Suicide and Panic Among Teens

Piloswky, D.J., Wu, L., & Anthony, J.C., (1991). Panic attacks and suicide attempts, in mid-adolescence, American Journal of Psychiatry, 156, 1545-1549

Most survivors are aware that one of the most important contributing elements to suicide is that of emotional disorders.  Suicide almost always happens to people with significant emotional problems, such as depression, alcoholism, drug dependence, and schizophrenia, as opposed to people who are simply under stress.  This is not to say that stress isn’t important – it is – but stress is more difficult to handle when one also has an ongoing emotional disorder.

One of the ongoing controversies in the field of suicidology is whether panic disorder puts a person at risk for suicide.  Some research studies seem to say “yes” whereas other do not.  All of the studies on panic disorder so far have been of adults.

Panic disorder is an emotional disorder in which people have recurrent panic attacks (or anxiety attacks).  These panic attacks come “out of the blue,” for no apparent reason, and during one a person typically feels fearful, panicky, or extremely apprehensive.  A panic attack usually lasts for a half-hour or so.  They are very scary, especially when a person doesn’t know what the panic attack is.  Often people think they’re going crazy, or they’re having a heart attack.  Along with the fear, an attack usually has a variety of physical symptoms.  These include sweating, a rapid heartbeat, a dizzy or unsteady feeling, hot or cold flashes, tingling in the extremities, an upset stomach or nausea, chest pain, and sometimes a feeling that one is about to do something out of control.  All of the physical sensations are that of the “fight-flight” reaction, but the problem is, there’s nothing around to be afraid of.  About 1-2% of the population have panic disorder (frequent recurrent attacks) sometimes in their lifetime, but many more people have occasional panic attacks.  One study found that 12% of a group of 14-year-old’s had had at least one panic attack in their lives.

This study focuses on whether panic attacks in adolescents increases their risk for suicide, and the tentative answer appears to be “yes.”  At least in this study, teens, with panic attacks had a higher rate of previous suicide attempts (not completions) and of thinking about suicide than those without panic attacks.  The researchers had to be careful to separate out those who did and did not have major depression, since it is well known that major depression increases suicide risk, and panic attacks often occur in people while they’re depressed.

This study was a health survey of 1580  13-and 14-year-olds in an eastern urban location.  In this group almost 23% reported having had at least one panic attack, 4.9% reported having had thoughts of suicide at some point (but no attempts), and 5.8% reported a suicide attempt.

Teens with panic attacks were over 3 times more likely to have serious thoughts of suicide than those without and twice as likely to have attempted suicide than those without.

It should be noted, however, that major depression was an even larger risk factor, and the teens with the highest rates of suicidal ideation and attempts were those who had both major depression and panic attacks.

This study adds to the evidence that, at least for teens, panic attacks increase the risk of suicide.  In many cases it appears that the elevated risk is due to the unknown nature of the attacks – teens can’t understand what’s happening to them, they think they’re gong crazy or out of control, or that they may die, and they’re terrified.  This is another case in which knowledge can be life-saving – just knowing that panic attacks are scary but harmless is an extremely valuable piece of information.

by Jay Callahan, Ph.D., reprinted from Obelisk, March 2000

Share on Facebook