Go to the emergency room at a local hospital
Download the MY3 App 888-628-9454
If you are in crisis, text "SOS" to 741741 or call 800.273-TALK (8255). If you are in extreme crisis, call 911 while you're looking in the front of your local yellow pages for the number of the local suicide prevention hotline. If you can't get through to either of those, click on Emergency Numbers. Also visit www.metanoia.org/suicide which contains conversations and writings for suicidal persons to read, gay youth suicide at www.sws.soton.ac.uk/gay-youth-suicide and youth: suicide at www.virtualcity.com/youthsuicide .
Wellness. Never end the sentence.
WARNING: "13 Reasons Why" Season 4 release date January 7-12, 2020 started May 18, 2018. Know the facts on Season 2 which started May 18, 2018.. Have these supportive resources available for parents, students and stakeholders.
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You Feeling Suicidal?
brains make them more vulnerable to
Teen Suicide & Firearms FIX
stories: USA Today
Semicolon Tattoo Project Facebook
Oregon Girl Got A Clever Tattoo To Get The Conversation
Going About Depression,
Chg vs Prev/Yr * Last years
national mortality data are available from the
CDC,Source: Source: www.comedsoc.org/Suicide_-_Oregon_Ranked_10th.htm?m=66&s=520
Chg vs Prev/Yr
* Last years
national mortality data are available from the
CDC,Source: Source: www.comedsoc.org/Suicide_-_Oregon_Ranked_10th.htm?m=66&s=520
Alcohol or drugs are
Pay particular attention if they experience:
1. Loss of a loved one
Young people dont always know how to get through stressful times. Adults tend to end their lives because of major life stressors, but for an adolescent, the breaking point is often less significant.
Risk factors line up like lights on
the street. For a student to go from thinking about suicide
to attempting suicide, all these lights have to turn green.
One light might be a fight with a parent. Another might be a
flunked test, a breakup, a peers suicide. They might
contemplate suicide for months, and then the final act is
often on impulse, if everything falls into place. Teachers
have even about a particular suicide. "If you would have
given me 200 names, hers would have been at the bottom of
the list of someone who would do this.
You may be afraid to ask your child if
they are having suicidal thoughts, assuming that you will
put the idea in their head. Dont worry. Either they
are already having suicidal thoughts, in which case it may
be a big relief to talk about it. If they havent,
talking about it openly will allow them to bring the subject
up again if this changes. And please note that even children
younger than 12 do commit suicide.
Youth and elderly suicides are on the increase in the US. And, according to The World Health Organization (WHO) over 786,000 people committed suicide around the world in 1997. This is an effective suicide rate of around 10.7 per 100,000 population per year. To put this statistic in perspective, that is the equivalent of one suicide every forty seconds, somewhere in the world.
Suicide is the ninth leading cause of death in the US with 31,204 deaths recorded in 1995. This approximates to around one death every seventeen minutes. There are more suicides than homicides each year in the US.
From 1952 to 1992, the incidence of suicide among teens and young adults tripled. Today, it is the third leading cause of death for teenagers aged 15-19 (after motor vehicle accidence and unintentional injury). Two-thirds of all suicides under 25 were committed with firearms (accounts for most of the increase in suicides from 1980 to 1992). The second most common method was hanging, third was poisoning. Suicide is increasing, particularly for those under 14 and in those over 65, while not the leading cause of death, the suicide rate is extremely high.
Young men commit suicide successfully
at a higher rate than women in all 30 countries listed
below. In the US, the ratio between men and women was 4.1:1
while in young people 15-24 the average ratio is 5.5:1 and
the ratio increases with age within this group. In white
males over 85, the suicide rate was 73.6/100,000 in 1993.
For more information: www.cdc.gov/ncipc/pub-res/10lc92c.htm
The most common signs of a suicidal person
1. Difficulties with
relationships between friends, family, and others
How to Help Someone
1. Resist trying to
help. People who feel suicidal dont want answers or
solutions. They want a safe place to express their fears and
anxieties, to be themselves.
2. They want someone to trust. Someone who will respect them and wont try to take charge. Someone who will treat everything in complete confidence.
3. They want someone to care. Someone who will make themselves available, put the person at ease and speak calmly. Someone who will reassure, accept and believe. Someone who will say, " care."
If the person is actively suicidal
Get help immediately. Do not leave your teen alone.
Ask your - "Are you thinking of suicide?" Asking someone if they are suicidal will not make them suicidal. Most likely they will be relieved that you have asked. Experts believe that most people are ambivalent about their wish to die.
Listen actively to what your teen is saying. Remain calm and do not judge what you are being told. Do not advise them not to feel the way they are.
Reassure your teen that there is help for their problems and that they are not "bad" or "stupid" because they are thinking about suicide.
Help your teen break down their problem(s) into more manageable pieces.
Offer to investigate counseling services.
Do not agree to keep their suicidal thoughts or plans a secret. Helping someone who is suicidal can be very stressful.
Suggest that they see a doctor for a complete physical. Although there are many things that family and friends can do to help, there may be underlying medical problems that require professional intervention. Your doctor can also refer patients to a psychiatrist, if necessary.
Encourage them to see a trained counselor. Do not be surprised if they refuse but be persistent. There are many types of caregivers for the suicidal. If the person will not go to a psychologist, or a psychiatrist, suggest, for example, they talk to a clergy, guidance counselor or teacher.
If you are concerned
that someone you know may be thinking of suicide, you can
help. Remember, as a helper, do not promise to do anything
you do not want to do or that you cannot do.
suicide is contagious, and the problem may be worse than we
Even though her mother had no sense that Riley was having problems, she knew it was important to talk to her daughter about suicide, and so she did. Between 2013 and 2015, 29 kids in their county had killed themselves, many from just a handful of schools, including Rileys. There had been gunshot deaths, hangings and drug overdoses. And then there were those choking deaths the victims parents insisted were accidental.
Riley knew of at least two of the kids who had killed themselves the previous winter: an older girl at school (they had mutual friends) and a boy in her Christian youth group. Such peripheral connections are all that seem to connect most of the kids in the area who had killed themselves, and school and county officials began to worry they were witnessing a copycat effect...until copycat became too weak a word. It was more like an outbreak, a plague spreading through school hallways.
About a year after Sjoerdsma and her daughter last spoke about suicide, Riley was staying at her fathers house one night when she downed a small bottle of whiskey, then sent out a series of troubling texts and Snapchat messages. Im sorry it had to be me, she wrote to one friend. Then she slipped on a blue Patagonia fleece and snuck out the basement window, carrying her fathers gun.
