HEALTH

If you are experiencing suicidal thoughts or are practicing self harm, please reach out to the National Suicide Prevention Lifeline by visiting their website or by calling 1-800-273-8255.

When Netflix aired 13 Reasons Why this past spring, a new TV series based on the best-selling young adult novel by Jay Asher, it became the most tweeted-about show of the year. The story centers on Hannah Baker, a teen who record a series of cassette tapes detailing the reasons why she killed herself—then shares them with her classmates. After her death, the characters listen to the tapes and, one by one, relive the moments that led to Hannah ending her life.

While some viewers appreciated how the show explored the challenges of being in high school and key issues facing teens, many experts thought the graphic portrayal of Hannah's death would inspire copycats.

In fact, families of two teenagers who committed suicide shortly after watching the show are accusing Netflix and 13 Reasons Why of playing a role in their daughters' deaths.

Addnig fuel to the fire? A study conducted by researchers at San Diego State University found that internet searches about suicide went up by 19 percent in the 19 days following the series' release—roughly 1 million more searches than usual.

In response to pressure to halt production, Netflix has pledged to strengthen and add to existing trigger warnings for the show's viewers when season two starts early next year.

But no matter how viewers and experts feel, 13 Reasons Why has shone a spotlight on the rising number of teens and tweens engaging in self-harm and suicidal thoughts.

And those numbers are absolutely alarming: According to the National Center for Health Statistics (part of the Centers for Disease Control and Prevention), the percentage of kids hospitalized for suicidal thoughts or serious self-harm in the United States doubled from 2008 to 2015—and the largest increase was among teenage girls. Even more staggering? Suicide rates among girls ages 10 to 14 tripled between 1999 and 2014. 

Big feelings
So why is suicide becoming more prevalent about teen and tween girls? Blame puberty, for starters. Researchers say there may be a link between girls hitting puberty earlier and the climbing suicide rates among this age group. After all, all of the crazy hormonal changes occurring throughout your body definitely increase stress and anxiety, which can lead to depression—and sometimes, suicidal thoughts or actions. 

Another huge risk factor are the various pressures teens are exposed to at school. A recent study from Vanderbilt University showed that more kids are hospitalized for suicidal behavior in the fall—and fewer are admitted in July during summer vacation.

While more conclusive research is needed, Stacy B., now 19, knows firsthand how the pressures of high school can lead to self-harm. She first contemplated suicide when she was 13. "I never really fit in with the 'friends' that I had," she says. "I was buillied within my own group, and it really damaged my self-esteem."

An older boy at school befriended Stacy, and when she went on a date with him, he sexually assaulted her. "After that, rumors spread. I began to hate myself and my life," she says. "I was afraid to go to school. I didn't want to get out of bed. I pushed my family away. I wanted to die, to disappear, to end the pain."

Her first act of self-harm was cutting. Soon, she moved on to burning her skin and starving herself. She also attempted suicide twice. "When I get an urge to hurt myself, it affects my whole body," she says. "I shake out of control, my heart starts to race, my head feels heavy and, worst of all, it feels as though my skin is ripping."

For Stacy, cutting was a way to make overwhelming emotions go away. "My thoughts and feelings were so heavy and intense and I didn't know how to express them," she says.

According to Esme Shaller, a clinical psychologist at the Young Adult and Family Center, University of California, San Francisco, most people engage in self-harm to regulate their feelings. "They have a big emotion they want to stop or turn down," she says, adding that Stacy's triggers—feeling rejected by friends and isolated—also are common. As if self-harm wasn't dangerous enough, Dr. Shaller notes kids who self-harm are nine times more likely to attempt suicide than kids who don't.  

Reluctant to reach out
Even girls with lots of friends are vulnerable, though, if they think sharing pain could be seen as weakness. "There's such a social pressure, on girls specifically, to be perfect," says Courtney Cruz, education director of the UCLA chapter of Active Minds, an organization that advocates for mental health. "They believe they'll be stigmatized as whining or seeking attention if they ask for help, so they struggle with self-harm because the support isn't there."

Kellie T., now 21, first contemplated suicide in fourth grade. "I'd recently moved to a new state, my family life was tumultuous. I felt alone and out of options," she says.

Her first instance of self-harm was in a room she shared with her older sister—after a family fight, she dug her nails into her wrist until it bled. As a shy kid who was new to the school, Kellie says she didn't have any friends to talk to. "I didn't confide in anyone," she says.

