Q: There is a preponderance of white older adolescent males who attempt suicide, or complete suicide. Why do you think that is?
Well there's a very interesting difference between boys and girls. While girls actually make many more suicide attempts than boys, boys are much more likely to succeed because they turn to fatal means. For boys, the most common means of trying to kill themselves is with a gun-actually a long gun in boys. These are obviously fatal methods.
With girls, overdose attempts and wrist slashings are more common. And these are rarely fatal.
Q: Does that indicate that girls are more likely not to really want to go through with it, but it's more a cry for help?
While there are some things that we think of as a suicide gesture, I think every time that someone is contemplating suicide, and makes an actual attempt, it should be treated very seriously. And it demands a medical evaluation. Sometimes people assume that these attempts are just an effort to manipulate. And while sometimes this may be true, it really demands an evaluation, ideally by a psychiatric professional.
Q: Sometimes teenagers are very dramatic. Should every suicide threat be taken seriously? How does a parent know when to worry?
Whenever a child says, "I'm going to kill myself," I always take that as a warning sign. So when parents tell me this, or tell a primary care provider this, I always urge those professionals to get that child an official expert evaluation.
It's not normal to say, "I'm going to kill myself." There may be a manipulation involved and it may not necessarily be a suicide risk, but there's something going on for that child that probably deserves an evaluation.
Q: What are some of the signs that parents should be seriously concerned about?
Parents should be aware of the signs of depression: a change in mood, a loss of interest in normal activities, thoughts or discussion of death, or withdrawal from friends. We know that substance use is a risk factor.
So if parents have concerns, they probably should act on them, because by the time you recognize that you have concerns, you've probably had them for quite awhile. And when you realize you're worried, it's time to act. Early intervention can mean the difference between life and death.