When Rileys mother and friends saw the messages, they went looking for her at local parks, gas stations and friends houses, all the while begging her via texts and calls to come home.
The next morning, they found her body in the woods behind her fathers house. Shed shot herself in the head.
Three days later, and two days before Rileys memorial service, another Discovery Canyon Campus student killed himself. Her daughter probably knew the boy, but they werent close, Rileys mother says. Nine days later, yet another classmate committed suicide. He had been on the swim team with the boy whod just killed himself. And that wasnt the end of it: Five students from the school of 1,180 died by suicide between late 2015 and summer 2016, a rate almost 49 times the yearly national average for kids their age.
Its not just at that one school. As of mid-October, the total for teen suicides this year in El Paso County, home to Colorado Springs, is 13, one short of the total for all of 2015. Neighboring Douglas County had a similar crisis a few years ago, and news of a classmates suicide no longer fazes students in the area, kids say. Its become almost commonplace, says Gracie Packard, a high school junior in Rileys district. Because it doesnt happen once every four years. It happens four times in a month, sometimes.
The youngest person to die this year in El Paso County was 13. [Even] for a job thats generally pretty tragic, its disheartening, says Dr. Leon Kelly, the countys deputy chief medical examiner. You feel powerless. You feel like, Another one?
Another day, another kid. Its hard.
Death on Instagram
Sociologists have long said people who form bonds are less likely to kill themselves, but sometimes the opposite is truestudies now show that one persons suicidal behavior can spur anothers, and one death can lead to more deaths.
Decades of research prove that a startling range of emotions and behaviors can be contagiousfrom moodiness to yawning. Young people are especially susceptible; they obsess over fads and fashion trends and copy illicit behaviors from peers, such as smoking, drinking or speeding. Or suicide. Using a statistical formula typically applied to tracking outbreaks of diseases, researchers at Columbia University and other institutions confirmed in 1990 that suicide is contagious and can be transmitted between people. Contagion spreads either directly, by knowing a suicide victim, or indirectly, by learning of a suicide through word-of-mouth or the media. Those same researchers found that people ages 15 to 19 are two to four times more prone to suicide contagion than people in other age groups. The way it spreads can be so similar to that of diseases that the Centers for Disease Control and Prevention (CDC) has sometimes gone into a region to investigate spikes in suicides.
Analysts call those spikes suicide clustersan unusually high number of people in an area kill themselves (or attempt to) in a short period of time. The clusters tend to happen where people socialize, such as schools, psychiatric hospitals or military units. Madelyn Gould, one of the analysts who made the contagion discovery, has said these clusters make up between 1 and 5 percent of teen suicides but are vitally important to understand because they represent a class of suicides that may be particularly preventable. And a few consecutive suicides can devastate a community.
Another reason it is crucial to understand these clusters is that suicide is likely becoming more contagious, thanks in large part to social media. Analysts have long assumed that a suicide typically has a profound impact on six people, but that estimate is from the early 1970s and limited to close family members. Social networks (both online and in real life) are much bigger today, and soon-to-be-published research by Julie Cerel, president-elect of the American Association of Suicidology, shows that a suicide may now touch around 135 people, and about one-third of them experience a severe life disruption because of that suicide. She and her colleagues previously found, in 2015, that people who know a suicide victim are almost twice as likely to develop suicidal thoughts as the general population. The closer the relationship, the greater the risk; the younger the person exposed, the greater the risk.
Young people arent the only ones facing a suicide problem; the national suicide rate across all demographics is at an almost 30-year high. But more than three times as many teens are killing themselves now than in the 1950s. Most of these suicides arent copycats, but some areas across the country are suffering from the sort of contagion that has stricken Colorado Springs; the CDC investigated cases in Fairfax County, Virginia, in 2014 and Palo Alto, California, in 2016. Other clusters have likely gone undetected because its often so difficult to make the connections between victims.
Suicide prevention advocates tend to blame television and newspaper coverage for inspiring copycats, but for teens, social media are a growing problem. Instagram pages for kids who kill themselves sometimes contain hundreds of comments. Many are about how beautiful or handsome the deceased were, how they can finally rest in peace and how there should be a party for them in heaven. Dr. Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention, says the message seems to be that if you kill yourself, youll not only end your suffering but also become the most popular kid in school. Teens sometimes have more than 1,000 Instagram followers, so kids far beyond one school or community can see digital shrines to dead friends. Moutier says those posts can seem as if theyre romanticizing death.
Scholars are struggling to keep up with the evolving technology, and they say theres still a paucity of research on how suicidal thoughts spread through social media. It makes these deaths no longer isolated, says Cerel, and kids are exposed and perhaps profoundly affected by someone they might have never even met in person. Analysts say clusters could become harder to spot, because they typically occur in a specific area, but social networks for teens now spread far beyond a school, a neighborhood, even a city.
The Choking Game
Its hard to identify patient zero in the Colorado Springs suicide outbreak because kids today are so interconnected, and the families involved have kept many details private. Researchers also know that they cant limit their search to one group; the first suicide at one school may have been inspired by the death of a student at another. Other factors muddling the search: The coroners office doesnt always track where the deceased went to school, and districts are hesitant to say how many teens theyve lost to suicide, citing student privacy laws and fear of copycats. (Editor's note: In the 2014/15 Oregon Healthy Teen Survey, 3.6% of 8th graders and 0.8% of 11th graders had participated in the 'Chocking Game'. Comparing the two, it might appear that the increase in popularity of the acitive is a 450% increase in the last three years.)
One known precursor to the current wave of suicides was in 2011, when a Colorado Springs father found his 12-year-old son suspended from a bunk bed. The parents insist it was not a suicide and instead blame the choking game, in which a person cuts off blood flow to the brain and then releases it in order to feel lightheaded or even high. The coroners office ruled the cause of death undetermined. In 2013, a 15-year-old from the same school district strangled himself, and his parents blamed the choking game. The number of teen suicides started picking up in the spring of 2015, when a Discovery Canyon Campus student shot herself. The next month, three local kids took their own lives. From June to November, there were five more suicides in the Colorado Springs area; in December, there was on average one teen suicide per week. The deaths surged again toward the end of the last school year, beginning with Rileys suicide.
