Suicide.

It’s a scary word, difficult to talk about and on the rise. However, with National Mental Health Awareness month upon us, the conversation is critical and potentially life-saving.

The Centers of Disease Control and Prevention (CDC) studies reveal a rising trend from 2000 to 2015, with a noticeable spike in 2008 and 2015. Rural communities are dealing with the highest suicide rates, especially for Native Americans and Caucasian people. Men are four times as likely to die by suicide, although females attempt suicide twice as often as males. The age range for the most deaths is 35-64.

According to the American Foundation for Suicide Prevention, 44,193 Americans die by suicide each year. It is the 10th leading cause of death with an average of 121 suicides per day.

West Virginia ranks 14 in the nation for suicide deaths annually. More than times as many people die from suicide annually than by homicide. It’s the second leading cause of death in West Virginia for people ages 15-34, and third leading cause of death for people ages 10-14.

According to the latest CDC data, of the 55 West Virginia counties – McDowell, Mercer and Tyler counties ranked 1, 2 and 3 respectively for highest suicide rates, while Berkeley County ranked 33, and Jefferson County ranked 53.

VETERANS

Although exact statistics vary, veterans have a higher suicide rate by anywhere from 16 to 30 percent higher than the national average. This is especially true in western states like Utah, Nevada, Montana and New Mexico.

In 2014, approximately 65 percent of all Veterans who died by suicide were age 50 or older. According to the data, veteran suicide was 49 percent of the total suicide deaths in the West Virginia for that year, which is higher than the national average, but not higher than the aforementioned western states.

The Department of Veterans Affairs released a report last month stating veterans who received higher dose prescription opioids were twice as likely to die by suicide than those receiving lower doses. Further investigation is being done as to why veteran suicides are higher, along with the role that opioids play, but veterans often face unique and complex factors.

Among veterans who have experienced combat trauma, the correlation with suicide risk increases in those who were wounded multiple times and/or hospitalized for wounds. Post-traumatic stress disorder (PTSD) and its related conditions like headaches and lower back pain, play a large role as well. Additionally, PTSD and others symptoms of psychosis, such as hallucinations and dissociation often appear together, causing further emotional distress and confusion.

In April, the Dept. of Veterans Affairs and the Pentagon launched a program called REACH VET after years of research.

The program allows the VA to analyze data from health records and identify veterans that are at a statistically higher risk for suicide, hospitalization, illness and other issues. Once an individual is identified, their doctor or mental health professional will reach out to them in an attempt at preemptive care. The VA believes that early intervention can and will lead to a better outcome.

Six months into the program, officials from the VA say they have had a generally positive response.

TEENS

The suicide rate among teen girls reached a 40-year high in 2015, according to new analysis from the Centers of Disease Control and Prevention.

Researchers found a substantial increase in suicides among teen girls and boys in the U.S. from 1975 to 2015, with the rate among girls hitting a record high. From 2007 to 2015 alone, suicide rates doubled among teen girls and by more than 30 percent among teen boys.

Mark Gregston is the founder of Heartlight, a residential counseling facility for adolescents in crisis. He also has a radio show called “Parenting Today’s Teens” and has authored several books.

Although parental influence is still critical in a teen’s life, Gregston says today’s teens are very concerned about what others think of them and they have the vehicle of social media.

“These peer relationships have become pretty fragile. That’s why they check their phone every five seconds. They are fearful that they’re going to lose a relationship if they don’t keep up with people. What’s happening is that a little bit of wording can push a child over the edge quickly,” Gregston said in a radio broadcast.

Researchers at UCLA’s Brain Mapping Center found that when teenagers get a lot of “likes” on social media, the brain response is similar to that of seeing loved ones or winning money.

Information correlating anxiety, depression and low self-esteem to social media is readily available, and Cyberpsychology is on the rise.

Results of a study completed earlier this year by the Royal Society for Public Health in the UK determined that Instagram is the most detrimental social app for teens, followed by Snapchat.

Instagram draws young women to “compare themselves against unrealistic, largely curated, filtered and Photoshopped versions of reality,” said Matt Keracher, author of the report.

Adolescents have a real anxiety-causing fear of missing out. In fact, FOMO (fear of missing out) was added to the Oxford dictionary in 2013 due to its prevalence in today’s society. The survey from the Royal Society for Public Health concluded that Instagram negatively affected body image, sleep patterns and added to a sense of FOMO.

