Dr. Mary Jo Podgurski is the founder and director of the Washington Health System Teen Outreach. She responds to 6–8 questions from young people daily and has written 'Ask Mary Jo' since 2005.

Note: I sought a suicide prevention related question to raise awareness during Suicide Prevention Week – Sept. 8-14. I’ve updated this column from 2006; the issue remains pertinent.

Q. As a teen, school years can be complicated and demanding. You are not sure who you are, what you want to be, or whether the choices you make from day to day are the best decisions. Sometimes, the many changes and pressures feel overwhelming. You can feel down and the pain seems unbearable, and it won’t go away. There are times when you feel maybe you would better off not around anymore. So how do you know if someone you care about is contemplating suicide and what sort of things can contribute to feeling this way? What can I do about it and who should I tell?

– Concerned adult

Mary Jo’s response: Thank you for your email. I believe all adults should take the time to be aware of the signs of depression in adolescents.

The American Academy of Child and Adolescent Psychiatry – AACAP – ( states suicide is the second leading cause of death for children, adolescents, and young adults age 15- to- 24-year-olds (June 2018). Adolescence can be a time of stress, confusion, self-doubt, pressure to succeed, questions about sexual orientation and financial uncertainty. Parental divorce or even moving to a new community can intensify self-doubts. For some teens, suicide may appear to be a solution to their problems. Many of the symptoms of suicidal feelings are similar to depression; teen depression should not be ignored. The majority of children and adolescents who attempt suicide have a significant mental health disorder, usually depression.

The AACAP lists the following teen warning signs for caring adults and parents:

  • Change in eating and sleeping habits;
  • Withdrawal from friends, family, and regular activities;
  • Violent actions, rebellious behavior, or running away;
  • Drug and alcohol use;
  • Unusual neglect of personal appearance;
  • Marked personality change
  • Persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork;
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.;
  • Loss of interest in pleasurable activities;
  • Not tolerating praise or rewards.
  • A teen who is considering suicide may also:
  • Complain of being a bad person or feeling rotten inside;
  • Give verbal hints with statements such as: I won’t be a problem for you much longer, Nothing matters, It’s no use, and I won’t see you again;
  • Put his or her affairs in order, for example, give away favorite possessions, clean his or her room, throw away important belongings, etc.;
  • Become suddenly cheerful after a period of depression;
  • Have signs of psychosis (hallucinations or bizarre thoughts).

Please get help from a professional if you are concerned about a teen’s mental health. The National Suicide Prevention Lifeline is 1-800-273-8255. The Trevor Project is dedicated to saving LGBTQ teen lives; their 24 hour Lifeline at 1-866-488-7386.

The American Psychiatric Association created a valuable resource about suicide in conjunction with the Netflix series “13 Reasons Why,” in which a teen takes her life and leaves messages blaming those who she feels drove her to suicide. The resource helps adult and teens look at the controversial way suicide is handled in the series: If a young person watches this series, an adult should be available to process the messages it gives and provide perspective.

Locally, the Washington County Crisis Line is 1-877-225-3567; it is available 24 hours a day, 7 days a week, 365 days a year.

Thanks for caring about young people.

Peer Educator response: We think you being concerned about young people is a good thing, as long as you don’t assume you know what their behavior means. It’s complicated and tricky. Don’t diagnose us – get professional support and help. Respect teens and try not to stereotype us into one bunch. We’re all different, just like adults. Finally, really listen to teens. Depression is a lot more common than most adults think. Be alert and be aware.

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