TEEN Suicide Mounting in INDIA

Teen suicides Mounting in India

Deep inside the U-shaped complex of Delhi’s premier All India Institute of Medical Sciences (AIIMS), the clock clacks against the heavy silence in psychiatrist Manju Mehta’s chamber.

A mother sits huddled in front of her. “I want to say sorry for not listening to you,” she stutters as she talks and searches for words, her eyes welling with tears. Neither she nor her husband had accepted Mehta’s diagnosis that behind her son’s falling grades and temper tantrums, lay learning disability and severe depression. “Conduct disorder is his way of gaining self-respect,” Mehta had told them.

The parents, more interested in improving his school performance, had not heeded the advice, “Don’t put pressure on him.” Just before the annual exams, he had suddenly turned over a new leaf: he was nice to everyone, listened to everything his parents said, met up with people he was fond of.

Finally, one afternoon, he took his own life. “I quit,” read the chit lying on his bed.

Being a teenager has never been easy. But in the new millennium, amidst unprecedented prosperity, growing up seems to have become more trying than ever for Indian teens.

While self-inflicted deaths among adolescents in the West are leveling off, India is topping the world in teen suicides. If drugs, alcohol and firearms are the favorite routes to self-destruction in the West, it’s exam stress and inability to cope with disappointments here.

Every 90 minutes a teenager tries to commit suicide in India. Many of these attempts are half-hearted cries for attention, help and love. But every six hours, one succeeds.

More adolescents die of suicide than AIDS, cancer, heart disease, obesity, birth defects and lung disease. In 2006-07 5,857 students took their own life, which works out to a stunning 16 suicides a day, says the National Crime Records Bureau (NCRB).

While the global teen suicide rate is 14.5 per 100,000, a 2004 study by the Christian Medical College (CMC), Vellore, reported 148 for girls and 58 for boys in India.

If globally, suicide is the fourth leading cause of teen deaths, in India it is at number one in some pockets and is the third largest killer all across. Over 150 students ended their lives across the country last month.

The grim epithet to their tormented lives is the suicide note. Sometimes they express an inability to cope with pressure, as in the case of a Delhi student who hanged himself from a ceiling fan by his mother’s sari. “Goodbye,” he wrote.

“I can’t take the pressure any longer. I love my family and I hope they will understand.” Ever so often there is helplessness: “I am not doing well in exams,” wrote a girl from Chandigarh to her parents before she took her life, “I can’t even manage my own affairs. I’ve frittered away my college fees on trivia. No one’s responsible for my death.”

At times, there’s self-reproach. “I couldn’t make it because of the exam backlog that I need to clear,” jotted down a student of IIT-Powai while his friends made merry at a campus fest, adding, “But I want to thank my professors and I am sorry for doing this.”

Often there is anger: “I’ll come back as a ghost to haunt my teachers,” read the last note of a student from Bangalore who shot himself in the head.

But what makes teenagers decide that adulthood is not worth waiting for? Until recently, such questions would not have had easy answers.

Lookout for warning signs 90% teens show extreme reluctance to go to school—a classic symptom. Over 70% show depressed, irritable mood, ill-temper, feelings of worthlessness, sadness, or self-hatred; inappropriate guilt and acting-out behavior (missing curfews and unusual defiance). Around 40-50% report headaches, loss of appetite and interest in daily activities and distinct weight change. Over 30% have persistent difficulty falling or staying asleep, excessive daytime sleepiness, fatigue, difficulty concentrating and preoccupation with self. About 48% think about suicide, have obsessive fears or worry about death and plan to commit suicide or actually attempt one.

Source: Child & Adolescent Psychiatry Clinic, AIIMS

“The idea of children becoming clinically depressed is still relatively new,” says Mehta. “Until the 1980s, doctors tended to hold the Freudian view that children are incapable of experiencing depression in the true sense because they don’t yet have a developed superego".

What tips a troubled teen over the edge 43% examination fear 40% sibling rivalry 36% issues at school 33% warring parents 20% fear of punishment 17% death of a loved one 17% distressed parents Source: Child & Adolescent Psychiatry Clinic, AIIMS

“Faster-paced lives with parents absorbed in their own lives and careers, often provoke feelings of alienation, rejection and emotions that can lead teenagers to suicide,” says Dr Rajesh Sagar of AIIMS

Talking to teens Build up rapport in six stages Start with generic experiences—the last holiday, what they like or don’t like. Discuss specific experiences— arguments, exam tension, etc. Thrash out the context in which the above occur—home, school and neighborhood. Talk about the institutions within these contexts, say, friendship and marriage. Experiences and feelings within these institutions—love, attraction and romance Hammer out issues like sexuality, depression or even suicidal ideas. Family matters 90% of depressed teens who respond to treatment have no perception of family discord— parental fights, with other family members or with themselves. Those who respond well report two hours of extra attention from parents, compared to those who do not. 52% of those who get better have parents encouraging sport, recreation and other cultural activities. 46% of depressed teens have pushy and achievement-oriented parents. 50% of depressed children have parents who control every aspect of their lives. Source: Child & Adolescent Psychiatry Clinic, AIIMS