Suicide is now the third leading cause of death among young people in America today, and girls are far more likely to "seriously consider" suicide than boys, according to a new study that is as surprising as it is depressing.
Only accidents, mainly motor vehicle, and homicide outrank suicide as the leading causes of death among adolescents and young adults who are 15 to 24 years old.
What in the world has gone wrong here? What could cause so many young people to lose hope so completely that they decide to end their own lives? What does that say about our society in general?
And why are girls more likely than boys to seriously consider, and even attempt, suicide?
Force of Friendship
Part of the answer emerges in a major study published in the January issue of the American Journal of Public Health. The simple answer is girls need close, personal friends more than boys, and when those friendships fail girls are far more likely to think of ending it all.
The study, by sociologists James Moody of Ohio State University and Peter Bearman of the Institute for Social and Economic Research and Policy at Columbia University, draws from a wealth of data collected during 1994 and 1995. That data is part of the National Longitudinal Study of Adolescent Health, sponsored by the National Institutes of Health, which resulted from interviews with thousands of adolescents across the country in an effort to measure the health and welfare of our young people.
Bearman and Moody combed through the data to see what they could learn about teenage suicides. They had expected to find some difference between boys and girls, but they were not prepared for the scale of that difference.
They found that girls were twice as likely as boys to attempt suicide if they had few friends and were isolated from their peers.
"That's an astonishing figure," says Moody. Isolation among girls ranks right up there with having a friend who commits suicide in terms of causing a youngster to think about ending it all. But it had no effect on boys.
The statistics also show that it's important for a girl's friends to be friends with each other.
The study focuses on data collected during interviews with 13,405 adolescents in 80 different communities across America. The participants were interviewed first at school, and six months later at home, and the answers were submitted on a laptop computer and known only to each adolescent. So this doesn't just boil down to macho boys refusing to admit they might think about suicide just as often as girls. There's a real difference here.
Among adolescent males, 10.2 percent thought about suicide during the year preceding the study, and 2.3 percent actually attempted it. Among females, 15.9 percent thought about suicide, and 5.4 percent attempted it. That latter figure is particularly troubling. A third of the girls who thought about suicide actually tried it.
Obviously, those who succeeded were not included in the study because they weren't available to answer the questions. But nationally, one out of 200 suicide attempts results in death, and more than a third result in injuries serious enough to require professional treatment.
The difference in the statistics for males and females lies primarily in their relationships with their friends, the researchers conclude.
"Boys' relationships tend to be more diffused," Moody says. "They hang out as a group, and the relationships are much more fluid."
"Girls spend a lot of time on their phones, in close, tight-knit social relationships," he says. You don't have to be a sociologist to see girls involved in intimate conversations, exchanging secrets that boys would never reveal. Take away those friends, and girls have fewer places to turn.
Isolation: A Chicken or Egg Issue
The study also suggests that when those relationships fail, girls tend to internalize it all. Boys, Moody says, tend to externalize it, making them more likely to carry a weapon to school to seek revenge. That, too, often results in suicide, but Moody says that's probably not the main motive. Boys just want to get even, he says, and girls are more likely to blame themselves.
Of course, it's easy to generalize these things and draw broad, sweeping conclusions on the basis of scant evidence. Peer relationships are very complex, and there's probably a little bit of the chicken and the egg question here.
Are girls who consider suicide pushed that way because they are isolated, or are they isolated because they are a bit suicidal and not exactly the kind of person anyone wants to hang out with?
"That's a great question," Moody says. "And we don't have a perfect answer."
There is probably a "reciprocal relationship" between moods and relationships, he says. If an adolescent girl is contemplating suicide, that may turn off some friends, causing the thoughts of suicide to "snowball," he adds. It's not always fun to pal around with a downer.
"When you start down this path it's very easy to end up in a position that is very strongly isolated and hard to get out of," he says.
So just thoughts of suicide may lead to further isolation, which increases the danger, at least for girls.
All of that, of course, is subject to debate, but the researchers say one fact screams out from their study. When a teenage girl admits to having considered suicide, and her friends seem to be drifting away, someone better be listening.
Lee Dye’s column appears weekly on ABCNEWS.com. A former science writer for the Los Angeles Times, he now lives in Juneau, Alaska.