 Causes of suicide

The reasons behind a teen's suicide or attempted suicide can be complex. Although suicide is
relatively rare among children, the rate of suicides and suicide attempts increases greatly
during adolescence.
• Suicide is the third-leading cause of death for 15- to 24-year-olds, according to the
CDC4 , after accidents and homicide.
• It's also thought that many more attempts are made for every completed teen suicide.
• The risk of suicide increases greatly when kids and teens have access to firearms at
home, and nearly 60% of all suicides in the United States are committed with a gun.
That's why any guns in your home should be unloaded, locked, and kept out of the
reach of children and teens.
• Overdose using over-the-counter, prescription, and non-prescription medicine is also
a very common risk for attempting and completing suicide. It's important to monitor
carefully all medicines in your home. Know that teens will "trade" different
prescription medicines at school and carry them (or store them) in their locker or
backpack.
• Suicide rates differ between boys and girls. Girls think about and attempt suicide
about twice as often as boys, and tend to attempt suicide by overdosing on drugs or
cutting themselves. Yet boys die by suicide about four times as often girls, and
experts think this is because they tend to use more lethal methods.

Research shows that approximately 90% of people who have died by suicide were suffering
from a mental illness at the time. The most common mental illness reported was depression.
Impulsivity and substance use, including alcohol and drugs, also warning signs for elevated
suicide risk. It is important to remember that suicidal thoughts and behaviours are not the
natural consequence of serious life stresses. People who experience a stressful life event may
feel intense sadness or loss, anxiety, anger, or hopelessness, and may occasionally have the
thought that they would be better off dead. In most people, however, experiences of stressful
life events do not trigger recurring thoughts of death, creation of a suicide plan, or intent to
die. If any of these are present, it suggests that the person is suffering from depression or
another psychiatric disorder and should seek professional treatment.

4
Centre for Disease Control and Prevention

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 Statistics- What data says?

If Indian states were countries, three states would have the third, fourth and fifth worst rates
of female suicide in the world, recent data shows. Men commit suicide at a higher rate across
the world, but India has not been able to lower the suicide rate among men, the data shows.

Rakhi Dandona, a researcher at the Public Health Foundation of India, and her colleagues
estimated suicide rates for both sexes in each state of India from 1990 to 2016 based on
multiple sources, including official sample registration and vital registration surveys,
medically certified causes of death, and verbal autopsy studies. Their research was part of the
2016 Global Burden of Diseases, Injuries and Risk Factors (GBD 2016), a worldwide
database of health indicators.

India accounts for a growing share of the world’s suicides.

India now accounts for over a third of the world’s annual female suicides and nearly a fourth
of male suicides, a significant increase in its global share from 1990. The suicide rates for
men and women in India were much higher than the global averages.
Who is at higher risk of suicide? In 2012, a team of researchers sent trained doctors to more
than a million homes to determine causes of death.

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Looking at the data for suicides within this data set, a group of public health researchers
found that higher education levels, residency in South India, and being Hindu were
significantly associated with the elevated risk of suicide. Drinking alcohol was associated
with the risk of suicide in men. Being widowed, divorced or separated was associated with a
slightly decreased risk of suicide in women.

Regional skew

India’s southern states are more developed, but also more suicide-prone. This follows a
global pattern, with more developed states having higher suicide rates.

However, in the medical literature, instead of “more developed" and “less developed"
countries or states are classed by their stage in the “epidemiological transition"—moving
from high rates of fertility to lower rates as incomes grow, health improves and women
become educated.
Among lower fertility states, Tamil Nadu, Haryana, Jammu and Kashmir and West Bengal,
and among higher fertility states Uttarakhand had significant declines in suicide rates for
women from 1990 to 2016. No state had a significant decline in suicide rates for men during
this period. There is another significant difference between suicides among men and women
in India. The highest age-specific rates of suicide for men were among elderly men aged 75
years or older, while among women it was for young women aged 15-29.

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A youth suicide crisis:
Young people in India die predominantly of suicide, the GBD data shows. For both sexes in
India, suicide was the leading cause of death among those aged 15-39 in 2016, while globally
it was the third most common cause of death for this age group.

The under-reporting problem:

In 2015, the most recent year for which data is available, there were 130,000 suicides in
India, according to the Accidental Deaths and Suicides in India report brought out by the
National Crime Records Bureau, India’s official source of suicide data recorded by the
police. That’s 100,000 fewer suicides than Dandona’s estimates, or a decrease of 77%.

