Tales from Adolescent Medicine
By Jessica Shannon Castonguay, DO, MPH
There is much stress associated with back-to-school time for parents and teens alike. Parents may worry about the cost of back to school, the difficulty of getting a dozing teen out of bed at 6 A.M. after a summer of sleeping until noon, or the forthcoming arguments about homework. Adolescents on the other hand have very different concerns with back-to-school. Will my new clothes be cool? Will I have class with my friends? Will I make the team? Will I pass geometry?
For teens, the stressors associated with school can become overwhelming. Patients with recently treated depression, anxiety, or other mood disorders can experience return of symptoms such as fatigue, irritability or difficulty concentrating. Patients with previously well-controlled OCD, anorexia nervosa or bulimia nervosa may fall into old behavior patterns that restore a false sense of security.
Now, add the high stakes world of getting a date to homecoming. Have you heard of the “promposal”? It’s a very well planned invitation to attend homecoming or prom. It’s easy to find examples online; a recent one was of a young man dancing to Beyonce’s “Single Ladies” in an effort to get the object of his affections to agree to attend a dance with him. Many of us had much less elaborate marriage proposals! Imagine planning such an event and being turned down. And what if you never got one?
For adolescents with underlying psychiatric diagnoses, these pressures can take them to the edge. Eventually there is a straw that breaks the proverbial camel’s back. In 2013, for those aged 15-24, the suicide rate in the United States was 10.9 per 100,000 individuals. While no data is kept on suicide attempts, it is estimated that for each completed suicide, there are 25 suicide attempts. Males are 3-4 times more likely to complete a suicide while females are 3 times more likely to attempt a suicide. For me, the start of the school year, homecoming, and prom coincide with an increase in admissions for overdose and suicide attempts.
If you are concerned that an adolescent in your life may be suicidal, encourage that adolescent to call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255). Trained counselors are available. Your local emergency room may be able to offer assessment and safety planning if a crisis team is not available to you.
What happens when you call the Suicide Prevention Lifeline?