Depression & Suicide

Suicide is the third leading cause of death in the U.S. among those ages 10-24. Roughly 157,000 people per year within this age group receive treatment for self-inflicted injuries in the emergency room*. Many people we talked with had suicidal thoughts, and a few had attempted suicide.

If you currently feel suicidal or know someone who is feeling suicidal, please call 911 or the National Suicide Prevention Lifeline, 1 (800) 273-8255.

Suicide as a sign of the seriousness of depression

For many people in our study suicidal thoughts were a sign that they needed to get help. Crystal says she experimented with actively attempting suicide, and “after a couple incidents that’s when it was noticed and I had to get help”. Marty says he let his depression control him, and this led to his depression becoming more serious. He warns others that, “depression might be overlooked by some doctors, but it’s a serious illness… it’s easy to overlook what can happen”.

Destructive thoughts and thoughts of death

People often had destructive thoughts or thoughts of death when their depression was severe. Teddy says he, “slipped into this really deep dark depression, where I wanted to die”. A few started having suicidal feelings in middle school, while most expressed first having thoughts in high school or college. Leanna says she “would take my mom’s sleeping pills in hopes that I wouldn’t wake up at a really young age”. Crystal says her thoughts of suicide increased when she started college. She “realized at that point that I have suicidal thoughts every day and they haven’t gone away. Beginning of college I started having them constantly, I remember that a little bit in high school but in college I really realized that every moment that I’m not actively engaging my mind in something else I go back to my original thought process and it quickly spirals into feelings of erasing myself”. Maya describes her thoughts as “being intellectually suicidal” but did not have any concrete plans to follow through with them.

 

Brendan describes having suicidal thoughts at a young age.

Brendan describes having suicidal thoughts at a young age.

Age at interview: 21
Gender: Male
Age at diagnosis: 15
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I know it was a thing from early on but the first really clear memory I have that stood out to me as being not normal was when I was about eight or nine years old. And I essentially noticed that I developed a suicidal fixation, and this particular image of being at my martial arts studio and bleeding out and collapsing and being hospitalized. And what I, and what I always found interesting about that in retrospect is not only the, the, the suicidal way, idealization, but also the very publicness of it. You know, I think there was something about attention. And, you know, because I was hospitalized, I was taken care of. So that was when I first really noticed that my mentality seemed to be kind of different and kind of darker than a lot of nine-year-olds. And when I was 11, during my brief stint in that private school. I actually considered suicide as an option for the first time. Luckily my, my brother became aware of it and intervened and he helped me get past what was going on there, which I think was mainly the drama in my life and the fact that I hated being at the new school but took the form of being about a girl.

For some people, the severity of these thoughts caused them to reach a breaking point. Colin says, “every day that I woke up I was so surprised that I woke up and I hadn’t killed myself”.

Reasons for feeling suicidal

The people we interviewed gave many reasons for feeling suicidal. They felt suicidal because life did not feel worth living or because they felt hopeless in particular situations, such as coping with family or a relationship. Elizabeth attributed her suicidal thoughts to her “lack of… coping skills… It felt like any little hurdle that I came to, I just couldn’t face it”.

Teddy started feeling suicidal when his relationship with his girlfriend ended. He says, “she found another guy and I found out just by putting all the pieces together she was trying to make me into the guy that she was really going after. And after that like, I was going in and out of mental hospitals trying to you know, just end it because there was nothing else I could do”. For more about relationships, see ‘Depression & relationships’.

Jackson, a man who identifies as transgender, said his feelings of being different made him feel more isolated. He watched a friend who had come out become “a target for ridicule and physical abuse”. This led Jackson to become “invisible and suicidal for many years”. For more about feeling different see ‘Depression and feeling different when young’. Others, like Myra and Brendan, also talked about being a target of bullying and abuse and related these experiences to their suicidal thoughts (see ‘Depression & abuse’).