Those tracking the situation are convinced its a contagion, but theyre unsure how its spreading. That makes it all the more frightening and difficult to stop. Its two years in a row weve dealt with the same sort of terrifying trend, says Kelly, the medical examiner.
Colorados Child Fatality Prevention System, which investigated all youth suicides in the state from 2010 to 2014, identified risk factors, (105 page pdf) including family arguments, relationship breakups and physical or emotional abuse. Others blame regional factors, like the nearby Army and Air Force bases, as the children of people serving in the military are at elevated risk for suicidal thoughts. (A parents deployment can lead to increased responsibilities at home for a kid or emotional problems because of the separation and possibility of a parents death.) Some blame the high altitude, which researchers have linked to suicide.
Analysts also point out that young people dont always know how to get through stressful times. Adults tend to end their lives because of major life stressors, Kelly says, but for a kid, the breaking point is often less significant. These risk factors line up like lights on the street, says Richard Lieberman, a mental health consultant for the Los Angeles County Office of Education. For a kid to go from thinking about suicide to attempting suicide, all these lights have to turn green. One light might be a fight with a parent. Another might be a flunked test, a breakup, a peers suicide. Kids might contemplate suicide for months, and then the final act is often on impulse, if everything falls into place, says Scott Poland, a school crisis expert from Nova Southeastern University in Florida. Poland and Lieberman are working with Discovery Canyon Campus and its district.
Riley didnt show any obvious signs of mental health problems, according to her mother, and wasnt in therapy or on medication. Teachers even said, If you would have given me 200 names, hers would have been at the bottom of kids who would do this.
But Riley was having trouble in the classroomshe fooled around during class, and her grades suffered, which added pressure. She kept saying she hated school; she just didnt want to be there, Sjoerdsma says. She also struggled with her parents 2005 divorce. But even a few hours before her death, at a Christian youth group gathering she was dancing around and holding hands with friends, says Sjoerdsma, acting like her normal self. In the car with family friends on the way to her fathers house, Riley rolled down the window and stuck her hands outside. She liked to feel the cool mountain air on her palms. When she was dropped off, she told the people she was with that shed see them tomorrow.
A little more than a week after Rileys suicide, Brittni Darras, an English teacher at a different school in the area, posted on Facebook that she had learned of another students attempted suicide during a parent-teacher conference. As her mom sat across from me, we both had tears streaming down our faces, Darras wrote. Feeling helpless, I asked if I could write my student a letter to be delivered to her at the hospital. The mother agreed. After the student received it, the mother emailed Darras to share what the girl had said: How could somebody say such nice things about me? I didnt think anybody would miss me if I was gone.
Darras had lost a student to suicide a few years earlier. Its something that, as a teacher, you never entirely recover from, she says. Losing one in my teaching career was more than anybody should ever have to go through. When she heard how the girl in the hospital had reacted, Darras decided to write letters to the rest of her 130 students. It took her two months. Her students were thankful, and word of what she did spread; nearly 200,000 people have shared her Facebook post.
Darras is one of many people in the Colorado Springs area fighting to stop the suicides. The initiative Safe2Tell, which began as a pilot program in the city in the 1990s and expanded statewide after the Columbine High School killings in 1999, lets young people anonymously report threats by others. State police receive the reports and connect with local law enforcement and schools to intervene. Last school year, Safe2Tell received 5,821 tips, up 68 percent from the previous year. The largest category involved suicide threats. For years, in all the work in suicide prevention, weve really focused on one thing, and that is seeking help if you need it, says Susan Payne, the initiatives executive director. That meant putting it on the victim thats struggling to make a phone call or seek help. Her program encourages bystanders to look for warning signs in others and report them.
Daniel Brewster wants that too. On December 31, 2015, hours before he and his daughter Danielle, 17, a Discovery Canyon Campus student, planned to celebrate the new year, she hanged herself. Brewster later looked at his daughters phone. This is the part that kills meI know she was texting other kids at the time and letting them know, he says. She wrote, My feet are off the floor, and Everything is getting hazy and dark. None of the kids intervened; one responded by suggesting she unhang.
Just having a meeting with [teens] and saying, OK, here are the signs; heres what you look for; heres what you need to dothats not enough, Brewster says. It needs to be ingrained in these kids heads, because theyre our first line of defense. Of all the young people in Colorado who killed themselves from 2008 to 2012, more than a third had told someone of their plans, according to a state report.
Danielles was one of at least three teen suicides in the Colorado Springs area in a three-week span. Then, six weeks later, Danielles mother hanged herself in her daughters bedroom. Theyre supposed to be here, Brewster says, choking on the words. Were supposed to be in this house together.
Some local students are starting their own prevention efforts. Gracie Packard was in the eighth grade when she set a date to kill herself. She had struggled with anxiety and depression since she was young and later practiced cutting. She couldnt sleep, her grades were slipping, and she was losing weight. She would cancel plans with friends and stopped dancing, once a passion of hers. Meanwhile, other kids around town, as well as one of her siblings, were killing themselves or attempting to. It was pretty much all around you, she says. She recalls telling herself, If things arent better by this date, then youve tried your best, and you can end it.
Her friends sensed something was wrong. Days before she planned to die, they staged an intervention. Were worried about you, they told her. Their concern, plus a suicide prevention nonprofit she stumbled upon called To Write Love on Her Arms, convinced her to ask her mom for help. I was physically shaking. I could hardly breathe, she says. But that 30 seconds of bravery in being willing to say out loud to somebody you trust that, Hey, Im not OK, its going to be one of the scariest things youll ever do, but it will be one of the best things youll ever do. She soon started therapy. Now 17, Gracie shares her mental health story publicly and advocates for suicide prevention. An event she hosted in September drew 150 people.
City and school officials are also working to stem the rising death toll. Last spring, the El Paso County Public Health department hired a specialist to create a screening system to identify young people at risk.
But not all parents are willing to address the problem. Kelly, the medical examiner, says family members almost always request that his office cite a cause of death other than suicide, such as the choking game. Ive had relatives ask me if I would call it an autoerotic asphyxia because they didnt want to tell Grandpa that his grandson had committed suicide, he says. That really speaks to what we as Americans think about mental illness. None of the obituaries for the Colorado Springs kids seem to mention suicide (a common omission everywhere), and its unlikely that their memorial services included more than a vague reference.
