SCOTCH PLAINS/FANWOOD/WESTFIELD, NJ – In the past few months, the local community has grieved the loss of young men and women from drug overdoses and suicide.
Suicide is complex. There are almost always multiple causes, including substance abuse and psychiatric illnesses that may not have been recognized or treated. In fact, mental disorders and/or substance abuse have been found in 90% of people who have died by suicide, according to Reportingonsuicide.org
Some statistics from the American Foundation for Suicide Prevention (AFSP):
- Suicide is the 10th leading cause of death in the U.S.
- In 2017, 47,173 Americans died by suicide, and there were an estimated 1,400,000 suicide attempts.
- Adolescents and young adults aged 15 to 24 had a suicide rate of 14.46 in 2017.
TAPinto reached out to several local experts to answer questions about teen and young adult suicide:
- Lidia D. Abrams, PhD, Executive Director, Resolve Community Counseling Center
- Maria Sikoutris Di Iorio, Director of Hellenic Therapy Center
- Janet Sarkos, Executive Director of Caring Contact
- Mandi Zucker, Program Director at Imagine
Why would someone with their life ahead of them commit suicide?
“That’s a very complex question because it is a very individual decision to end life, and it does not have one single cause,” said Maria Sikoutris Di Iorio of Hellenic Therapy Center. ”Certain factors like substance abuse and untreated depression and mental illness can lead to higher risk of suicide.”
How important is it for friends and classmates to hold a vigil and discuss their feelings about the suicide?
“Teens, just like adults, need to mourn after any kind of a loss, whether the loss is due to an accident, or physical or mental illness,” said Mandi Zucker, Program Director at Imagine, an organization that provides free, year-round grief support for children, families, and communities. “Vigils are not an uncommon way for friends to be together, support one another and share memories, which are all tasks of grieving that are important after a death.”
“With teenagers, parents should be encouraged to attend the vigil as well as mental health professionals in the community to provide support and monitor for other youth who may be at risk,” Zucker continued. “Permanent memorials should be discouraged, as they can be triggering for some people who see that memorial on a regular basis. If memorials are displayed in a school (flowers, stuffed animals, pictures, etc.) they should be taken down after a limited amount of time and given to the family.”
“From the individual perspective, people need to express themselves when they're grieving,” said Janet Sarkos, Executive Director of Caring Contact, an award-winning, volunteer-staffed caring and crisis hotline and listening community. For some a vigil might feel right, for others learning about suicide may help. For others, working one on one with a grief counselor or therapist might be right. Overall, people need to express their feelings and have them heard, validated and not judged.
Zucker believes that schools should have a policy about how the death of a student is handled, no matter how the student died. All student deaths should be handled in the same way.
How significant is it that parents acknowledge how the young person died, rather than listing “a brief illness" as the cause?
“Talking about suicide does not increase the likelihood of another death; in fact, it decreases loneliness and isolation,” said Mandi Zucker. “Naming how someone died allows others to know that they are not alone. The fact that parents acknowledge the cause of death is a powerful message that brings suicide out of the shadows of shame and communicates that it is OK to talk about suicide or drug use.”
How does family move on from a suicide?
“Moving on after a loss of any kind is incredibly difficult, but after a suicide or drug overdose, there are often feelings that can make grief complicated,” said Mandi Zucker. “Finding support is key. Often, a peer support group provides grievers with the experience of not being alone and being able to share feelings in a way that you may not do with friends and family that know you. One of the things we say at Imagine is that it is not so much about ‘moving on’ as it is about learning to integrate the loss into your life. Your life will never be the same… but it can be good again.”
“A family might never move on. The pain of losing a child especially to suicide is very deep and one that forever changes a family’s life,” said Maria Sikoutris Di Iorio. “Death by suicide leaves family and friends not only grieving the unexpected death, but confused and lost by the haunting loss. Grief takes a lot of time. There is no timetable. Birthdays and holidays become very difficult, and the grief continues on each anniversary date.”
"The family will never be the same," said Dr. Lidia Abrams. "One cannot move on from the death of a child. However, families can find a way of meaningfully incorporating their child’s death into their thoughts, feelings and choices moving forward."
What are the warning signs of a teenager who might be contemplating suicide?
