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Clinical depression affects many teens who try to kill themselves
March 25, 2002
JOLIET — Most teens who end up as inpatients in the adolescent mental
health unit at Provena Saint Joseph Medical Center have tried to kill
themselves.
In the past year, about 200 teens have been admitted to the unit
and close to 90 percent of them are suffering from clinical depression,
said Dr. Shyamsunder R. Chakilum, child and adolescent psychiatrist for
Professional Health Associates Ltd. in Joliet.
"It's important for people to recognize and treat depression. It
is the best way to prevent suicide, Chakilum said. "The only way to
prevent suicide is to treat depression and to make sure it doesn't come
back."
Each year almost 5,000 young people, ages 15 to 24 years old, kill themselves, according to the National Mental Health Association.
The rate of suicide has nearly tripled since 1960, making it the third leading cause of death among youth. In Will County, there were six youths, ages 12 to 19, who died by suicide in 2001 Girls attempt suicide more than boys, but boys are more successful because they choose more violent means, such as guns or one-car accidents, said Michele Batara, counselor who teaches free intervention and prevention workshops to schools and parent groups for the Crisis Line of Will County.
The majority of people who die by suicide have clinical depression, Chakilum said. Their sadness doesn't go away naturally when the stress is gone. Instead, they feel hopeless, guilty and have suicidal thoughts.
However, teens show depression differently than adults. They will be irritable, act rebellious, talk negatively, be angry and use drugs.
"Teens may deny feeling sad and blue, but be irritable all the time," he said. "Teens use a lot of denial."
What makes it even harder is teens don't share feelings with parents freely, he said.
So how can one tell their child is suicidal?
"Suspicious changes may indicate clinical depression," Chakilum said.
Sudden change in behaviors are warning signs, whether it is a decline in sleeping, eating and performance in school or an increase in isolation and sleeping.
If parents see sudden changes in their children, Chakilum suggests that they get a professional mental health assessment done by calling their primary care doctor and ask for help, he said. The doctor may refer them to a psychiatrist. Schools also have social workers who can determine if children need more help.
"Suicide is a cry for help. It's not necessarily a cry for attention. A lot of people ignore the warning signs," Batara said. "It is a cry for help. They don't want to die."
Teens don't have alternative ways to deal with pain, said Cagney Cappelli, child and adolescent therapist with the Will County Health Department. He helps teens explore their options, telling them suicide is not one of them.
"Suicide is a permanent solution to a temporary problem," said Cappelli who works with teens at their schools and homes in the Bridges program.
"The help is here. It's important for the community to know we are here," Cappelli said.
Screening Assessment and Support Services, (SASS) in Joliet offers parents without insurance intensive help for their children with mental health problems, said Tom Tassone, SASS program supervisor at Grand Prairie Services, 3077 W. Jefferson, Suite 207.
SASS started seven years ago because there was a need to help children, ages 3-17, with no insurance. The program is funded by the Department of Human Services and Department of Children & Family Services.
"We have a crisis therapist who responds to calls 24 hours a day, seven days a week," Tassone said.
Often times, a SASS therapist will have their first encounter with a teen in the emergency room after a suicide attempt is made.
"Our most common type of client would be a teen-age girl who is depressed and thinking about suicide," he said.
"Typically because our clients may have not had a whole lot of contact with medical or mental health providers - these are kids who have slipped through the cracks over the years," Tassone said. "Once they reach us these are kids who maybe should have been diagnosed with depression or a mood disorder year and years before."
A psychiatric screening can be done at the hospital and therapists make recommendations for care from inpatient psychiatric care in the hospital to home visits.
"The goal is to provide that intensive level of intervention they need during the stabilization process and eventually link them and get them to the point where they can access whatever they need outside of our program," he said.
"I like to think we have done so well because we haven't lost any kids," he said.
Tassone said often the key question to find out if a kid is depressed is by asking them if they cry a lot.
"They will disclose that they cry in the shower so nobody will hear them or at night - that's really a tip that things are very severe and intense. It's just a matter of asking that question and often depressed kids who contemplated suicide will readily admit it," he said.
Through psychotherapy and/or medication, clinical depression can be treated. Often, cognitive behavior therapy is needed to help students rethink their false assumptions, such as "Everybody hates me."
"They feel no hope. They feel hopeless and helpless. They feel the situation is hopeless," Batara said.
"They feel there is no future - that the world is a bad place and nobody likes them. They feel they can't make a difference," Chakilum said.
Teens tend to build the wrong assumptions, Chakilum said. The therapist will help teens look at the truth. Maybe they don't have any friends and it might be because they don't have any social skills.
Family therapy is often used because parents and family need to understand how the teen is feeling and offer support.
"They need to adjust their expectations to the child's capacity while encouraging the child to do better, but not demanding it," Chakilum said.
