Markus Spiske
Source: Markus Spiske

On Saturday, January 28, 2017, the national advisory board of the Center for Adolescent Research and Education (CARE) gathered on the balmy campus of Nova Southeastern University, just west of Ft. Lauderdale, Florida. Top on the agenda was a presentation by Dr. Scott Poland, a nationally known expert on youth suicide. Seventeen-year-old student board member John Calicchio, a senior at a private boarding school in New England, could not participate. He had just learned of the death by suicide of one of his classmates. On campus.

Tragic.

Dr. Poland’s remarks were part of a larger discussion about the transition from high school to college, a time during which stress, mood disorders and suicidal ideation (and action) are, sadly, not uncommon.

Through his tears, John pronounced the action “selfish,” reflecting the pain—even anger—of those left behind. Such feelings abound for “survivors,” maybe especially young ones.

John told me, “It was one of the worst experiences of my life and it took a couple of days to really sink in. But once it became a reality, I was miserable. Everyone on campus was affected some way or another. I kept asking myself, ‘Why did he do it? And was there was anything I could have done to prevent it?’ My friend should not have left us this way. He had so much more life to live. I can't begin to imagine what he was going through during those dark times. Honestly, I have a lot of regrets.”

How to process the permanence of loss?

Of course, there are the well-known stages of grief: denial, anger, bargaining, depression (or despair), and, ultimately, perhaps, acceptance. What may be a harder sell for still-developing frontal lobes slighted in judgment is a reality-based grasp of the finality of suicide.

An essay that the late Ann Landers suggested should be mandatory reading in all high schools, “Dead at Seventeen,” presents the magical thinking of a young man killed in a car crash. In it is perhaps an analog to suicide.

Agony claws my mind. I am a statistic. When I first got here I felt very much alone. I was overwhelmed by grief, and I expected to find sympathy. I found no sympathy … Strange that I couldn't feel anything. Hey, don't pull that sheet over my head. I can't be dead. I'm only 17. I've got a date tonight. I'm supposed to have a wonderful life ahead of me. I haven't lived yet. I can't be dead. Later I was placed in a drawer. My folks came to identify me. Why did they have to see me like this? Why did I have to look at Mom's eyes when she faced the most terrible ordeal of her life? Dad suddenly looked very old. He told the man in charge, “Yes, he's our son.” The funeral was weird. I saw all my relatives and friends walk toward the casket. They looked at me with the saddest eyes I've ever seen. Some of my buddies were crying. A few of the girls touched my hand and sobbed as they walked by. Please somebody – wake me up! Get me out of here. I can't bear to see Mom and Dad in such pain. My grandparents are so weak from grief they can barely walk. My brother and sister are like zombies. They move like robots. In a daze. Everybody. No one can believe this. I can't believe it, either. Please, don't bury me! I'm not dead! I have a lot of living to do! I want to laugh and run again. I want to sing and dance. Please don't put me in the ground! … All I want is one more chance. Please, God, I'm only 17.

Those left behind.

Four years ago this month, another close-knit educational community grappled with a loss similar to John’s. A parent asked me to write a column counseling young people on how to comprehend the incomprehensible. In “A Time Too Short – Helping Youth With Loss and Grief” I offered, “The loss of a young person, by accident or by design, devastates families, communities and institutions. It may also prompt a series of questions, some answerable and some not.”

What questions can we answer? Dr. Poland offers several.

Why did he die by suicide? We are never going to know the answer to that question as the answer has died with him. The focus needs to be on helping students with their thoughts and feelings and everyone in the school community working together to prevent future suicides.

Didn’t he make a poor choice and is it OK to be angry with him? He did make a very poor choice, and research has found that many young people who survived a suicide attempt are very glad to be alive and never attempted suicide again. You have permission for any and all of your feelings in the aftermath of suicide, and it is OK to be angry with him. The suicide of a young person has been compared to throwing a rock into a pond with ripple effects in the school, church and community, and there is often a search for a simple explanation. These ripple effects have never been greater than at the present, with the existence of social networks (e.g., Facebook) … Many individuals who died by suicide had untreated mental illnesses, and it is important that everyone is aware of resources that are available in the school and community so that needed treatment can be obtained.

Isn’t someone or something to blame for this suicide? The suicide victim made this decision and there is no one to blame. The decision to die by suicide involved every interaction and experience throughout the young person’s entire life up until the moment he died, and yet it did not have to happen. It is the fault of no one.