Some worry that discussing suicide might inspire more kids to do it, but just because suicidal behavior can spread quickly doesnt mean it has to. Moutier, from the American Foundation for Suicide Prevention, says thinking suicide is contagious might give young people the impression that anyone can catch it, even a stable, happy kid. Thats not true, she says.
Whether the parents of the deceased will admit it or not, suicide in most cases involves an underlying mental health condition. Researchers have found that if someone close to an adolescent dies by suicide, the adolescents mental health history is a bigger predictor of future suicidal behavior than his or her relationship to the suicide victim.
El Paso Countys most recent teen suicide was on September 19a hanging on school grounds. Because teen suicides there tend to spike at the end of semesterswhen students may feel as if theyre losing whatever support they had at school, Kelly saysofficials may not know until winter break if things are improving. Students arent necessarily sending panicked glances around the classroom, wondering whom this plague will strike next. They have other things to worry aboutexams, rehearsals, sports games, college applications. When it first happens, thats all that is on everyones mind, says Chloe Love, a junior at Discovery Canyon Campus, who does suicide prevention work. Then they move on. They have to. Sometimes, she says, the memories just hurt too much.
Sjoerdsma says she wont hide how Riley died. Im fully aware that my daughter committed suicide, and I dont know why. She has done social work, and her husband is a local middle school teacher; neither saw the signs. Since her daughters death, she hasnt been sleeping well, and the spate of suicides makes the grieving process more difficult. At night, she often lies awake, thinking about how she and Riley used to say good night: I love you here to heaven, Sjoerdsma would say. I love you back to heaven, Riley would respond.
Sjoerdsma still says it every night.
Only now, theres no one to say it back.
facts about mental health
Myth: People with mental health conditions never get better
Fact: Treatment works for more than 8 in 10 people who get help for depression, and as many as 9 in 10 people who get help for panic attacks.
Source: Mental Health America
Myth: People with mental health conditions are just weak
Fact: Many factors can impact mental health including biology, environment, and challenging life events. Anyone can develop a mental health condition theres no single cause, and it isnt anyones fault.
Myth: If I get treatment, my employer will find out
Fact: You decide who you want to tell and not tell about your care. Your medical record is confidential, and you cant lose your job or your health insurance for getting treatment for a mental health or addiction issue.
Myth: If I get treatment, Ill have to take medication
Fact: There are many types of
treatment. Medication is just one of them and
its typically combined with therapy, self-care
resources, and other types of support. We dont
automatically recommend medication to everyone
its a personal decision members and providers make
You Wanna Kill Yourself? Gays and Suicide."
more women suffer from depression that men do, so it seems
odd that women would commit suicide at only one-fourth the
rate of men. The key difference between the two sexes may be
that women talk out their problems. George E. Murphy, an
emeritus professor of psychiatry at Washington University
School of Medicine in St. Louis, says that women may be
protected because they are more likely to consider the
consequences of suicide on family members or others. Women
also approach personal problems differently than men and
more often seek help long before they reach the point of
considering suicide. 'As a result, women get better
treatment for their depressions,' Murphy says. To reduce the
rate of suicide in men, Murphy suggests that physicians
should be alert for risk factors in men and refer them into
treatment. Writing in the Journal of Comprehensive
Psychiatry, he says that identifying men at risk require
mental health professionals to recognize that depressed men
may understate emotional distress or difficulty with their
problems." Black Men, 3/99.
It's important for people with suicidal feelings to let themselves be assisted in overcoming deep depression. It's also a good idea to talk about your feelings with friends. No man is an island and there's nothing wrong with leaning on people who love you in times of need.
available locally. Dial 411 for your city's Suicide
Prevention Hotline, or try your local Gay & Lesbian
Center, which offers referrals for counseling, domestic
violence and suicide prevention. Crisis Text Line is
available 24/7 by texting "SOS" to 741741
Clustering of Teenage Suicide
The young are heated by nature as drunken men by wine.
Aristotle made that observation 2,300 years ago, and since then, not much has changed about the way the adolescent brain behaves. But these days, researchers are beginning to understand exactly why a teenagers brain is so tempestuous, and what biological factors may make teens brains vulnerable to mood disorders, substance abuse, and suicide.
Suicide is the third leading cause of death among teens 15 to 19 years old, according to the National Centers for Disease Control and Prevention. The percentage of high school students who reported seriously considering suicide increased from 14 percent in 2009 to 16 percent in 2011. Locally, the city of Newton is reeling from the suicide of Roee Grutman, 17, a high school junior, in February, the third suicide in a single school year. The towns of Needham and New Bedford have experienced similar spates of teen suicides in recent years.
Misconceptions about teen suicide abound, says Dr. Barry N. Feldman, director of psychiatric programs in public safety at the University of Massachusetts Medical School, and a suicide prevention expert who has worked with many Massachusetts high schools
Neither bullying, pressure to succeed in sports or academics, nor minority sexual orientation can cause suicide, he says, but are among a number of possible risk factors. If you focus too much on just bullying or sexual orientation, you take your eye off the underlying vulnerability a kid may have, Feldman says.
Warning signs that a teen is in danger for suicide
Suicide is typically caused by a constellation of risk factors and underlying vulnerabilities. Its an attempt to solve a problem of intense pain with impaired problem-solving skills, he says.
Researchers have long known that the basic problem with the teenage brain is the asymmetric or unbalanced way the brain develops, said Dr. Timothy Wilens, a child psychiatrist at Massachusetts General Hospital specializing in adolescents, addictions, and attention deficit disorder.
The hippocampus and amygdala, which Wilens calls the sex, drugs, and rock n roll part of the brain, feels and stores emotions and is associated with impulses. It matures well ahead of the section of the brain that regulates those emotions and impulses, the prefrontal cortex.
Throughout the teenage years and up until about age 25, this executive section of the brain, also responsible for planning and decision, lags behind, Wilens says.
Until the front part of the brain catches up, if kids get sad, they really experience sadness un-tethered. He adds. Its why first love really does break the heart.
Its during this period of brain development that kids often act out based on their moods, get involved in substance abuse, and when they may be at a heightened risk to commit suicide, Wilens says. This is also when adolescents have a higher susceptibility to psychiatric disorders including depression, drug addiction, and schizophrenia.
Dr. Mai Uchida, a child and adolescent psychiatrist at Mass. General, is leading two joint studies at the MGH Biederman Lab and the Gabrieli Lab at the Massachusetts Institute for Technology that are searching for biomarkers to identify the underlying vulnerability in teens. The studies are funded by The Tommy Fuss Fund, which memorializes a Belmont Hill teen who committed suicide in 2006.
