Suicidal Behaviours in Children & Adolescent

childProf. Dr. SuhailShiekh

Suicide is a crime, but still it is the third leading cause of death in the world. Suicidal behavior is increasingly becoming a phenomenon associated with children & adolescent  all over the world . According to a study by Lancet, as many as 1, 87,000 people committed suicide in India in 2010 (Volume 379, 23 June 2012). The World Health Organization (WHO) estimates that India records nearly 1, 70,000 suicidal deaths each year. Of the total cases of suicide, nearly 35 per cent were recorded in age group of 15-29 years. Meanwhile, the Lancet study indicates that suicidal deaths in the same age group at 46 percent of the total. A comparison of the number of suicides in states with high literacy rates with those with low literacy rates reveals that the states with high literacy (top ten states) contribute 33 per cent to suicidal deaths. However, these states make up for not more than 21 per cent of India’s population. The  rate of Suicide  is high among young generation, according to some authentic suicide surveys.

 Keywords: Suicide, India, Education System, prevention of child suicide, Internet and mobile culture,Entertainment media.

Introduction :
What makes an child or adolescent to commit suicide. It has multiple  reasons. The  recent data and survey carried out by child help lines in nine of the world’s highest ranking Human Development Index (HDI) nations, show that children and adolescent in developed nations  and developing nations are highly prone to boredom, high study and job pressure  and  hence have higher suicidal tendencies.

According to world Health Organization Assistant Director-General Catherine Le Gals-Camus points out more people die from suicide around the world than from all homicides and wars combined. There is  increase in the rates of suicide in India over the years . Teenage suicides have become an almost daily occurrence in Mumbai the capital city of Maharashtra – one of India’s most developed states. The toll of teenage suicides from the beginning of the year until 26 January 2010 stood at 32, which is more than one a day. The survey data indicates that for every teenage suicide in Mumbai there are 13 failed attempts. During the past twenty years, the number of suicides has tripled among those between the ages of 15 and 29.

In U.S. reports more than 5,000 teen suicides a year; in 1996, Los Angeles teachers and counselors identified as many as 2,000 suicidal children. One out of every twelve high school teenagers attempted suicide in 1995.30% Of teenagers have thought about suicide. For every teenager that actually commits suicide, there are another 50-200 attempts. The American Association of Suicidology estimates that every hour and 40 minutes, a young person kills himself.

Common Reasons why Young People Commit Suicide (SUICIDE TRIGGERS)

 1.Physical and mental  effect of stress on a child & adolescence :

From infancy through adolescence, the body’s biological development  is a continues process . Normal biological functioning of a child  is partly determined by environment he is living in. When a child grows up with fears  and  constant or extreme stress  then  normal development of his  immune system and body’s stress response systems becomes  weak . Later on, even under ordinary levels of stress his  systems may automatically respond as if the individual is under extreme stress. Child may  experience significant physiological reactivity such as rapid breathing or heart pounding.  When exposed to   minute stressful situations will respond  as if to a   significant threat which is  often perceived by others as “overreacting” .

Stressful  environment can impair the development of the brain and nervous system to its full potential  in  a growing child . Children with histories of complex trauma may  shown  more chronic physical & mental conditions and problems. They develop chronic or recurrent physical complaints. Adolescence  with histories of mental  trauma in childhood may show  behavioral changes and indulge in  conditions like  smoking, substance use, and diet and exercise habits that lead to obesity.

Children who have experienced complex trauma often have difficulty  in identifying, expressing, and managing emotions. They often  hide  stress reactions because they don’t even trust loved ones and as a result may experience significant depression, anxiety, or anger.Having learned that the world is a dangerous place full of stress and  where even loved ones can’t be trusted to protect them ,this makes the  child   often vigilant and guarded in their interactions with others and   may exhibit   unpredictable or explosive emotional responses like  violence  or  suicidal . This suicidal thoughts are because their posture is always  defensive posture i.e. protective as if he is under an attack ,  and his response in such condition will be  intense reactions making them vulnerable to take extreme steps  because they have never learned how to calm themselves down once they are upset .  This children are never calm but always in a stressful posture as if always alert .