Some people felt a more general hopelessness about the world or a lack of reason to live. Sierra Rose says her thoughts were telling her, “look at the world we live in, the crap world and blah blah blah all of those negative voices talking in the back of your head, convincing you that life isn’t worth living.” She also expresses that she didn’t have a choice in terms of being born and and couldn’t understand “why can’t I make the decision to just leave”. Similarly, Colin says he “would just wake up and just couldn’t find any reason or purpose in the day whatsoever” and “felt so guilty for it because… I had good parents, good family”. For Colin, his suicidal thoughts were connected with his struggle with OCD. For more about OCD, see ‘Depression and obsessive compulsive disorder (OCD)’.

 

Colin describes his experience in the hospital after attempting suicide.

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Colin describes his experience in the hospital after attempting suicide.

Age at interview: 20
Gender: Male
Age at diagnosis: 18
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And, once I realized my plan A wasn’t working, my mind just started going to those really dark places that it always used to where, oh, if plan A isn’t working then what’s the point, I guess. Just, couldn’t think of any reason to keep going on if that one goal I had was so far out of reach all of a sudden. And then, yeah, I just felt very empty and lost, and so un-expressively sad that I just gave up on school. I just stopped going and I, it was like the first time in my life that I was 100% certain that I’d go through with the thoughts I had with suicide. And then, I had it all really well planned out. And then, one night, it was a Tuesday night, I finally went through with it. And, unsuccessfully of course, I took about 120 Xanax with vodka, which, I don’t know, is beyond lethal. And I don’t know, I don’t know, it’s really just, like the doctors told me, in the hospital, that it was sheer luck that I survived because somebody found me on a park bench at like three in the morning. I don’t know why they were out there and I don’t know who found me. But, they got me to the hospital in time. And, I woke up two days later in the ICU at [name], and I was kind of going in and out of consciousness, I didn’t really know what was happening.

And, once I woke up for good, I was just, I said all the wrong things, I guess. They sent a psychiatrist in to me to do a psych eval, and like I said, I didn’t say what I, like I said what I meant at the time which was I was mad, I was really mad that I woke up. He was asking me what brought you to this point, like, why are you here? Why are we having this conversation right now? And, I obviously knew what he meant. He meant like what has transgressed in your life, like, in the past, what has gone on that led you to this point of depression?

But, I decided to be really snarky about it because I was mad. I was like, oh, why am I in this bed right now in front of you? And then, my answer was because I didn’t drink enough. And, that was like the one thing I said, I think, that got me sent to the inpatient. And, he told me that, that’s not what they want to hear, that a lot of people usually feel glad or relieved, or regretful and like repentive of it. And, I didn’t.

Others described feeling like they were worthless, or not good enough. Crystal says she felt that her depression was, “something that I’m just born with and… I really shouldn’t be here”.

 

Crystal discusses the pressure she feels and how it relates to her suicidal thoughts.

Crystal discusses the pressure she feels and how it relates to her suicidal thoughts.

Age at interview: 20
Gender: Female
Age at diagnosis: 15
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Part of me is just continuing to feel like you know there is an end, and for, for me like nothingness is a really great end for me because I am so tired of you know the daily struggles that I go through and all of the voices and things that go on in my head, all of the anxiety that I feel, and all of the pressure that I feel, it’s hard to move, how to get up and when you even have a taste of that it, it makes me just wish that I could just erase myself completely and just forget about everything.

Medication and suicidal thoughts

A few people talked about how being on medication or not being on medication influenced their thoughts of suicide. Sierra Rose described how a medication, “made me feel so much more suicidal. I couldn’t even cross the street without thinking about jumping in front of the next car I see… which was you know really bad because I lived along a highway and had to cross the highway to get to work. So, you know, you’ve got semi’s rushing by you at 40 miles per hour it’s really hard to avoid the thoughts in your head saying, “Jump, just do it, just step out in front of them.” Colin experienced a similar increase in suicidal thoughts when on a medication and said he “became twice as suicidal as I was before.”