Just as hypertension and high cholesterol are biomarkers for heart attack, mood disorders are indicators of kids at risk for suicide, Uchida said.
In a healthy teen, even though brain structure is unbalanced, the developing prefrontal cortex still should be communicating and working in concert with the brain section that feels and stores emotion, according to Uchida.
In one of the studies, researchers used magnetic resonance imaging to compare the brains of 38 children between the ages of 8 and 14 who had a parent with a depressive disorder with a control group of 25 children with no genetic predisposition.
Looking at the brains while the children were in a resting state the researchers saw less synchronized activation between the amygdala and the medial prefrontal cortex in the kids who had a genetic predisposition for depressive disorder than in the control group.
The fact that these two brain regions are not activating together could be a potential biomarker, indicating a vulnerability for potential mental or mood disorders.
In the second study in which 62 subjects between ages 18 and 24 were given pictures of people crying and asked to think about a positive way to interpret the picture the subjects who could not spin a positive narrative also showed less connectivity between the brain regions.
These deficits could represent a unique biological vulnerability that puts youth at risk for depression and suicide, Uchida said.
Uchida and her team are currently readying these two studies for publication. She says there is a lot more work to do, but she is hopeful the results might eventually lead to early-intervention screening.
In a study published in December, researchers at the Douglas Institute Research Centre affiliated with McGill University identified the gene known as DCC as having a possible role during the maturation of the prefrontal cortex and in healthy brain connectivity.
Higher function or expression of DCC appears to be associated with a greater risk of psychiatric disorders, depression, and suicide, according to Cecilia Flores, a professor of psychiatry at McGill and lead author of the study.
We are very excited to discover the function of this gene, she said. Experiments in mice also showed that DCC gene function could be altered by both positive and negative experiences, and influences behaviors later in a rodents adult life. If the results translate to humans, Flores said, it offers hope that early therapy and support during the critical time in adolescent brain development could have long-term positive impact.
Wilens says that one of the most useful early interventions for adolescents who might have depression, mood, or attention deficit disorders is cognitive behavioral therapy, a non-pharmaceutical approach that can help teach kids how thoughts and thought patterns influence behaviors.
These are areas in which kids are lacking because of the imbalance of brain development, and could assist them in making better connections between what they are feeling and what they are thinking.
It helps put it all together and has a component that gets you to stop doing something that may harm you, Wilens said.
Feldman encourages parents and school systems to create protective buffers a caring relationship with an adult, whether that is a parent, guardian, teacher, or someone in the community. UMass Medical is currently collaborating with the Department of Public Health and Department of Elementary and Secondary Education to train school personnel to develop comprehensive programs that include suicide intervention and prevention.
And parents and students are urged to
take the warning signs of a troubled and potentially
suicidal teen seriously. Dont casually dismiss
signs as a cry for help, Feldman says. Teens at risk
for suicide should be taken to a hospital emergency room or
somewhere where they can get immediate mental health
services. Dont make an appointment for a doctor
down the road.
adolescent suicide prevention
Sources of information
A literature review was performed using Ovid MEDLINE with the key words suicide, attempted suicide, and evaluation studies or program evaluation, adolescent.
Challenges for family physicians The following case presentation illustrates the complexity of dilemmas presented to family physicians who work with adolescents with mental health concerns. This review of adolescent suicide will equip physicians with an approach to help such patients.
Sarah, a 16-year-old patient you have not seen in several years, has booked an appointment to discuss starting birth control pills. Sarahs mother was at the office last week for renewal of antidepressant medication and mentioned that Sarah has been very irritable at home and once yelled, I might as well be dead! You know that Sarahs parents divorced last year. While taking Sarahs blood pressure you notice that she has several scars from superficial cuts to her left wrist. How can you address these issues and determine her risks?
Morbidity and mortality
Canada witnesses more than 500 suicides per year among those 15 to 24 years old, with the next most common cause of death being cancer at 156 deaths per year.6 It has been estimated that for each completed suicide, there are approximately 400 attempts.7 Many high-school students contemplate suicide,3 and with the shortage of pediatric psychiatrists, much of the burden of identifying and treating high-risk youth is placed on family physicians.
This article has been peer reviewed.
Cet article a fait lobjet dune révision
par des pairs Can Fam Physician 2010;56:755-60
Four of the five most popular forms of social media harm young peoples mental health, with Instagram the most damaging, according to research by two health organisations.
Instagram has the most negative impact on young peoples mental wellbeing, a survey of almost 1,500 14- to 24-year-olds found, and the health groups accused it of deepening young peoples feelings of inadequacy and anxiety.
The survey, published on Friday, concluded that Snapchat, Facebook and Twitter are also harmful. Among the five only YouTube was judged to have a positive impact.
The four platforms have a negative effect because they can exacerbate childrens and young peoples body image worries, and worsen bullying, sleep problems and feelings of anxiety, depression and loneliness, the participants said.
The findings follow growing concern among politicians, health bodies, doctors, charities and parents about young people suffering harm as a result of sexting, cyberbullying and social media reinforcing feelings of self-loathing and even the risk of them committing suicide.
Its interesting to see Instagram and Snapchat ranking as the worst for mental health and wellbeing. Both platforms are very image-focused and it appears that they may be driving feelings of inadequacy and anxiety in young people, said Shirley Cramer, chief executive of the Royal Society for Public Health, which undertook the survey with the Young Health Movement.
She demanded tough measures to make social media less of a wild west when it comes to young peoples mental health and wellbeing. Social media firms should bring in a pop-up image to warn young people that they have been using it a lot, while Instagram and similar platforms should alert users when photographs of people have been digitally manipulated, Cramer said.
The 1,479 young people surveyed were asked to rate the impact of the five forms of social media on 14 different criteria of health and wellbeing, including their effect on sleep, anxiety, depression, loneliness, self-identity, bullying, body image and the fear of missing out.
Instagram emerged with the most negative score. It rated badly for seven of the 14 measures, particularly its impact on sleep, body image and fear of missing out and also for bullying and feelings of anxiety, depression and loneliness. However, young people cited its upsides too, including self-expression, self-identity and emotional support.
YouTube scored very badly for its impact on sleep but positively in nine of the 14 categories, notably awareness and understanding of other peoples health experience, self-expression, loneliness, depression and emotional support.