According to Maria Sikoutris Di Iorio, there can be many warning signs:
- Threatening to hurt or kill oneself or talking about it,
- Looking for ways to kill oneself by seeking access to firearms or pills,
- Talking or writing about death,
- Expressing feelings of rage, anxiety or depression (especially untreated depression)
- Withdrawing from family and friends,
- Mood changes,
- Loss of interest in school activities or in daily activities,
- Feeling excessive guilt or shame,
- Feeling hopeless, helpless, and/or trapped,
- Increased use of alcohol or drugs.
“There are many signs to watch for, and everyone is different, so it is difficult to give a clear answer to this question,” said Janet Sarkos of Caring Contact. There are however signs to look for. We use the acronym FACTS.
F – Feelings - watch for an expression of difficult feelings that are uncommon for that individual.
A – Actions - are they withdrawing from friends or activities? Giving things away? Sleeping too much or too little?
C – Changes - ANYTHING you notice that may be different from someone's norm. This is so important. If it makes you pause, pay attention!
T – Threats - Are they saying or drawing alarming things? Do they use offhand comments like "I may as well just go die!" or "No one cares if I'm here anyway"?
S – Situations - Has the person just suffered a loss? Been exposed to a suicide? Are there family issues like divorce or illness?
How do friends move on from this? What is the typical grieving period?
“Adolescents are in the process of learning how to cope with intense feelings, although the feelings that come with the suicide or overdose death of a friend are not typical for people at any age, so they may not have the tools to cope well,” said Mandi Zucker. “Adolescents and young adults typically rely on friends more than family for emotional support, but being that friends don’t always have the right coping tools yet either, it’s important for healthy adults to check in and assess how they are coping, and offer coping strategies when needed.”
“Having a professional counselor meet with friends in small groups is often preferred, as it takes pressure off of an individual and also allows them to be with their primary support systems,” Mandi Zucker adds. “Identifying friends who may also be at risk is important so you can make a referral to a support group or therapist if needed. Because there is no typical grieving period (everyone grieves in their own time frame), it is challenging to determine when additional support is needed.”
"The death of a peer highlights how all the choices we make have consequences, and can motivate the grieving teens to do better for themselves, for loved ones. Unfortunately it can also intensify these friends’ own feelings of depression and hopelessness, and give an example of a way out," said Lidia D. Abrams PhD, Executive Director, Resolve Community Counseling Center. "Parents of grieving teens should pay a great deal attention to them, show them love and make sure that they can see the light at the end of the tunnel of their grief."
“Talking about the deceased and honoring them can be very healing,” said Maria Sikoutris Di Iorio. “There is no timetable to grief. It can take months or years.”
How should parents talk to their children about the death of a friend who has died by suicide?
“Questions should be answered honestly and directly depending on age appropriateness,” said Maria Sikoutris Di Iorio. “With younger children answer only with questions they ask. Sitting with our teenagers and talking with them is crucial and provides a safe place to discuss their feelings about themselves, the suicide, and their grief. Listen to your child without judging; it can open up the space for more conversation.”
What should people do if they feel guilty that they "could have done more"?
“There will always be a sense of ‘survivor’s guilt’ with suicide,” said Maria Sikoutris Di Iorio. “When we lose a loved one to illness or old age, we can talk about fond memories. What makes grieving different for survivors of suicide is that they are constantly asking questions such as: Why didn’t I see their pain? Why were they so unhappy? How did I miss this?”
"In retrospect, every parent can find situations where they could have done things better. Many children of these imperfect parents go on to do wonderful things in the world. Parents cannot control their children’s outcomes, there are too many other variables at work," said Dr. Lidia Abrams. "Healthy parents of children who committed suicide must strive to have self-acceptance, acceptance of the fact that they did the best they could, not knowing what really would have made the difference."
“Telling someone not to feel guilty can make them feel even guiltier for feeling that way! It is natural for someone to want to tell a mourner that they have nothing to feel guilty about, but that doesn’t take away the very real feeling of guilt that they have,” said Mandi Zucker. “Verbalizing this feeling to another human being who can tolerate this pain is often exactly what they need. People who feel guilty should keep talking about it. They are not alone.”
There are many support groups and resources, such as Caring Contact, the Society for Prevention of Teenage Suicide, and American Foundation for Suicide Prevention, Suicide Awareness Voices of Education (SAVE), the National Institute of Mental Health (NIMH), and The National Suicide Prevention Lifeline (800) 273-TALK (8255). Counseling one-on-one can also be very helpful at places like Hellenic Therapy Center, Imagine and Resolve Community Counseling Center.