Suicide Rates Skyrocket in Girls

Youth suicide rates may be on the rise again, with the most alarming increases seen in girls and young women, reports the CDC.

The numbers fell steadily since 1990, but statistics from 2004 -- the most recent available data -- described the single largest increase in that time.

It's too soon to know if the new numbers are part of a trend, but they're very troubling, particularly when broken down by age. Between 2003 and 2004, suicide rates in girls aged 10 to 14 rose by 75.9%; by 32.3% in young women aged 15 to 19; and by 9% in young men aged 15 to 19.

The CDC didn't speculate on the reasons for the increase, but both the Wall Street Journal and Bloomberg News cited a possible decrease in child antidepressant use. Reported the latter,

One possible reason for the increase may be that doctors are reluctant to prescribe antidepressant drugs to children because of warnings about side effects, said Mark Riddle, director of the division of child and adolescent psychiatry at Johns Hopkins Children's Center in Baltimore.

"It's probably reluctance on the part of clinicians to identify and treat kids with depression,'' he said in a telephone interview. "We know that any treatment for depression in teenagers is quite effective in reducing suicidal thoughts and suicide attempts. When you take away one of the treatments, you are just leaving more kids vulnerable for trouble.''

The idea that doctors are "reluctant to prescribe antidepressant drugs to children" is absurd. The ballooning off-label antidepressant use for conditions likeinsomnia betrays that statement. Maybe doctors are slightly less enthusiastic than before, but reluctant? No.

On top of that is the fact that a December 2006 study found that taking antidepressants doubled the risk of suicidal behavior in young adults.

The WSJ at least cited a study from pharmacy benefits manager Medco Health Solutions showing a 10 percent drop in child antidepressant prescriptions during 2004. The connection is plausible, but it's irresponsible to bring it up superficially:
the figures are meaningless without studies showing that suicides occurred in children who would previously have received the drugs.
Numbers would also be needed to track antidepressant prescriptions by gender: did 75 percent fewer girls receive antidepressant drugs in 2004, compared to just 9 percent fewer teens?

Moreover, if the suicide numbers have increased because of decreased prescriptions, why are kids, particularly girls, becoming suicidal in the first place? Might it have something to do with the mental and social conditions of modern adolescence? And if the only thing stopping them from suicide are drugs, isn't that deeply fucked up?

Moments like this call for Marilynne Robinson's essay "Facing Reality", last cited in my take on schizophrenia research:

Antebellum doctors described an illness typical of enslaved people sold away from their families, which anyone can recognize as rage and grief.
By medicalizing their condition, the culture was able to refuse the meaning of their suffering. I am afraid we also are forgetting that emotions signify, that they are much fuller of meaning than language, that they interpret the world to us and us to other people. Perhaps the reality we have made fills certain of us, and of our children, with rage and grief -- the tedium and meagerness of it, the meanness of it, the stain of fearfulness it leaves everywhere. It may be necessary to offer ourselves palliatives, but it is drastically wrong to offer or to accept a palliative as if it were a cure.

Suicide Trends Among Youths and Young Adults Aged 10--24 Years --- United States, 1990--2004 [CDC]

Suicide Rate Among Kids And Young Adults Rises 8% [Wall Street Journal]

Youth Suicides Rise the Most in 15 Years, CDC Says [Bloomberg News]

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