However, the leader of the UKs psychiatrists said the findings were too simplistic and unfairly blamed social media for the complex reasons why the mental health of so many young people is suffering.
Prof Sir Simon Wessely, president of the Royal College of Psychiatrists, said: I am sure that social media plays a role in unhappiness, but it has as many benefits as it does negatives.. We need to teach children how to cope with all aspects of social media good and bad to prepare them for an increasingly digitised world. There is real danger in blaming the medium for the message.
Young Minds, the charity which Theresa May visited last week on a campaign stop, backed the call for Instagram and other platforms to take further steps to protect young users.
Tom Madders, its director of campaigns and communications, said: Prompting young people about heavy usage and signposting to support they may need, on a platform that they identify with, could help many young people.
However, he also urged caution in how content accessed by young people on social media is perceived. Its also important to recognise that simply protecting young people from particular content types can never be the whole solution. We need to support young people so they understand the risks of how they behave online, and are empowered to make sense of and know how to respond to harmful content that slips through filters.
Parents and mental health experts fear that platforms such as Instagram can make young users feel worried and inadequate by facilitating hostile comments about their appearance or reminding them that they have not been invited to, for example, a party many of their peers are attending.
May, who has made childrens mental health one of her priorities, highlighted social medias damaging effects in her shared society speech in January, saying: We know that the use of social media brings additional concerns and challenges. In 2014, just over one in 10 young people said that they had experienced cyberbullying by phone or over the internet.
In February, Jeremy Hunt, the health
secretary, warned social media and technology firms that
they could face sanctions, including through legislation,
unless they did more to
tackle sexting, cyberbullying
and the trolling of young users.
One of the myths about suicidal talk, and actual suicide attempts, in young people is that they are just a bid for attention or a cry for help. Kids who talk or write about killing themselves are dismissed as overly dramaticobviously they dont mean it! But a threat of suicide should never be dismissed, even from a kid who cries Wolf! so many times its tempting to stop taking her seriously. Its important to respond to threats and other warning signs in a serious and thoughtful manner. They dont automatically mean that a child is going to attempt suicide. But its a chance you cant take.
When thinking about this, it helps to understand what factors make a young person more or less likely to consider or attempt suicide. What do we know about young people who try to kill themselves, or who actually die by suicide? Lets take a look at both the risk factorsthings that increase the likelihood that a child will engage in suicidal behaviorand the protective factors, or things that reduce the risk.
If a child has a lot of risk factors and hardly any protective factors you need to be extremely concerned about him. On the other hand, if he has a fair number of risk factors but a lot of protective factors you may be somewhat less concerned, although you still, of course, need to be concerned.
Here are some key suicide risk factors:
But what about protective factors, things that can mitigate the risk of engaging in suicidal behavior?
Here are some key protective factors:
So what do you do if your child fits the profile of someone at risk for youth suicide? Warning signs of suicide to be alert to include changes in personality or behavior that might not be obviously related to suicide. When a teenager becomes sad, more withdrawn, more irritable, anxious, tired, or apatheticthings that used to be fun arent fun anymoreyou should be concerned. Changes in sleep patterns or eating habits can also be red flags.
Acting erratically, or recklessly is also a warning sign. If a teen starts making really poor judgments, or he starts doing things that are harmful to himself or other people, like bullying or fighting, it can be a sign that he is spinning out of control.
And, finally, if a child is talking about dying, you should always pay attention. I wish I was dead. I just want to disappear. Maybe I should jump off that building. Maybe I should shoot myself. Youd all be better off if I wasnt around. When you hear this kind of talk, its important to take it seriouslyeven if you cant imagine your child meaning it seriously.
What to do? The first thing to do is talk.
For more information and resources on
suicide, see the APAs suicide help
Coping With A
Parents Suicide How to help the children who are left
As with all traumatic events, the way in which kids are supported in processing their feelings about the loss affects how successfully they will recover. Children are very resilient, and while a parents suicide will never stop being an important event in their lives, with help they can recover their emotional health and vitality.
When children experience the sudden death of a parent, they go through what we call traumatic grieving. This kind of death is not just a painful thing to assimilate; it triggers an emotionally complicated or conflicted process.
When a death is shocking and disturbing it generates frightening thoughts, images, and feelings a child may want desperately to avoid. In the case of a suicide, children may have feelings toward or about their parent that they feel are unacceptable, that they want to deny. So they try to block them out, by not talking or thinking about the person theyve lost, who they may feel has betrayed them, or rejected them. But to grieve in a healthy way, its necessary to think about the person youve lost, and allow yourself to feel sadness and pain. Kids need to be able to remember the parent theyve lost as a loving person despite his or her flaws.
Even more than an accidental death, a suicide generates horror, anger, shame, confusion, and guiltall feelings that a child can experience as overwhelming. The biggest risk to a childs emotional health is not being able, or encouraged, to express these feelings, and get an understanding of what happened that he or she can live with. When a mother who has been depressed commits suicide, for instance, we want that understanding to be that she suffered from a mental illness, a disorder in her brain that caused her death, despite the efforts of those who loved her to save her.
Researchers at Johns Hopkins Childrens Center found that children who are under 18 when their parents commit suicide are three times as likely as children with living parents to later commit suicide themselves. This highlights the vital importance of providing support to children who are grieving. Not only are we treating the trauma of sudden parental loss, we are also trying to break the suicide cycle in families.
What do children need most in the aftermath of a suicide? First, they require simple and honest answers to their questions. They need to know that their feelings are acceptable: anger at a mother or a father who committed suicide is normal, and it doesnt mean a betrayal of the love you have, or the terrible loss you may be feeling. If the person who died has been mentally ill for a long time, a child might actually feel relieved at the death, and that, too, he or she needs to be allowed to feel.
After a suicide, children need to know that theyre not to blame. Being natural narcissists, kids tend to put themselves at the center of the narrative: If I had behaved better, if I had come home right after school, if I had tried harder to cheer Mom or Dad up, etc., this wouldnt have happened. What we want them to understand is that the parent was ill. We did our best to help, but it didnt succeed. This isnt an understanding thats achieved in one conversation; its something that has to be worked on over time.
It helps children recover to keep their lives as normal as possibleto return to routines as soon as possible, to return to school and regular activities.
Signs of trauma
When should you worry about a child failing to recover in a healthy way? Though its difficult to distinguish problem behavior from the expected process of grieving, there are some key things to look for.
