The students at SCEGGS and other Sydney private schools rocked by suicides in the past few months will all be united in asking why their respective fellow student made the choice to end their own life. They will undoubtedly be plagued by many questions and will run a gamut of emotions, from sadness, confusion, anger and fear. Youth suicide is an immensely complex interplay of social, psychological, neurological, biological and cultural variables. The problem is that these variables carry unequal weights and no single one has been demonstrated to be necessary or sufficient to cause an individual to take their own life. This makes it very difficult to predict whether a young person is likely to die by suicide and therefore, as many schools in Sydney have found out, difficult for others to act in time to prevent it. Despite all that has been done by successive governments, research shows that suicide remains the leading cause of death for young people aged 15 to 24. Almost a third of young people have experienced suicidal ideation in their lifetime and in an average year 12 classroom, one young person has made a suicide attempt. In trying to fashion an answer to the question, I am reminded of a young woman I met a decade or so ago. She was just 15 and I’ll call her Lucy. A few months before I met her, she had tried to take her own life. When she was asked in a public forum, why she made this decision, she told the gathering: “I thought I would never see, hear, or know anything ever again.” So for her, this act seemed to be about problem-solving. Digging deeper, it seemed that her problems were not actually out of the ordinary, there was some conflict at home and a few problems with school and friends. The problem was that Lucy had undiagnosed depression.
A series of psychological autopsy studies over the last few decades, have identified several important risk factors and studies show that 90 per cent of young people who end their lives have a mental disorder at the time of their death, the most common being depression, psychosis and substance abuse disorders. They say everyone is a genius in hindsight and looking back at her history, Lucy did show some signs of depression. In the previous weeks she had told her mother that she was feeling unwell and sad, she no longer participated in previously pleasurable activities such as cooking and helping around the house. She had trouble falling asleep, waking during the night and waking very early in the morning. She complained of being tired and having no energy. Lucy became overly self-critical and developed a preoccupation with past failures and mistakes. Her depression distorted her moods, incited uncharacteristic behaviour, destroyed the basis of rational thought and finally eroded her desire to live. She finally reached the point where she no longer found anything interesting, enjoyable or worthwhile. Everything that was once sparkling in her life, now seemed flat. Her depressed brain did little more than torment her with a litany of what she felt were her inadequacies and shortcomings, taunting her with the desperate hopelessness of it all. Without the reinforcements afforded by antidepressant medication and cognitive behavioural therapy, mindfulness, exercise and dietary changes, thoughts of death became her constant companion. For Lucy, dying seemed the only release from the unbearable misery an overwhelming sense of inadequacy and blackness that surrounded her. So what is the legacy of these recent Sydney school tragedies? It is that all schools and parents redouble their efforts to build the emotional literacy of students and that all know the difference between sadness and depression, that depression is treatable and that help is just a phone call or a click of a mouse away.
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This article first appeared Sydney Morning Herald, 27 March 2015.