Teen Guides to Health & Wellness Anxiety, Depression, and Mood Disorders Diets, Cleanses, and Fitness Drugs and Alcohol School and Your Health Sexuality and Gender Identity Sleep and Hygiene Smoking and Vaping Social Media and the Internet Suicide and Self-Harm Tattoos, Piercings, and Body Modifications

Teen Guides to Health & Wellness

H.W. Poole

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Copyright © 2023 by Mason Crest, an imprint of National Highlights, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, taping, or any information storage and retrieval system, without permission in writing from the publisher. Printed in the United States of America First printing 9 8 7 6 5 4 3 2 1 Series ISBN: 978-1-4222-4419-7 Hardcover ISBN: 978-1-4222-4429-6 ebook ISBN: 978-1-4222-7392-0 Cataloging-in-Publication Data on file with the Library of Congress

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CONTENTS Introduction. ...................................................................6 Chapter 1: Understanding Suicide...................................9 Chapter 2: Evolving Views. ............................................25 Chapter 3: Addressing Suicide Risk................................ 39 Chapter 4: Self-Harm..................................................... 57 Chapter 5: What Do I Do Now?. ...................................... 71 Organizations and Hotlines............................................88 Further Reading and Online Resources...........................90 Series Glossary of Key Terms.......................................... 92 Index. ............................................................................94 About the Author / Credits. ............................................96 K E Y I C O N S T O L O O K F O R : Words to Understand: These words with their easy-to-understand definitions will increase the reader’s understanding of the text while building vocabulary skills. Sidebars: This boxed material within the main text allows readers to build knowledge, gain insights, explore possibilities, and broaden their perspectives by weaving together additional information to provide realistic and holistic perspectives. Educational Videos: Readers can view videos by scanning our QR codes, providing them with additional educational content to supplement the text. Examples include news coverage, moments in history, speeches, iconic sports moments, and much more! Text-Dependent Questions: These questions send the reader back to the text for more careful attention to the evidence presented there. Research Projects: Readers are pointed toward areas of further inquiry connected to each chapter. Suggestions are provided for projects that encourage deeper research and analysis. Series Glossary of Key Terms: This back-of-the-book glossary contains terminology used throughout this series. Words found here increase the reader’s ability to read and comprehend higher-level books and articles in this field.

After many years of gradually declining suicide rates, suicides among Americans have been increasing in recent years. In what has been justifiably called a public health crisis, we now lose more than 100 Americans to suicide every single day—nearly 50,000 Americans per year. In 2017, suicide was the second-leading cause of death among Americans between the ages of 10 and 34. The only greater cause of death was unintentional injury, such as car accidents and accidental poisonings. A report published in the Journal of the American Medical Association (JAMA) found that in 2017, suicide rates among young people increased by 47 percent as compared to the year 2000. There are probably a variety of reasons for this, but the JAMA study highlighted the opioid crisis as a contributing factor. Because a large number of completed suicide attempts involve guns, other researchers have also pointed to rising rates of gun ownership as another significant factor. There is a lot of media coverage of gun violence in the United States, but people are sometimes surprised to learn that suicides outnumber homicides by two to one. When researchers at the Harvard School of Public Health compared data on gun


ownership, they found that states with larger numbers of gun owners also had higher suicide rates. This book will introduce teen readers to the potential risk factors for suicide and the red flags to look out for. We will look at attitudes toward suicide throughout Western history, and we’ll introduce the concept of the “suicidal crisis” and what to do about it. The book will also cover self harm—not in itself a suicidal behavior, but a clear indicator of a mental health issue that needs addressing. And finally, this text offers gentle, actionable ideas about how to talk to someone in crisis.

National Suicide Prevention Lifeline (800) 273-TALK (8255) En Español: (888) 628-9454 Deaf and hard of hearing: (800) 799-4889 Chat: https://suicidepreventionlifeline.org/chat Online support: https://afsp.org/find-support/


Sometimes a slow accumulation of small problems can become overwhelming.


ambivalent: being “of two minds”; undecided or uncertain contagion: the spread of disease from one person to another cumulative: the overall effect created when many things are added together impulsive: something spur-of-the-moment, without much thought or planning profound: describes something deep-seated and overwhelming time-limited: describes something that lasts a set amount of time, with a beginning and end vector: an organism that transmits a disease (for example, a tick is a vector for Lyme disease)


Understanding Suicide

When a suicide occurs, people who care about the person are often left wondering why. What situation could be so bad that a person would choose to end their life? Loved ones often torture themselves with agonizing questions that will never be answered: Did I say something wrong? Should I have done something differently? Was it this, was it that? And, of course , Why did this happen? But as much as we long for simple answers, usually there is no clear-cut or straightforward explanation. Instead, a number of very complex factors are at play. You’ve probably heard the expression “the last straw.” It comes from an old proverb, “it was the last straw that broke the camel’s back,” or, in an even older version, “it was the last feather that broke the horse’s back.” Whether it’s a straw or a feather, the proverb refers to the idea that a slow accumulation of small problems can become overwhelming all of a sudden. The proverb may help us understand what is going on with people who attempt suicide. Their actions