2. Genetic disposition: A family history of depression and suicidal tendencies can pass down through genetics. It can be inherited by children from parents, grandparents, or great-grandparents either from the mother or father’s side.

3. Education System The question is. Is the present modern education system driving youth to stress, depression and suicide?  Suicide is a process, not an event. It evolves gradually. In young children & adolescents suicidal tendencies build up very slowly from social conditions. There is growing competition in every sphere of life even in school which increases stress among children and eventually leads to the development of fatal tendencies like depression & suicide The stress inflicting the education system in India is one of the cause of concern in suicidal tendencies in children .The modern education system was oriented to gaining skills such as reading, writing, convergent thinking, numerical aptitude. It was aimed only for increasing productivity and not for  encouraging wisdom, confidence, warm-heartedness and life-dealing skills. Western system is materialistic and they feel that material prosperity is the sole cause of happiness . Today’s educational system does not  provide value education.  India’s education system is based on memorizing  without thought of   the meaning and with a strong emphasis on scoring high marks.

Education in India has become very competitive. In today’s India, there is a persisting fear among the youth, the fear of competition. Difficult admission procedures in top educational institutions as well as tough teaching syllabus. Even a six-year-old child who is supposed to be fearlessness and cheerfulness worries about exams. Come exams and hundreds of students surrender their youthful enthusiasm to the fear of examinations. The insecurity of falling below the cut-off leads into depression and to a tragic end called suicide.

In India there is   abrupt increase in suicides among students.  Psychologists says  that a child’s strongest emotional bond is with parents. Parents rationalize this emotional bond by making children perform under immense pressure. Parents   push their children up as per their ambitions and do not look at the ability and condition of their children mental performance. Children are forced to study what their parents want them to study. Students say “My parents want me to become a doctor, for this I have to come in merit”. They also say “My school & parents tells me to excel in studies”. The  consequences of this over ambition of parents & school  leads to  stress, anxiety, frustration and despair in children at early tender age, and  they are unable to meet the expectations of their parents. Failure in examinations and condemnation by family in such situations break these children emotionally and lead to depression in early age. Majority of students does not how to deal with this stress and this is one of the reasons a child contemplates suicide because he thinks he is the only person who has ever had those feelings and problems.  Their inability to accept failure or loss in self esteem leads to dejection, self reproach and  this ultimately leads to suicide.

4. Job Pressure
According to the World Health Organization, if stress level is not controlled then  depression is the No 1 occupational disease of the 21st century.  In recent time due to economic growth and open markets there is more job opportunities, higher payments and with it  job stress & anxiety. Higher expectations by employer put more pressure on the employee &leads to tremendous anxiety & fears. Corporate employees have more job stress .A survey released recently by the US-based Regus group, a corporate consultancy, found that 57% of Indians thought that their stress levels had become higher, or much higher, since 2007. It is observed that 6 in every  10 corporate employees in India experience stress at their work place.  There is always fear lingering in a person mind  of losing one’s job  or not being  competitive enough to advance in one’s career . In corporate sector especially IT professionals usually show signs of stress related psychiatric disorder. This professionals get addicted to drugs. 1 in every 20 IT professional contemplates suicide, says the study.

5. Social Life & Depression .
Internet and mobile culture is promoting a isolated  community. More  time is spent on social networks.  Meaningful personal relationships with  friends ,  family members and relatives is  replaced by social networks such as facebook, WhatsApp and other social sites . Youth and children are living in the  isolated virtual world. They are only  involved with gadgets which  gives them company and no social contacts . Too much addiction to internet and self-centered approach often aggravates their isolated life. Teens in this age of social networking  gets isolated and live a solitary  life. This isolated life is a very important  reasons for the rise in suicide among young people. They don’t  get any  moral and emotional support from any one . They don’t have any near ones to express their problems and  does not get an proper  advise .  They easily lose confidence in life and  hopelessness is one of the most crucial factors in the development of their serious suicidal thought. They are not mature enough to analyse things themselves  . They think their problems are insoluble and suicidal  thoughts comes to them through despair.

