Deep inside the U-shaped complex of Delhi’s All India Institute of Medical Sciences (AIIMS), the clock clacks against the heavy silence in psychiatrist Manju Mehta’s chamber. A mother sits huddled in front of her. “I want to say sorry for not listening to you,” she stutters as she talks, her eyes welling with tears. Neither she nor her husband had accepted Mehta’s diagnosis that behind her son’s falling grades and temper tantrums lay a learning disability and severe depression. “Conduct disorder is his way of gaining self-respect,” Mehta had told them. The parents, more interested in improving his school performance, had not heeded the advice, “Don’t put pressure on him.” Just before the annual exams, he had suddenly turned over a new leaf: he was nice to everyone, listened to everything his parents said, met up with people he was fond of. Finally, one afternoon, he took his own life. “I quit,” read the chit lying on his bed.
Being a teenager has never been easy. But in the new millennium, amidst unprecedented prosperity, growing up seems to have become more trying than ever for Indian teens. The grim epithet to their tormented lives is the suicide note. Sometimes they express an inability to cope with pressure, as in the case of a Delhi student who hanged himself from a ceiling fan by his mother’s sari. “Goodbye,” he wrote. “I can’t take the pressure any longer. I love my family and I hope they will understand.” Ever so often there is helplessness: “I am not doing well in exams,” wrote a girl from Chandigarh to her parents before she took her life, “I can’t even manage my own affairs. I’ve frittered away my college fees on trivia. No one’s responsible for my death.”
In India, as many as 12.8 percent of adolescents now suffer from psychiatric disorders, says the Indian Council of Medical Research. But what explains the high-levels of depression? By every measure, urban children have much more—clothes, toys, gadgets—than their parents, who were raised on post-Independence values of thrift and self-sacrifice, ever did. It’s a problem of plenty, say psychologists. Recent studies show that children who have been given too much too soon grow up to be adults who have difficulty coping with life’s disappointments.
“They have a distorted sense of entitlement that gets in the way of success both in the workplace and in relationships,” says Dr. Gururaj, head of the department of epidemiology at the National Institute of Mental Health (NIMHANS) in Bangalore. “They often grow up to be self-centred and self-absorbed, and those are mental-health risks.” A suicide survey which he conducted in 2004 found that 57 percent of youth suicides were sudden acts of frustration.
New India’s obsession with fancy degrees and anxiety about the future is a real issue. A stream of such parents and children passes through city psychiatrist Aniruddha Deb’s chamber every year “before exams begin and after results are out”. “And they show the same psychological bent—fear of failure,” he says.
When children are young, parents marvel at their every little accomplishment—school recitations, runner-up prize in swimming. But then a day comes when all these mean nothing. The only premium is in topping the class. “I come across scores of children whose every waking hour is crammed with study-related activities,” he adds. “Everything else that they could do well—sport, music, painting—is pushed to the past. The damage this can do to a child’s self-esteem is enormous. Failure is a word that gives students continuous nightmares. After all, parents don’t give them credit for any activity they excel in, besides studies.” No wonder March to July is the year’s cruellest stretch. With boards, college and competitive exams clustered around this time of the year, the pressure to excel can be lethal. There is evidence to suggest that suicides or suicidal behaviour peak around this time.
Strangely enough, in most cases, family members remain unaware of the inchoate emotional forces running rampant in adolescent minds. Shekhar Sheshadri of NIMHANS says, “This is one of the major reasons why suicide rates are so high. Parents often don’t pick up the signs of disorders when the child internalizes problems and gets bogged down by anxiety, phobias, and academic and socialisation plights.” Any of these may cause a susceptible person to break down and slide into depression.
School is the other control factor determining the ups and downs of teen lives. On April 4, 2008, a 12-year-old student in Mumbai, tried to kill herself by jumping on the railway track from a flyover. Reason? She had been caught copying red-handed by a teacher the previous day. Her parents were summoned to the school and she was not allowed to take the English examination. The next day, she was barred from sitting for other exams as well, despite profuse pleading and apologies. She returned home and later in the afternoon tried to scale the wall to end her life. Worse, the person who rescued the distraught girl was rebuffed by the school for taking her over to them. New research by AIIMS, probing the teen mind, throws up “school refusal” as a classic cause for adolescent depression.
Medics tell parents to look for dramatic changes in behaviour or appearance, in weight, and in school performance. Any talk about wanting to die or committing suicide should make a parent go on red alert. Yet many families are loath to discuss the topic with their children. “There is this notion about depression, and certainly about suicide, that if you ask or mention the subject, you’re going to make it happen,” says Sheshadri. Quite the contrary; talking with a son or daughter about dark feelings will help assuage the sense of hopelessness the child may have.
Despite the extent of knowledge today, signs of deep trouble too often go unheeded. “In nearly every case of suicide I have reviewed, clues to the adolescent’s plans were overlooked or downplayed,” says Gururaj. “Not intentionally but unknowingly.” Not all suicides can be prevented, but parents who keep an eye on their teenagers and work hard at communicating with them are the ones most likely to save their children’s lives.