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 Suicide Prevention

Adolescents and young adults are especially prone to mood lability because their emotional
centres (limbic system) and impulse control (prefrontal cortex) are still developing. Thus,
depressed youth are predisposed to suicide attempts.

Suicide is the second leading cause of death in adolescents behind unintentional injuries. The
mixture of an intense emotional trigger with impulsive thoughts of escape or death increases
the likelihood of an irrational action. Access to lethal means such as guns, sharp objects or
pills/drugs are the last part of the equation for suicide completion. The most important thing
we can do for youth in our lives, personally or professionally, is be aware of signs and
symptoms of depression and be armed with the appropriate resources to support them. The
American Academy of Pediatrics recommends depression screening at least once annually.

Bringing up the topic of mood is often innately therapeutic. If teens discuss sensitive issues or
meet criteria for major depression it is our duty to provide appropriate treatment services and
support for depressed youth at the time of diagnosis.

Three key components of depression treatment include psychotherapy, medication and

appropriate follow-up. Psychotherapy ('talk therapy') is evidence-based and the primary
treatment for depression. In these sessions, the goal of cognitive behavioral therapy and
interpersonal psychotherapy is to provide alternative healthy coping skills. Research also
shows that medication improves moderate to severe depression for some people. The most
commonly prescribed medications in this age group are selective serotonin reuptake
inhibitors (SSRIs) and are appropriate once acute psychosis and risk for bipolar disorder have
been ruled out.

Case in India :

Unlike developed nations, researchers and policy makers in India are clueless on the spread
of the problem and cost to the nation. No major study has been conducted in India to estimate
the impact of pandemic on mental health.

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Since performance in colleges and universities determine their future, students are invariably
stressed. Parents’ expectations, workload of studies and hyper-competitive environment
contribute to creating severe distress among the majority of the students.
Now with pandemic around, the students are imprisoned in their homes. They desperately
miss their place of education. This is a major reason why the impact is more severe on their
mental well-being.
The UN estimates that the pandemic has affected more than one billion students worldwide.
As of mid-July, schools were closed in some 160 countries, affecting more than 1 billion
students, while at least 40 million children have missed out on pre-school.

Alarming numbers of users, especially among the younger generation, are excessively using
social media. When we use it, there is a direct neurological effect on our mind. Some even
say that social media is like the world’s largest slot machine. Indians spend nearly 4.3 hours
on mobiles in a day. It was 3.5 hours last year. Students spend from 4 to 7 hours a day on the
phone. Some even use mobile for more than 10 hours in a day. According to a survey,
millennials (those who were born between 1980 and 1994) check their phones even more
often: more than 150 times per day. Digital obsession is having a wide impact on youngsters’
studies, health, career, and relationships.
That so many students are mentally and physically occupied with social media obviously
takes a toll on their studies, which in turn impacts their career. And as attention to studies
decreases, work pressure from parents and teachers increases, and this leads to greater mental
stress.

*Management is the key*

It’s a great dilemma that digital technology is helping as well as disrupting the lives of young
people. It’s a double-edged weapon, depending upon how we use it.

There are plenty of things students can do, not only to make them productively busy but also
improve their ability to focus and concentrate on their studies. This will, in turn, make them
mentally fit and healthy. Besides getting adequate sleep, eating healthy food and avoiding
smoking and excessive alcohol, the younger generation should focus on managing stress.

Stress is often unavoidable, but knowing what triggers this and knowing how to cope with it
is key in maintaining good mental health. While activity and exercise are essential in
maintaining good mental health, it is important to connect with others and be sociable.
Having friends is important not just for our self-esteem, but also for providing support when
we are not feeling too great.

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 Conclusion

Depression is a quiet crisis, but it need not be. Increased awareness, with the development of
needed mental health programs, can reach teens who need help. Working with social media
can reach teens who may be suffering in silence. Collaboration with teen support groups and
faith organizations can create safe havens for teens. Through a coordinated effort on the part
of public and private industry, government agencies, concerned family, friends, schools, and
healthcare professionals, we can make a difference in preventing suicide and saving lives.

For a difference to occur, people need to acknowledge the severity of teen depression and the
significant risk of suicide. Teens need our attention to make them feel valued, accepted, and
secure in the knowledge that people are there to help them.
Teens taking their lives is a tragedy.

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