Broken homes and unconcerned parents  is other main cause of mental trauma and depression in them . Because of the high divorce rate in modern society its seen that  one out of every six children now under 18 lives with a single parent. Either they miss fathers or mothers love & protection.  Emotionally weak child or one who already has depression or another emotional disorder suffers differently. When these stressful  situations arise, an emotionally fragile child or adolescent may go into a deep bout of depression, which intensifies the chances of thinking about or attempting suicide.

In  working mothers  67 percent work outside the home . The children of such parents feels isolated , abundant, and uncared at early age. Millions of  children come home from school to empty houses. Television has now become the babysitter.

6.Entertainment media: Dr. Jay Nagdimon, the director of the Los Angeles Suicide Prevention Center believes that another strong influence facilitating suicide is community violence: “Movies are violent, television is violent, music is violent, and sports are violent. By our obsession with violence, we make death seem easy. Even a kid can do it.” Violent television shows can be scary and confusing to young children  due to the mixed messages they send.

7.   School  or college bullying or ragging: Bullying or ragging  by senior students  in college or school which  can be physical, verbal or emotional and can make teens feel lonely, depressed, insulting  and unsafe.  This is also a common cause of suicides in children and teens in college or  residential  school.

Risk factors & diagnostic criteria:
In 75% of all suicides there will be a verbal warning or some sign. This won’t be a simple sign but  the words spoken by him or her could have helped you save your child’s life if it  would have been understood at that time. Unfortunately these verbal warning signs mostly  ignored since most parents never expect their child will attempt suicide.

The LAUSD Suicide Prevention Unit identifies the following as signs that a young person is at risk:

  • Depression.
  • Feelings of hopelessness.
  • Loss of interest in activities.
  • Change in appearance.
  • Previous suicide attempts.
  • A plan to commit suicide.
  • Sudden changes in behavior, eating or sleeping habits, or relationships with friends.
  • Statements such as “I want to kill myself” or “The world would be better off without me.”
  • Increase in risk taking.
  • Writing or drawing about death themes.
  • Using alcohol or drugs.
  • Giving away prized possessions.
  • Withdrawing from social activities.
  • Difficulty concentrating.
  • Feelings of hopelessness.
  • History of previous suicide attempts
  • Family history of suicide
  • History of depression or other mental illness
  • Alcohol or drug abuse
  • Stressful life event or loss
  • Easy access to lethal methods
  • Exposure to the suicidal behavior of others
  • Incarceration

In studies its observed that children  with suicidal tendencies are very intelligent, socially isolated, aggressive, suspicious, physically precocious, and highly vulnerable to criticism. Environmental and demographic factors also play a role in childhood suicide tendencies.

Discussion with conclusion:
Family is the unit of society. It is the strength and the stability of the nation. It’s also a center of social force. In  home there should be atmosphere of love, care, concern, sacrifice, trust and respect. Parents should provide their children with discipline, encouragement, praise, support , security and not condemnation & discouragement . This is the only solution for healthy mental condition of future generation and prevention of self-destruction. The present education system must be over-hauled. Presently, the exams, marks and percentage do not test a student’s abilities, skills, emotional intelligence and aptitude. Research has demonstrated that the most effective way to prevent suicide is through the early identification and treatment of those at risk.

