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Teen Suicidal Thoughts
Question: We recently received a phone call from a mom of one of my son's friends. She was concerned about text messages my son was sending to her daughter saying he would like her to be more than a friend, but she doesn't want that. In the texts, he mentions that he wonders what it would be like to lay on his bed and put a gun in his mouth, along with other texts similar to this. He started sending these a couple of days ago. We haven't noticed any changes in behavior or any drop in activities or grades. How do we discuss these text messages with him? He has always kept things to himself, but we can usually tell when something is bothering him. But these text messages are a shock and we want to make sure we approach it the right manner.
Posted By: Ann, Marysville Answer: I expect you got quite a shock when your son’s friend’s mom called about these text messages, but how lucky you are that she let you know so you can do something about it. Although he may be angry at his friend for showing the texts to her mother (I am assuming this although the mom may have just been snooping), most teens who are having suicidal thoughts indicate warning signs mostly to a peer, rarely to a parent. From the content of these texts it sounds like your son is thinking of possibly harming himself.
I suggest you be very up front with your son and let him know that his friend’s mom called as she was very concerned about the suicidal text. Ask him directly, in an empathic way, is he thinking of hurting himself. Most teens are relieved if they are having suicidal thoughts if someone asks them directly. You will not be putting the idea into his head. The fact that he has written about putting a gun in his mouth is very serious. I would suggest that you have your son evaluated by a professional to assess the extent of his suicidal thinking. It is possible that he is depressed if the girl he likes is not reciprocating his feelings and this could be triggering the suicidal thoughts.
He may get angry at the friend and her mother for sharing the text message but that is OK. It is better that he be angry and lose the girl as a friend than be dead. Please do not delay in speaking with your son about this and getting him professional help. Very often teens shield parents from their darkest and gloomiest thoughts but generally are relieved when they are brought to light and they can get the help they need.
If you want to know more about the warning signs of teenage depression and suicide go to www.teenlineonline.org. It is not uncommon for teens to begin to feel hopeless when a love interest does not work out. What is important is that they feel understood, not criticized for their feelings. Please do not ignore these text messages. Although he may be using these text messages as a means to keeping this girl connected to him, the content of the texts must be taken seriously. Again, please do not delay.
Elaine Leader, Ph.D.
Dr. Leader is the Executive Director of TEEN LINE. Please read Signs and Symptoms of Suicide, written by Dr. Leader, on our website.
Expert: Elaine Leader, Ph.D.
Question: why do teens think it is cool to cut or burn themselves?
Posted By: Kevin, batesville ar Answer: Self-injury is intentionally hurting yourself physically. In fact, 1 in 10 adolescents have hurt themselves at least once. Although there are different types of self-injury, most common are using objects to cut or burn the skin. All are methods of self-mutilation.
Self-injury unfortunately has become a too common way for young people to try to cope with feelings they find difficult to handle. Some teens try it because they are curious; others saw it in a movie or heard about it from a friend. But many begin on their own. They might have heard that cutting brings some relief and even some temporary euphoria. This slight rush is because of the release of pleasure chemicals in the brain. So to some, perhaps this can be thought of as being cool. However, this kind of behavior can soon become a coping mechanism that ends up being addictive, and without therapy many teens find it difficult to stop.
Teens say when they cut or burn themselves they get a sense of relief from feeling stressed, angry, depressed or anxious. Many believe that if they feel out of control inside, they can re-gain that control by hurting their outside. To stop self mutilating behavior it is important to find what triggers these behaviors then find new ways to deal with them. Although it can be hard to stop, many teens have gotten help and never cut again. It helps to talk with a therapist or counselor. Former self injurers have found the following helped them to stop when they had the urge to self mutilate:
- Take a shower (with no razors)
- Go for a walk or play a sport
- Draw, paint, or write – even use a marker on your skin
- Listen to music or play an instrument
- Play with a peer
- Read a book or magazine, or watch your favorite movie
- Rub ice on your skin.
Although most people who cut are not suicidal it can lead to accidental death. Plus, dirty or non-sterile cutting objects can lead to severe infections. Cutting can lead to blood loss, stitches, even hospitalization. Burns get infected easily too. Bottom line is that it really is not cool to cut or burn for though it may provide temporary relief, the issues are still present.
Expert: Elaine Leader, Ph.D.
Question: How do you tell the difference between a teenager that has an eating disorder and one who doesn't have an appetite, but doesn't have the psychological issues associated with eating disorders? Our teenager is not bulimic, but is simply not eating enough. She is under a doctor's care, but I have questions about dealing with this at home. How can we help her break the cycle of not eating because she doesn't feel well and then not feeling well because she's not eating?
What techniques are successful in getting a teenager to eat a balanced diet?
Posted By: Anonymous, Los Angeles CA Answer: You are approaching the issue with your daughter quite smartly by having her under a doctor’s care. You don’t mention whether the doctor is a psychiatrist or an internist. Also, you don’t tell us what diagnosis your doctor gave for your daughter’s problem or whether she is maintaining her normal body weight. So to answer your question generally about how to tell the difference between an eating disorder and a constant lack of appetite, you need to know the definitions of Anorexia Nervosa and Bulimia Nervosa to determine if your daughter is exhibiting any of these characteristics.
Individuals who misuse the eating function to solve or camouflage problems of living that otherwise seem insoluble suffer from eating disorders. The eating disorders of Anorexia Nervosa and Bulimia Nervosa, characterized by severe disturbances in eating behavior, are coping mechanisms for the realistic resolution of conflict; however, they are inappropriate in that the soothing and comfort are only temporary.