Although increase in suicidal thoughts is an uncommon side effect of antidepressants, it is serious and needs immediate help. The FDA has placed a “black box” warning label on antidepressants to alert people up through age 24 about this rare but serious possibility.

If you or someone you know is considering harming themselves, please call 911 or The National Suicide Prevention Lifeline, 1-800-273-8255.

Others, like Ben, said he would have suicidal thoughts when he wasn’t taking medication.

(For more information about taking medication for depression, see ‘Depression, medication, & treatment choices’.)

Asking for help

Several people we talked to described realizing they needed to ask for help from family or friends when feeling suicidal or as part of a suicide attempt. Some felt their suicide attempts were a sign they needed help from others. Marty said, “I understand how they were just cries for help, because if I wanted to die I would be dead right now”. Sierra Rose described feeling desperate and how she “had to call my mom to talk me down”, even though she felt their relationship was strained at time and they had not talked for over a year. Whitney said she was committed by her father after her second suicide attempt and was not given a choice about hospitalization.

A few people discussed reaching out via suicide helplines. Crystal said she, “called suicide hotlines daily” when she needed “short term solutions to help get me out of a panic attack or some sort of crash”.

 

Devin describes telling his parents about needing help before he attempted suicide.

Devin describes telling his parents about needing help before he attempted suicide.

Age at interview: 21
Gender: Male
Age at diagnosis: 16
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I was probably 16 at the time now and I was probably there for less than a week and I just started to absolutely break down because it was everything all over again. And I was in the room next to my mother while she was sewing or something and I was just breaking down crying. I, I ended up having to message one of my friends on Facebook or something like that to tell her to contact my mom because I could not speak at that moment, I was just so overwhelmed I guess. And it had gotten to the point with the self-harming that I just wanted to kill myself at that point and I was going to do it that night, unless somebody helped me out. And I told my mother that I needed to go to the crisis center and she seemed upset about it, which I was kind of confused. And when we got to the crisis center, had somebody speak to me, they called my dad along and both my parents weren’t in the same room for what had been for I don’t know, it had been a long time since I had seen them in the same room, it was weird. But it was like, they were sitting on the opposite side of the table, my father was just pouring tears because I told him straight up that I just wanted to kill myself. I didn’t want to be alive anymore and that’s why I needed to go to a crisis center. While my father was crying my mother was just sitting there stone faced, no expression at all.

What prevents suicide

People we talked with reported a range of things that contributed to their decision to live. Most were concerns related to a greater sense of purpose, but a few worried about the “shock” their death would be to people they cared about. For many, a greater sense of purpose included wanting to be there for family or friends. Crystal felt she had a “duty” to finish school and take care of her family. Teddy and Sierra Rose felt a similar sense of responsibility, but for their pets. (See ‘Depression and pets’.)

Sierra Rose talks about her difficult living situation and being scared to live with her mother’s boyfriend, but realizing that she did not want to die and wanted to be there for her brother.

 

Sierra Rose who was experiencing abuse from her mother's boyfriend describes telling her brother about her suicide attempt.

Sierra Rose who was experiencing abuse from her mother's boyfriend describes telling her brother about her suicide attempt.

Age at interview: 18
Gender: Female
Age at diagnosis: 11
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He was scary to live with. He had me frightened for my life at points and that made me just want to end my life even more. I didn’t want to live there anymore. I hadn’t wanted to live there for years and he just kind of added to that. And so November 2013, I attempted to kill myself. I went into the bathroom, I wrote a note out, and I tried to slit open my wrist. Part way through I realized that I don’t actually think I want to die. I had a boyfriend at the time, not my current boyfriend a different one, and he was my entire life, I didn’t want to not be with him, so I made the decision to, you know, go upstairs, tell my mother. She took me to the hospital, her and her boyfriend. The entire time we were there in the waiting room I was sitting there with the towel to my wrist and they were sitting there talking and laughing with each other and her boyfriend actually had the balls to accuse me of trying to kill myself for attention. I was the one who had to explain to my brother, who was at the time 13 years old, that no I wanted to die. I wanted to kill myself and it hurt so much to see the pain in his eyes. My brother and I, we’ve always fought a lot, what siblings don’t, especially when you’re 4 years apart but I, I love him to death and I would do anything for him and I know that the feeling is mutual, there’s a sibling bond there that can’t ever be broken. And seeing his heart break because his big sister wasn’t wanting to live anymore, it should have been an eye opener, it was for a little while.

