This is the third instalment from the soon-to-be-released second edition of Dr Donovan Thomas' book, Confronting Suicide: Helping Teens at Risk. Last week, we presented three of the 10 signs of suicidal tendencies among Jamaican teenagers. See numbers four to 10 below:

4. Mental Illness

Mental illness does not always mean madness. Psychological disorder can take many forms, some barely detectable. Therefore, youth need to be carefully supervised because mental illness or 'breakdown' is a high-risk possibility and cause for considering suicide.

Persons who, with some regularity, experience depression are especially vulnerable to suicidal 'contemplation'; more technically expressed as 'ideation'. Dr Maureen Irons-Morgan in 1998 after having conducted psychological autopsy research in two of Jamaica's most populous parishes found that 90 per cent of those who committed suicide in Kingston, St Andrew and St Catherine had clear psychiatric disorders, including depression, alcoholism, conduct disorders and personality disorders.

5. Preparatorysteps for death

Persons who are planning suicide tend to "get their affairs in order". Such ordering is seen in organising of insurance papers, paying off bills, writing letters and preparing legal documents. Therefore, such an ordering would seem to clearly suggest suicidal tendency or propensity.

In addition, there are behavioural indicators that point in the same direction, such as the giving away of special toys, jackets or other treasured items to trusted friends or relatives.

6. Negative emotions

Unusual eruptions and repetition or consistency of negative emotions such as hostility, masochism, hopelessness, helplessness and worthlessness, sometimes strongly indicate propensity toward suicide.

7. Stress

Stress, which is sudden, severe and prolonged, can overwhelm a person's defence mechanisms. Such situations make persons viable candidates for a suicidal attempt.

In continuing to be alert for potential signs, one should keep in mind that suicide attempts are more common in families where there is a significant history of medical problems and psychiatric illnesses. Research has established that familial instability and a chaotic family atmosphere contribute appreciably to stress and correlate with suicide attempts.

8. Loneliness

Humans are social beings. We are created for interpersonal relationships. Where interaction with other human beings is lacking, loneliness with depression is a likely outcome. Loneliness and alienation tend to destroy ego strength and can easily lead to an individual's loss of self-control. Therefore, teenagers observed to be lonely, especially those who might be continually articulating that fact, are vulnerable to suicide.

9. Economic strain

Research has shown that economic strain among families tends to increase the vulnerability of the children as it regards attempting suicide. When there is parental unemployment and preoccupation with economic survival, children tend to be neglected.

Significantly, single-parent families seem to have a higher suicidal rate as against two-parent families.

10. Success 'pressures' and 'emptiness'

An excessive and demanding 'need' to attain success can be associated with suicidal acts. Persons who are very successful usually work very hard and have more responsibilities. However, success and attendant responsibilities can increase to inordinate levels and the need to stay ahead may exacerbate a person's stress level causing him/her to feel overwhelmed.

Much sought-after 'success' and achievement can sometimes lead to disappointment and a feeling of 'emptiness'. The attainment of success marks the end of a long and hard effort, at which point a void may be experienced. The severity of this unusual emptiness may leave yet another person at risk of committing suicide as life then seems pointless when 'all is said and done'.

NEXT WEEK: We conclude the series with the account of one woman who tells why she tried to take her life.

Dr Donovan Thomas is the founder and president of Choose Life International, a non-profit suicide-intervention organisation. He is the immediate past national director of Jamaica Youth for Christ, a post he held for 15 years. He holds a doctorate in ministry and has done extensive research on the subject Confronting Suicidal Propensity Among Jamaican Teenagers. He can be reached at 869-3403/ 920-7924 or email donovanthomas@chooselifeintl.org.