With a regular traumatic experience, like being close to an accident, an attack, a disaster, we expect signs of recovery in about a month. But the timetable for grieving is less clear, so the recovery process can take longer. If a childs sadness and withdrawal from normal activities dont dissipate over time, and they begin to cause impairmentrefusal to go to school, changes in sleep habits, a decrease in appetite, irritabilitythey can be cause for concern.
The biggest sign that someone is not grieving in a natural way is a disturbed relation to the memory of the loved one. This can include avoiding places or situations that might remind a child of the parent who died, emotional numbing, or selective amnesia about the traumatic loss. On the other hand, it can manifest as intrusive thoughts about the event. These all get in the way of the process of forming memories of a parent thats part of the healthy grieving process.
Who is at most risk for suffering long-lasting trauma? Children with avoidant personalities or extreme anxiety will more easily fall into an unhealthy coping style. Children who have experienced other traumas are also more likely to respond poorly, given the practice they have had. Kids who lack strong support networksboth within the family and within the community at largesuffer more. And girls, for reasons we dont fully understand, appear three times more likely to have traumatic reactions to disturbing events.
Finally, when we imagine a childs experience of the loss of a parent to suicide, we need to recognize that the family may have been struggling with mental illness, and often addiction, for years, which must surely have taken a toll. The most important thing to keep in mind is that the antidote to traumatic grief is honesty, loving support, and the continuation of the family in its strongest possible form.
When death intrudes in the lives of children in a school community, the classroom is one of the key settings in which kids will experience grief and anxiety, and struggle to come to terms with their feelings.
I wish I could give you words that would protect the youngsters in your class from grief and fear. But since thats not possible, I offer some thoughts and guidelines, based on my experience, to help you help them process their feelings in a healthy way.
Acknowledge the loss
When a tragedy involves a school communityespecially when the lives of students or teachers are lostits likely that it will be in the classroom where the loss may be felt most keenly. Some kids may be very uncomfortable with that awareness. That means its particularly important for you to acknowledge the loss and give your students an opportunity to express their feelings about the traumatic event.
Give kids time to talk
Though there may be a school-wide meeting or service on helping children cope, for many kids in the classroom will be the most important setting for asking questions, sharing feelings, and offering memories. Studies have found that children are more able to get comfort from adults they know well, and even from other children, than from crisis experts who are not familiar to them. Studies also show that adults listening to children is more important in this kind of situation than knowing the perfect thing to say to them: A comfortable and safe setting where kids are allowed to be sad and upset and confused is the most valuable thing you can offer.
We recommend that you convene a group discussion, in whatever style is familiar to your kids, and let them know that youre sad, and many others are sad, and that when a tragedy happens and we lose friends and classmates, its important to talk about how we feel and how we want to remember them. You should invite, but not force, questions, and answer them as simply as possible, in a developmentally appropriate way.
Address safety concerns
Since young children are egocentric, its likely that some of your students will be worried about their own safety. Could the same thing happen to them? If it was a fire, reassure them that house fires are very rare in this day and age, and remind them about safety measures like fire drills that are taken in schools. If it was an act of violence, you can stress, again, efforts by their parents and teachers to make sure they are safe. If they ask questions you cant answer, its okay to tell them you dont know.
Return to routine
After youve given them plenty of time to formulate their questions, express their feelings, and respond to each other, its important to go back to your regular routine. Thats not only because youre trying to model healthy resilience, but because routine is deeply comforting for children.
Memorialize the lost
Keep in mind that the first time you talk about a tragic event that affects your children wont be the last time. Coming to terms with loss takes time, and will involve transitioning to positive ways to memorialize those who were lost, as a classroom and as a school. In your conversation (and subsequent ones) you can suggest ways the class might remember friends and classmates they miss: write stories about things you did together, draw pictures, plant trees, raise money to donate to children in need. Its helpful to remind children that a person continues to live on in the hearts and minds of others. And doing something that benefits other children not only helps them feel good about themselves, but helps them learn a very healthy way to respond to grief in the future.
Teach and model resilience
Remember that, as with everything you do as a teacher, you are teaching, and modeling, and allowing children to devise for themselves ways to handle challenges in a positive way. Its a skill that will be as important in their lives as reading and writing, and worth your efforts to nurture when kids are in crisis.
Children After the Suicide of a Classmate: Responding
to a painful loss in the healthiest way possible
Grieving and coming to terms with a disturbing death take time, and theres nothing we do can do to bypass or hurry the process. But by giving kids opportunities to share their feelings we can help them rebound in a healthy way. And by talking about suicide openly and matter-of-factly, as the result of an emotional illness, we can help kids put it in a realistic and useful perspective.
Read our guide Helping
Children Cope With Grief for
Rash of Teen Suicides in Palo Alto, the CDC Sends Team to
Six young people in Palo Alto died by suicide in 2009 and 2010, and another four in 2014 and 2015. Several among them took their lives on the tracks of the Caltrain, the commuter train that runs through town and connects San Francisco and San Jose. Of high school students in Palo Alto surveyed during the 2013-2014 school year, 12 percent had seriously considered suicide in the last year. From the beginning of the following school year through March, 42 students at Henry M. Gunn High School in Palo Alto had been hospitalized or treated for significant suicide ideation. Overall, the suicide rate at Palo Altos two public high schools in the past decade is four times the national average.
Following the two clusters of youth suicides in Palo Alto in recent years, the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration have sent a five-person team to conduct an epidemiological assessment, the San Jose Mercury News reports. The California Department of Public Health issued a formal request for help from the federal agency on behalf of Santa Clara County Public Health Department.
I really appreciate when we can have federal support and can leverage that expertise at a local level, Mary Gloner, executive director of the Palo Altobased Project Safety Net, told the Mercury News.
The inquiry will be in the form of whats called an Epi-Aid, or an investigation of an urgent public health problem. Over the past few months, the CDC has been working with Santa Clara County health officials to prepare for the visit, collecting data on fatal and non-fatal suicidal behavior among youth in the area between 2008 and 2015.
The team was scheduled to arrive in the area Tuesday and is expected to conduct fieldwork in Palo Alto and the surrounding Santa Clara County through February 29, reviewing data and convening informal meetings with community groups to discuss suicide prevention strategies already in place and other potential programs.