 

Crystal describes how she uses self talk to prevent suicide.

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Crystal describes how she uses self talk to prevent suicide.

Age at interview: 20
Gender: Female
Age at diagnosis: 15
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Sometimes life just feels really meaningless to me and sometimes just the daily work that I do to just distract myself from what’s going on in my head, some of that is just like, “Well it’s still meaningless, I don’t want to be alive even, and so then you think about ok, how do I make what’s more permanent imitation and what makes more of a lasting impression on people those sort of things are more abstract and float above more of the daily sort of material things that happen in your life. And so being dedicated to continuing to be a role model and continuing to help my family in whatever ways that I can is what has occupied myself. So whenever I have a question like, whenever you know I get distracted, I, I sink back into my negative thought process and I asked myself, “Ok what are you doing here?” Instead of, either I’ll say you know, “I’m here because I need to finish this homework assignment,” And sometimes that helps or I say, “Oh I’m here because I need to finish this homework assignment, that way I can get a degree so that way I can help make money so that way I can help bring my family to a better situation.”

Some people we talked with had a friend or a pet reach out to them at the right time, or found someone that was particularly special to them. Teddy had a friend call him and say, “If there’s anything you need just know that I’m here for you and I’ll do the impossible”. This led him to share his thoughts about suicide and “was pretty much the push for me to get help”. Colin said he met someone during a study hall in high school that brought light to his life. He says, ”And just every day when I had nothing to look forward to I would just look forward to going and seeing her, every day… it really turned my whole life around. It didn’t make it good, but it made it bearable.”

For others, seeing a family member or a friend attempt or commit suicide prevented their own attempts. One participant says after her friend attempted suicide “that was really the turning point for me, when I realized I could end up like that too”.

A few people said finding distractions or something to occupy their mind helped prevent thoughts of suicide. Crystal used goal setting, which helped her occupy herself “until that next discrete point”.

Despite difficult circumstances, a few participants still felt hope for the future. Jackson said that although he “didn’t feel like I had anything to look forward to” after his mother was sent to prison and his father died unexpectedly, he felt that “anything could happen”. Although his circumstances changed negatively, he thought there could also be a positive spin and that “things can get better”. He says, “I… had the adulthood to look forward to, where I was like, oh, maybe I can finally be free of these horrible people and make my own choices. So, maybe it will be better”. Brendan realized that “periods of hopelessness are temporary” and still feels positive for the future, despite having bad days.

 

After having cycles of depression, Brendan feels hopeful about the future.

After having cycles of depression, Brendan feels hopeful about the future.

Age at interview: 21
Gender: Male
Age at diagnosis: 15
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I feel optimistic about the future, but there are still even today, there are certain days where like, I know that things are good but I’m just tired, I’m just sad, I just feel a little awkward. It’s something that you live with. It’s something that you make adjustments to, you know, it’s, I try to think of it as like, you know, having like a sore shoulder or something. You want to be careful with heavy, lifting heavy objects. You don’t want to hurt yourself but it’s an annoyance, it’s not something that’s taking you out of the game. And that’s what I try to remind myself is that no matter, no matter how bad I feel, it’s almost never actually that bad and if I just keep on doing what I’m doing then I normally turn out OK.

References

*“ Suicide Prevention”. Injury Prevention and Control: Division of Violence Prevention (Centers for Disease Control), 10 March 2015, Web. 7 February 2016.