What is Anorexia Nervosa? Anorexia Nervosa, "the starving disease," is the relentless pursuit of thinness. It begins most often as a diet and often there does not appear to be notable differences between food restriction and normal dieting, except the anorectic youngster will exclude all of the fattening foods. The dieting develops into an obsession with weight loss and fat. It is characterized by dramatic weight loss of 20-25% of normal body weight, a pervasive fear of fatness, and a constant obsession with food and dieting. Anorexia usually begins in adolescence, but its onset can occur well into adulthood. The condition is prevalent in westernized countries and in all socio-economic and ethnic groups. Anorexia can affect both sexes although 92% are female.
About 25% of anorectics will alternate their self-imposed starvation with episodes of binge-eating and self-induced vomiting. In this way, they are able to give in to their yearning for food without the fear of gaining weight. The anorectics often deny their appetite and struggle to control their body weight to assert their authority over their bodies. People who suffer from Anorexia Nervosa have a disordered body image and perceive themselves as perpetually fat despite their dangerously low body weight. They reject the concern and criticism of family and friends. It is a serious emotional disturbance causing mental, emotional and physical deterioration. The anorectic is not able to think clearly and cannot accurately perceive reality. Emotions fluctuate between states of euphoria and periods of despair, self-loathing, and feelings of utter worthless. Medical complications include an absence of menstrual periods, and cardiac arrest, kidney failure and malnourishment which can be fatal. Anorexia has a higher mortality than any other psychiatric disorder. The rate varies from 2% to 15%, depending on the severity of the illness and the commitment to and effectiveness of treatment.
What is Bulimia Nervosa? Bulimia is a food obsession characterized by repeated overeating binges followed by purges of forced vomiting, prolonged fasting, or abuse of laxatives, enemas, diuretics (water pills) and amphetamines. It begins when the person turns toward food for comfort, relaxation and escape and provides temporary relief to other problems such as fear, frustration, rage, and emotional pain. The onset often starts in adolescence or young adulthood most often between 15 and 19 years of age. Evidence has been accumulating over the past 10 years that Bulimia Nervosa is on the rise, and numerous studies suggest that bulimia is probably between five and 10 times as prevalent as anorexia. The effects of this disorder can also be devastating. They include ulcers, hernias, severe gastric and dental problems, and disturbance of the blood's chemical balance, which can lead to heart attacks.
What Causes Anorexia and Bulimia? The assumed causes reflect the interaction of biological predisposition, psychological problems, and social factors.
The nervous system and the endocrine system control and regulate important functions of your body. The nervous system, which includes the brain and spinal cord, uses electricity to direct a number of functions (e.g. breathing, sleeping, heart beating, feeling pain and pleasure. Your endocrine system, made up of a collection of glands (e.g. the hypothalamus, pituitary, thyroid, and adrenal) releases chemicals called hormones and is influential in regulating such functions as mood, tissue development and metabolism. The hypothalamus, a collection of cells located in the brain, produces hormones which help to control the pituitary gland, especially in response to stress and also helps to regulate such body functions as body temperature, growth, puberty, sex drive, weight and appetite.
Neuroendocrine research, which studies the interaction between the nervous system and endocrine system, has been investigating how eating disorders influence their functioning. Studies reveal that the low body weight of the anorectic negatively impacts the endocrine system. The body stops producing estrogen that disrupts the menstrual cycle. Major losses in bone density usually occur. The feeding centers in the hypothalamus that control hunger and satisfaction are also affected.
Evidence is accumulating that links bulimia to an underlying mood disorder.
The western societal emphasis on slimness and beauty, along with the changing female roles, are viewed as determining factors. These pressures aggravate the inner conflicts of the anorectic and bulimic around their need for admiration and approval. To balance their fragile self-esteem they try to maintain an ideal weight even if it means bingeing, purging, starvation, and emaciation. Youngsters who are perfectionist and have high expectations for achievement and accomplishment are most susceptible.
Psychologically, the central issue is not food but a desire for control and independence. Afraid to openly separate from their families, they overcome their sense of helplessness by exercising extreme control over their body size and shape and over their eating habits. Some are successful and develop anorexia. Others are less successful and develop bulimia.
Other possible causes of loss of appetite and significant weight loss can occur in medical conditions (e.g., gastrointestinal disease) and depression; but, unlike people suffering from eating disorders, individuals with such problems usually do not have a disordered body image, a dread of fat, and a desire for further weight loss. Perhaps, too, your daughter may just be going through a phase and will regain her appetite in due time.
Where loss of appetite occurs, mealtime can become stressful as parents try to encourage their teenager to eat a balanced diet. At home, I can appreciate your wanting to help your daughter break the cycle of not eating. Although, I do not know the reasons for your daughter’s loss of appetite, I have a few suggestions that you might find useful. Pierre Lecher, Dave Hall, and Rose Calderon have offered the following techniques to facilitate healthy eating patterns among eating disordered people and these strategies can also be applied to non-eating disordered teenagers:
- Develop a negotiated, collaborative approach with your daughter if she is willing to participate
- Stay emotionally calm and be a positive role model by demonstrating your comfort with food and eating.
Most experts agree that parents should avoid the following behaviors when helping their teenagers with eating and appetite issues:
- Parents are advised not to become overly involved in their teenagers eating habits as this can exacerbate the eating problems
- Avoid lecturing, bribing, and bargaining
The key is to remain loving, supportive, and non-critical of your daughter’s eating patterns. It is useful to try to develop a dialogue with her on topics other than food and weight.
I hope this helps.
Expert: Lynda Chassler, Ph.D
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