People with depression or other mental disorders are at an increased risk for suicide.

are often both long in coming and yet also impulsive at the same time. People who have survived suicide attempts frequently talk about long periods of despair, loneliness, and self-hatred; the suicide attempt is their way of trying to bring an end to their pain. Many people who attempt suicide are living with mental health challenges that resist easy explanations or “fixes.” People with depression, addiction, post-traumatic stress disorder, bipolar disorder, and eating disorders are all at increased risk for suicide. Complicating matters is that these mental health challenges are not always diagnosed in time. That’s one reason why loved ones are sometimes left deeply confused; they were not aware that the person had a mental health challenge, because it was well hidden or had gone completely undiagnosed.

Teen Guides to Health & Wellness: Suicide and Self-Harm


The Suicidal Crisis TV shows and films tend to portray suicide attempts as planned-out, logical actions. A suicidal character takes deliberate steps, such as saying goodbye to friends and giving away their possessions, all leading up to the act itself. But while that may make good drama, it’s often not how real life works. Yes, some acts of suicide are planned out in advance, but most are not. In fact, nearly half of the people who attempt suicide have thought about it for less than ten minutes, and fully 60 percent have considered it for twenty four hours or less.

A suicidal person often struggles with feelings of despair over a long period of time.

Understanding Suicide


Nearly half of the people who attempt suicide have thought about it for less than ten minutes.

A more realistic portrayal of a suicidal person would involve the character who struggles with feelings of despair over a long period of time, and is then pushed into what mental health experts call a “suicidal crisis.” This crisis can be brought on by something big (a death in the family, a romantic breakup, a failure at work or school), or by an event that might seem very minor to outsiders but is still significant to the person involved. Some mental health experts use the image of a risk curve to explain the emotions of a person going through a suicidal crisis. The curve rises as the risk increases, and then falls as the person moves out of the crisis moment—that

Teen Guides to Health & Wellness: Suicide and Self-Harm


could happen because they change their minds, or because some other person intervenes to help them. There are three key things to understand about a suicidal crisis: a. It is time-limited . In other words, a suicidal crisis is temporary. Depression, anxiety disorders, and other mental health issues may be chronic, but a suicidal crisis is it is a temporary state. b. It occurs in the context of broader feelings of despair. A suicide attempt is never about “just” one event, person, or comment. c. People who attempt to take their own lives are generally ambivalent about the decision; part of them wants to, but another part deep down does not.

“Please stay. If you’re hurting, afraid, or need someone to talk to, please reach out. . . . Someone will reach back. You are so deeply valued, so incomprehensibly loved—even when you can’t feel it—and you are worth your life.” —Live Through This (www.livethroughthis.org)

Understanding Suicide


If you take these points together, you’ll see that if the person can survive the most intense moments of their suicidal crisis, their chances of long-term survival increase a great deal. In fact, of all the people who attempt suicide but don’t succeed, 90 percent do not go on to make another attempt. Remember: people who attempt to take their own lives are usually ambivalent . They don’t want to die, exactly—what they want is for their overwhelming pain to end, and they have started to believe that suicide is the only method available.

A suicidal person just wants their overwhelming pain to end.

Teen Guides to Health & Wellness: Suicide and Self-Harm


A suicidal person's crisis may end when another person intervenes to help them.

Some Words on Words When people talk about the act of taking one’s own life, it’s common to hear it described as “committing” suicide. But there’s big a problem with that expression. The verb commit is only used with an action that’s understood to be bad. We’d never say that someone committed a favor or a good deed— we’d only say that someone committed a crime or a sin. We don’t commit a birthday party, but we do commit murder. So to use the word committed in relation to a suicide attempt is to convey that the person has done something immoral. As you’ll read in the next chapter, suicide has been considered a criminal or sinful act during many periods of

Understanding Suicide


human history. That’s likely why our language developed this way. However, society’s views are changing. It’s not that suicide is suddenly “okay”—it’s definitely not! But we understand that suicidal behavior exists in the context of profound emotional and mental crises. People who are in crisis are neither criminals nor sinners—they are friends, family members, colleagues, and neighbors. They need and deserve our empathy, not our judgment. This is why it’s important to strike the word commit from our vocabulary when we discuss this very painful topic. As society’s understanding of suicide evolves, so too should the words we use to describe it.

The motivations of people who attempt suicide are complicated.

Teen Guides to Health & Wellness: Suicide and Self-Harm


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