How can I cope with this suicide? It is important to remember what or who has helped you cope when you have had to deal with sad things in your life before. Please turn to the important adults in your life for help and share your feelings with them. It is important to maintain normal routines and proper sleeping and eating habits, and to engage in regular exercise. Please avoid drugs and alcohol. Resiliency, which is the ability to bounce back from adversity, is a learned behavior. Everyone does the best when surrounded by friends and family who care and by viewing the future in a positive manner.

In my column, I went on to cite statistics from the Centers for Disease Control and Prevention declaring suicide as the third leading cause of death for young people ages 15-24. Today, it is the second.

And in a more recent piece, “A Moment in Time,” I noted that the November 2016 cover story in TIME magazine, “Teen Depression and Anxiety: Why the Kids Are Not Alright,” stated, “Adolescents today have a reputation for being more fragile, less resilient and more overwhelmed than their parents were when they were growing up. Sometimes they’re called spoiled or coddled or helicoptered. But a closer look paints a far more heartbreaking portrait of why young people are suffering. Anxiety and depression in high school kids have been on the rise since 2012 after several years of stability. It’s a phenomenon that cuts across all demographics ...”

Falling to pieces.

But who is most at risk?

According to the Jason Foundation (JFI), a collaborator at CARE, those more likely to be thinking of suicide include individuals with depression and other mental illness or addictive disorders. Additional risk factors include exposure to conflict and violence, volatile family environments and self-mutilation. JFI’s founder and president Clark Flatt told me, “There are many conditions that can elevate the risk for any group of youth. However, the number-one young person in America today, in my opinion, who is lost to suicide is usually the better than average student, active in extracurricular activities at school, one who seemingly ‘had everything to live for.’ Just the ‘regular all-American kid’ describes the young person most often lost to this tragedy.”

To wit, in her 2015 Huffington Post blog piece, then 16-year-old Elise Jamison wrote, “I want you to picture a person with depression. Are you seeing the dark bedroom, filthy sweatpants, empty eyes, poor health and general lack of prosperity? You know what I see when I picture depression? A blonde, blue-eyed teenage girl. She gets awesome grades, loves to paint, go to football games, drink Starbucks, Instagram and giggle with her friends. She can quote Harry Potter, obsesses over makeup tutorials and cannot wait for college. She looks back at me every morning in the mirror.”

Also important to remember is that not only younger adolescents are at risk. A 2016-2017 academic year “wave” of suicides—seven of them—has rocked the campus of Columbia University in New York.

So, how can we know?

Signs and symptoms are offered in an article published by the National Association of School Psychologists.

  • Sadness, depressed mood, or irritability.
  • Agitation, defiance, or sullenness.
  • Lack of pleasure in daily activities.
  • Withdrawal or crying.
  • Unexplained physical complaints.
  • Lethargy or chronic boredom.
  • Poor concentration or inability to make decisions.
  • Poor academic performance.
  • Negative thoughts about self, the world, and the future.
  • Self-blame, guilt, and failure to recognize one's success.
  • Change in appetite or weight gain or loss.
  • Excessive sleeping.
  • Increased-risk behaviors (e.g., sexual risk-taking or abuse of drugs and alcohol).

According to an article at KidsHealth.org, when a suicide has already occurred “Children feel and show their grief in different ways. How kids cope with the loss depends on things like their age, how close they felt to the person who died, and the support they receive.”

How to best support them?

The same article proffers some advice.

  • When talking about death, use simple, clear words.
  • Listen and comfort.
  • Put emotions into words.
  • Tell your child what to expect.
  • Talk about funerals and rituals.
  • Help your child remember the person.
  • Give your child time to heal from the loss.

Across the land—in communities and schools urban, suburban and rural—our children, boys and girls, are falling apart. It is our responsibility, our job, our duty … and our opportunity to put them back together. Again.

References

Axelrod, J. (2017). The 5 stages of grief & loss. Psych Central. https://psychcentral.com/lib/the-5-stages-of-loss-and-grief/ (7 Feb. 2017).

Berrio, J. (2002). Dead at seventeen. Ann Landers. Sun-Sentinel. http://articles.sun-sentinel.com/2002-05-01/lifestyle/0205010322_1_dear-ann-landers-police-officer-essay (7 Feb. 2017).

Cash, R. (2003). When it hurts to be a teenager. Counseling 101. Principal Leadership. October 2003. National Association of Secondary School Principals. http://www.naspcenter.org/principals/nassp_depression.html (7 Feb. 2017).

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