Stacy, too, hid her self-harm and negative feelings, partly because she felt she didn't deserve to be having them. "I was an A+ student with a loving family," she says. "I felt so guilty because I knew other people had it worse—and that guilt prevented me from reaching out sooner. I thought people wouldn't believe me."

Life online
That feeling of being alone with the pain is a huge factor for kids who consider suicide—and social media can intensify it. "It's easy to compare your life to other girls'," says Cruz. "People forget that what everyone posts on social media is the good side—they're not showing the tough times." 

Stacy says life online was "extremely hard" for her. "I experienced a great deal of cyberbullying and it was traumatic," she says. "When people can post anonymously, they feel like they can say anything." This aspect of Stacy's life also created a wedge between her and her parents, who had trouble understanding why she didn't just stop reading negative things.

But anyone who's been on social media can relate to how addictive it is. "It can be hard to disconnect and pull yourself away from negativity," says Stacy. "As painful as it is, you feel you just have to know what's being said." 

Steve Simpson, child advocate and author of The Teenage and Young Adult Survival Handbook, says that what you see online can feel bigger than it really is. "If something gets 28 likes, it can look like the whole world is at a party, or if you see three negative comments, it might seem like everyone is against you," he says. "The internet amplifies everything." 

Revealing the secret
Like Kellie's parents, Stacy's mom and dad didn't know about her self-harm and thoughts of suicide at first. "I got good grades, I played soccer, never got in trouble," she says. "I think for a long time I was overlooked because of that."

When her parents did begin to notice Stacy's mood swings—and that she always wore long sleeves—Stacy thinks they weren't sure what to do. "They tried to talk to me, but I couldn't communicate what was going on," says Stacy. Her mom and dad set her up with a few therapists, but it wasn't until they reached out to the school social worker that Stacy found someone she could connect with.

"She said she was interested in knowing more about me, that if I was feeling down I could come to her and that she was glad to meet with me," Stacy says. "She made me feel as though I had control over things. Eventually, I confided in her and gave her my razor." The social worker put Stacy in touch with the hospital where she began her recovery process.

Stacy says that a major part of her healing has been being able to share her feelings with her parents.

"What helped was reaching an agreement that, in the moment, I don't have to talk or say anything, and they don't have to say anything either," she explains. "We just sit together or hug. Being in their prescence so I couldn't hurt myself was helpful, and waiting out the pain together was effective."

Dr. Shaller says that Stacy's family's practice of just being together is right on. In fact, emotional distance between kids and parents is cited as a possible explanation for the increase in children's hospital admissions involving attempted suicides and serious self-harm. And even if it's too awkward or difficult to directly discuss those sad thoughts, simply being around your family and feeling their love can help sort things out.

Finding hope
Though it wasn't easy, Stacy knows talking about her feelings was key. Dr. Shaller stresses that parents usually don't react as badly as teens fear they will, but also acknowledge it's sometimes easier to tell another trusted adult. "Find a teacher, counselor or therapist who can help you tell your parents what's going on," she says.

Kellie recalls the moment she decided to finally confide in her older sister about her desperate thoughts and self-harm—and the relief that came with saying what she felt out loud. "It just felt so much better to know people care about you—and where you are isn't where you'll always be," she says. "There's something better ahead."

Whether it's a friend, sibling or an adult you trust, that person also may be able to explain things to your parents in a way that you aren't able to. Stacy says the social worker there was crucial. "She really helped our communication," says Stacy.

Stacy still struggles with a desire to self-harm. "I have to fight off urges to hurt myself, and at times the suicidal thoughts flood my mind," she says. "But I'm more aware of my feelings and have more tools to help myself. Each time I overcome an urge, ask for help, get a good grade, make a friend, anything, I am grateful."

Stacy has a message for girls in the dark space of self-harming or contemplating suicide. "Remember that what you are feeling will *not* last forever. Just get through one moment at a time," she says. "Look for your passion and build on it. There is so much you have yet to experience. You are important and loved and worthy of happiness. Ask for help! Don't make a permanent decision based on temporary feelings."

In the suicide support group he runs, Simpson always tells his members that every single suicidal person he knows who has been able to keep living is so glad they never went through with it. Why? "Because it got better. It always does—100 percent," he says. "Take a deep breath, make a wish, take an action. It gets better so much faster than you ever thought it would."

This article was originally published in the October/November 2017 issue of Girls' Life magazine. 

by Melissa Walker | 1/2/2018