Homoeopathic medicines :
Aurum Met :    Feeling of self-condemnation and utter worthlessness. Profound despondency, with increased blood pressure, with thorough disgust of life, and  thoughts of suicide.Talks of comitting suicide. “Looks on the dark side, weeps, prays, thinks she is not fit for this world, longs for death, strong inclination to commit suicide.” Brood over some sin which they have committed. Sense of unworthiness. Violent if contradicted  Dr. Nash says ,  “Strange that this noble metal, for which mankind strives for its pecuniary value, should, when taken into the organism, cause the greatest unhappiness.  Aurum is  the most common and most definite of all the depression remedies. In a case of acute depression the patient is brooding melancholy and just sits and peers in front of him and will not speak .  They look extremely depressed and have all sorts of strange ideas. They thnk they hae lost the affection of their friends and family, or that they have done something frightful and that they are therefore feeling like this because they are to blame for it.l They blame themselves for everything and get a real disgust of life. They are the paients who become suicidal.

MIND – SUICIDAL disposition – children, in  aur

Magnesium carbonicum
Forsaken feeling, FEELS AS IF NOT BELOVED by his parents, friends, etc.  Intolerant of disharmony. Sensitive to what people think about them. Reserved. Easily hurt and depressed. –   Sensitive to noise, touch, etc.  Remedy often seen in orphans, abandonned children (Kent). Also        adopted children.  Can be very irritable (Cham). Discontented.  Anxiety and fears all through the day, < warm food, > going to bed.   Biting nails.

Magnesium muriaticum:
Emotional vulnerability. Sensitive to any kind of confrontation.   Pacifists. Tries to resolve conflicts. No cowardice. Ailments from quarrels, even between others.    Suppresses emotions for the sake of others (Staph). Want others to be happy.  Introverted. Avoid being hurt. Develop bitterness. Sour temperament.  Dissatisfaction. Irritable. Depressed. Stronge sense of duty. Overload themselves. Become overwrought. Nervous restlessness. Normal sleep cycle becomes disturbed. Never quite catch up. Completely unable to relax under any circumstance.  RESTLESSNESS AND ANXIETY ON LYING DOWN AND CLOSING EYES.  Tries to run on nervous energy. Break down with hysterical fits. Anxious over little things .Every thought tends to repeat itself in the mind.  While reading felt she must keep reading faster and faster.

Nat  mur
Emotionally sensitive and vulnerable. Mentally, they have a high degree of objectivity and awareness, as well as a great sense of responsibility. Throughout life this  individuals  experience deeply all impressions of life & accumulating awareness and understanding beyond their age. At first, they enjoy company and thrive on the nourishment of emotional contact with others. Adolescents, for example are reluctant to date, for fear of rejection. Even imagined slights can cause suffering. After being hurt several times, they learn to become cautious. They will think twice before becoming involved in an emotional experience. They turn to introverted activities which are emotionally “safe”, i.e. reading books (usually romantic fiction or things having practical value in human relations), listening to music, dwelling on ideas and fantasies.  Child is very sensitive to disharmony. If the parents fight the child may not react immediately but will suffer inside, perhaps even to the point of acquiring a physical ailment. As the emotional vulnerability becomes increasingly pathological the patient becomes depressed. This is a depression which is inconsolable, and may even become suicidal.

Ignatia : Where depression follows from bereave­ment, loss, or a shock, such as witness­ing a fatal road accident, Ignatia can be useful. The symptom picture is typified by emotional ups and downs with mood swings . Often the sufferer can prove difficult for friends and loved ones to deal with as they are SO up and down, being resist­ant to sympathy and oversensitive to well meaning advice, which may be wrongly taken as criticism. It may be hard for them to talk if they are overcome with their miser­able situation and friends can find it well nigh impossible to cheer up such patients. Poor sleep is common.

Referance :
World Health Organization.Global Burden of Disease. 2004.
US National Library of MedicineNational Institutes of Health

Prof  Dr. SuhailShiekh
Professor & H.O.D. Dept of Repertory
Motiwala Homoeopathic Medical College & Hospital Nasik-city, 422222

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