The main goals of the assessment, according to a fact sheet posted on Project Safety Nets website, are to identify and track trends in suicidal behavior among youth between 2008 and 2015; examine whether media coverage met safe reporting guidelines for suicide; inventory youth suicide prevention policies, activities and protocols; compare those to national and other evidence-based recommendations; and, ultimately, use all of that information and insight to make recommendations on youth suicide prevention strategies that can be used at the school, city, and county level.
Though Epi-Aid investigations are usually directed toward infectious disease outbreaks, the Santa Clara County assessment is not without precedent. In November 2014, the CDC sent a team to Fairfax, Virginia, to conduct a similar investigation of youth suicides, culminating in a 224-page report detailing its findings, provided to the Fairfax County Health Department in June 2015. According to the Mercury News, the Epi-Aid team that arrived in Palo Alto on Tuesday will release a preliminary report soon after it completes its field work and follow up with a more comprehensive report in several months.
News of the assessment comes just a
few months after The Atlantic published a cover story by
Hanna Rosin titled The Silicon Valley Suicides,
which tried to understand why so many kids with bright
prospects [are] killing themselves in Palo Alto.
1. Identify problems of those participating Native American youth from their perspective as it relates to drug, alcohol and substance abuse along with physical and sexual abuse.
2. Evaluate the depth and source of the problem.
3. Identify intervention services to combat these problems by overcoming the source of the problem and the perceived solution.
4. Implement methods to address appropriate counseling services in local areas and on a regional basis.
5. Attempt to identify the cause of the suicide attempts among the Native American youth in the area.
6. Locate and recruit participation in the development and correctional programs from positive role models from the local surrounding Native American community.
7. Develop participation in the programs by Native American youth utilizing a peer guidance and community support program.
Flying With Eagles, Inc., is
registered in Pennsylvania as a not for profit corporation.
Flying With Eagles,Inc., is a public charity exempt from
federal income tax under Section 501(c)(3) of the Internal
Warning Signs and Major Risk Factors of Teenage Suicide
Although it is almost impossible to predict precisely which teenager will attempt suicide, there are warning signs that parents can look for. The American Academy of Child and Adolescent Psychiatry has assembled this list of indications. If one or more of these signs occur, parents should talk to their teenager and seek professional help.
In high-risk patientsthat is
patients who have threatened or attempted suicidethere
are four risk factors that account for more than 80% of the
risk for suicide: major depression, bipolar disorder, a lack
of previous mental health treatment, and the availability of
firearms in the home. If these four problems were solved,
most suicides would be prevented.
Suicide and Self-inflicted Injury per 100,000 age 15-24,
Suicide in the Community: Prevalence and Correlates in One
Results. Forty-eight percent of weighted participants (n=816/1,687) reported lifetime exposure to suicide. Current depression and anxiety symptoms were higher in suicide-exposed than in suicide-unexposed individuals. Suicide-exposed individuals were twice as likely as suicide-unexposed individuals to have diagnosable depression and almost twice as likely to have diagnosable anxiety. Suicide-exposed individuals were more likely than suicide-unexposed individuals to report suicide ideation (9% vs. 5%). Closeness to the decedent increased the odds of depression and anxiety and almost quadrupled the odds of posttraumatic stress disorder.
Conclusion. Exposure to suicide
is pervasive and occurs beyond family; as such, it is
imperative to identify those with perceived closeness to the
decedent. This hidden cohort of suicide-exposed people is at
elevated risk for psychopathology and suicidal ideation.
Many Teens at Risk
for Suicide Don't Get Help
Teen-ager Suicide Rates Increase
Have you seen anyone with a
semicolon tattoo? Here's what it's about.
Have you seen anyone with a tattoo of a semi-colon? If not, you may not be looking close enough. They're popping up...everywhere.
That's right: the semicolon. It's a tattoo that has gained popularity in recent years, but unlike other random or mystifying trends, this one has a serious meaning behind it. (And no, it's not just the mark of a really committed grammar nerd.)
This mark represents mental health struggles and the importance of suicide prevention.
Project Semicolon was born from a social media movement in 2013.
They describe themselves as a "movement dedicated to presenting hope and love to those who are struggling with depression, suicide, addiction, and self-injury. Project Semicolon exists to encourage, love, and inspire."
But why a semicolon?
"A semicolon is used when an author could've chosen to end their sentence, but chose not to. The author is you and the sentence is your life."
Originally created as a day where people were encouraged to draw a semicolon on their bodies and photograph it, it quickly grew into something greater and more permanent. Today, people all over the world are tattooing the mark as a reminder of their struggle, victory, and survival.
I spoke with Jenn Brown and Jeremy Jaramillo of The Semicolon Tattoo Project, an organization inspired by the semicolon movement. Along with some friends, Jenn and Jeremy saw an opportunity to both help the community and reduce the stigma around mental illness.
In 2012, over 43 million Americans dealt with a mental illness . Mental illness is not uncommon, yet there is a stigma around it that prevents a lot of people from talking about it and that's a barrier to getting help.
More conversations that lead to less stigma? Yes please.
"[The tattoo] is a conversation starter," explains Jenn. "People ask what it is and we get to tell them the purpose."
"I think if you see someone's tattoo that you're interested in, that's fair game to start a conversation with someone you don't know," adds Jeremy. "It provides a great opportunity to talk. Tattoos are interesting marks we put on our bodies that are important to us."
Last year, The Semicolon Tattoo Project held an event at several tattoo shops where people could get a semicolon tattoo for a flat rate. "That money was a fundraiser for our crisis center," said Jenn. In total, over 400 people received semicolon tattoos in one day. Even better, what began as a local event has spread far and wide, and people all over the world are getting semicolon tattoos.
And it's not just about the conversation it's about providing tangible support and help too.
Jenn and Jeremy work with the Agora Crisis Center. Founded in 1970, it's one of the oldest crisis centers in the country. Through The Semicolon Tattoo Project, they've been able to connect even more people with the help they need during times of crisis. (If you need someone to talk to, scroll to the end of the article for the center's contact information.)
So next time you see this small punctuation tattoo, remember the words of Upworthy writer Parker Molloy:
"I recently decided to get a semicolon tattoo. Not because it's trendy (though, it certainly seems to be at the moment), but because it's a reminder of the things I've overcome in my life. I've dealt with anxiety, depression, and gender dysphoria for the better part of my life, and at times, that led me down a path that included self-harm and suicide attempts.
No matter how we get there, the end
result is so important: help and support for more people to
also be able to say " I'm still here."
We can't tear out a single page from
"If you're feeling suicidal this would
be an ideal time to try what you always wanted to try