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Book Review   |    
Coping With Teen Suicide
Douglas G. Jacobs, M.D.
Psychiatric Services 2001; doi: 10.1176/appi.ps.52.4.541
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by James M. Murphy, M.D.; New York, Rosen Publishing Group, 1999, 125 pages, $17.95

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Coping With Teen Suicide is written for teenagers to help them cope with stress and overcome depressive and suicidal thoughts. The author, James M. Murphy, M.D., is a psychotherapist and an ordained minister. The book provides a discussion of life stressors, suggestions for means of coping with stress, and signs and symptoms of depression and suicidality. The author uses vignettes based on the experiences of real teenagers to illustrate his points. Also included is a list of places to go for help.

The book is succinct, and the writing is geared to adolescent readers. Chapters are short and divided into sections, making the book easily accessible to laypersons of all ages. The chapter topics include ways to cope with stress, defining depression, ways to deal with feelings, the role of friends and family, the varieties of mistaken thinking, suicidal crises, and where to get help. Stories about teens of various ethnic backgrounds and sexual orientations provide concrete examples of the topics covered.

Coping With Teen Suicide is not addressed to clinicians, who would find the information in the book too superficial to be helpful. However, clinicians may find the book useful as a resource for teenagers who are struggling with emotional difficulties as well as for their parents. Among the book's most helpful components is the chapter on coping with stress, which provides concrete suggestions for ways teens can manage emotionally difficult situations.

The author also provides some good advice on handling negative feelings. The discussion of different forms of harmful thinking, such as "either-or" thinking that blocks out alternatives, could be a useful tool for working with depressed or suicidal adolescents. A list of possible indicators of a suicidal crisis can instruct young persons on warning signs to be aware of in themselves and friends.

I do have some serious reservations about the book, however. Most notable is that depression is not formally addressed as an illness, and suicide is not discussed as an event that often occurs with psychiatric illness. The author continually uses the phrase "influences to be suicidal" to talk about peers and negative thought patterns. He suggests that teens can change their own thinking as well as the thinking of others. I feel the author puts too much emphasis on the individual's ability to control his or her own ways of thinking and coping, thus minimizing the impact an underlying psychiatric disorder can have and the importance of obtaining treatment. This approach could cause truly depressed teens who are unable to change their way of thinking without intervention to become even more frustrated and hopeless about their situation.

I believe this book functions better as a guide for healthy teens than as a book for seriously depressed or suicidal teens, who may be misled by the underlying message that depression and suicide are a result of patterns of thought and behavior that individuals can change on their own.

Dr. Jacobs is executive director of the National Mental Illness Screening Project and associate clinical professor of psychiatry at Harvard Medical School in Boston.

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