Gregston said that most of the teens he works with in a counseling setting feel lost and hopeless. They are living in a society that is highly focused on looks and performance and they are looking for unconditional love from their peers. When they don’t receive it, they become very frustrated.

“It’s interesting to me that kids will ignore the strong relationship they have with family, and they’ve shifted their focus to their peers where they can’t get what they’re longing for – to be loved not only when they’re doing well, but when they’re not doing so well,” Gregston said.

Even though bullying has always been part of our society, parents need to understand that it has reached dangerous levels and has far-reaching implications today due to the heightened role of social media, which allows boundaries to be broken. As such, the boundary of restraint has been broken and it takes mere minutes for negative information or rumors to get around, which has tragically contributed to an increase in suicide deaths.

In general, neuroscience shows that adolescents, as compared to adults, are more susceptible to influence, less future oriented, take more risks and less able to manage their impulses and behavior. Kids who make attempts at suicide are in pain. It should not be viewed as a means to create drama or draw attention. Many teens might not necessarily want to die, but they want the pain to stop and don’t see another way out.

It’s important to know the signs of a teen at risk. Sudden change in behavior can be a tell-tale indicator. Even if it seems like change for the better. For example, if a teen was previously withdrawn and quiet and suddenly wants to go to parties and increase social activities, that could indicate a problem.

Observe a teen’s behavior. Is there indication of depression, drug or alcohol use, giving away possessions, loss of interest in things they used to enjoy, uncontrolled rage, sleeping too much or insomnia, excessive or dangerous risk taking, lack of interest in personal hygiene? If so, discussion is needed. Listen for wording such as:

If a parent is concerned about their child’s behavior, they should initiate calm discussion and be willing to listen and never shrug off suicidal signs as “melodrama.” It is recommended that parents make sure to not overreact, even though their teen may disclose shocking and painful information. Parents should share their own feelings and look for ways to relate to their teen. Encourage the teen not to isolate themselves and recommend exercise, even partaking in exercise together. Professional help for the teen and parent is critical, but making sure the adolescent knows not to expect immediate results is important. Lastly, parents are urged to ensure that the teen does not have access to firearms in the home, and all prescription medication should be locked up.

SUICIDE CONTAGION

Despite the fact that suicide is not a communicable disease, there is evidence that suicide is “contagious.” People ages 15 to 19 are two to four times more prone to suicide contagion than people in other age groups, although other age groups are still susceptible.

In certain counties and cities in the United States, the teen suicide rate has increased at an alarming rate. In Palo Alto, California, there were 10 deaths in seven years, which is 10 times the national average.

El Paso county in Colorado saw 29 student suicides between 2013 and 2015, 49 times the national average.

The way suicides spread is so similar to the spread of diseases, that the Centers for Disease Control and Prevention has gone into areas to investigate the suicide clusters. Researchers say that clusters are prone to happen in areas where people socialize like schools, psychiatric hospitals and military units.

It used to be believed that people who were well-connected, form bonds with others and not isolated were at lower risk of death by suicide, but studies are showing that one person’s death can spur another.

Celebrity suicides also have that effect. One study reports that after Marilyn Monroe’s death in 1962 was reported as a likely suicide, national suicide numbers went up by 12 percent from the previous year. Extensive media coverage of a death, coupled with tactless reporting can exacerbate the problem of contagion. However, when Kurt Cobain, Nirvana frontman died in 1994, local coverage was closely tied to suicide prevention information and mental health treatment. In the months following Cobain’s death, the number of calls to suicide hotlines in the Seattle area increased, but the number of deaths by suicide actually went down.

Contagion is also in part why the popular Netflix show, “13 Reasons Why” (based on a book of the same title) is deemed dangerous. The show is about a girl who kills herself and leaves 13 audio recordings addressed to individuals who played a role in her decision to end her own life. Her motivation for suicide is revenge and experts fear that vulnerable teens who watch the show could see it a viable option. Opinions vary, but a general consensus among experts is that people under the age of 16 should not watch the show, while parents may want to view to better understand the youth culture of today.

The National Suicide Prevention Lifeline is available 24 hours a day, 7 days a week at 1-800-273-TALK (8255). Online chat is available at their website, suicidepreventionlifeline.org.