Q: Dear John & Wes: We are having a debate concerning suicidal tendencies. Would you say that it is something that a person ever really gets “cured” from? If not, at what point would it be of concern if the thoughts came back? In other words, if it is “normal” for a person to revert back to thinking about suicide, at what point would you feel like it is a problem? – A Reader

A: Wes: I presume you’re asking because of some history you’ve had with this problem. If I’m correct I hope you are headed back to therapy. Contrary to popular belief, teens are not at a statistically high risk for suicide. Older males are. But it’s still a serious concern and one you want to address early and as frequently as necessary thereafter.

Some consider suicidal tendencies in a sort of Alcoholics Anonymous model – once you’ve crossed a certain line, you’re there for life. I don’t quite see it this way, but I think that once certain doors are open a person finds it easier to walk back through – or at least give it some consideration. The closer one has been to an actual suicide attempt, the easier that door may be opened again. In fact, the door can be opened by someone else – a friend, family member, etc. I’ve seen it happen many times.

This is due to something very much like “systematic desensitization.” In psychotherapy we use this as a technique to treat phobias (fears) or post-traumatic stress. In each session you get a little bit closer to encountering the feared object (snakes, planes, snakes on a plane, etc.) At each step you practice calming yourself and facing the fear. So first you might look at a snake in a picture. Once you are able to stay calm, you go to Science City and see the snake in the cage. Once you are calm with that, you hold the snake and so on. Eventually you have no fear.

This same process happens naturally, and, in an unfortunate way, with suicide and other forms of violence. The closer you get to the act of suicide, the less you fear it – which is, of course, a scary thought. This is particularly problematic for teenagers, because on average they are fairly desensitized to begin with due to the perception of invincibility inherent to all but the most anxious youths. Our rather violent culture doesn’t help much, either.

That said, passing thoughts of suicide are pretty normal in adolescence. While the actual rate of attempt is comparatively low, suicidal thoughts (or “ideations,” as we call them) may emerge in many teens. I’d become concerned if those thoughts became frequent or intrusive (you can’t get them to go away); you begin acting on them overtly or in a metaphorical way (e.g., drinking excessively, using hard drugs); or if you begin to consider practical ways to harm yourself. Simply put, if these thoughts get anywhere beyond the “I’m sure frustrated with living” level, you need to talk to someone. Suicide hot lines are available locally and nationally. While they’re not designed to substitute for an ongoing therapy process, they can get you by until you get lined for a session.

John: It is important to reflect upon death throughout one’s life. After 9/11, I wondered what it would be like to give up my life in a rescue mission. Sometimes I ponder dying in a military conflict like our troops in Iraq, or in a freak accident like Steve Irwin. Death has a way of putting life in perspective, and it is healthy to reflect on the ways in which our life could end. The problem comes when reflection turns to fantasy. It’s hard to imagine contemplating suicide as “normal” for any creature. As human beings, we thrive to exist, and to bear children and build monuments that will honor us long after we die. To will one’s own annihilation seems like a paradox. But it is typical in teens. It’s difficult to find precise numbers, but research seems to indicate that a substantial number of young people have at some point considered suicide.

Suicide has a romantic appeal to many teenagers – a way out of their anxieties that is quick and seemingly without consequences. We like to think of our friends mourning over us, and our loved ones suddenly understanding our anxieties. But a dead person feels no sympathy, and suicide only creates confusion for those left behind.

A person who fantasizes about gorging in donuts will have a difficult time sticking to a diet. It doesn’t matter if it’s your first time or your 10th; romanticizing suicide is counterproductive and will prevent you from achieving the goals you desire. If you have a habit of indulging in suicidal thoughts, only a disciplined effort to stop will break the pattern. There is no “cure” for obesity, only a healthy lifestyle. Likewise, a habit of suicidal thoughts will not be outgrown or drugged away without serious effort on your part. Thoughts become actions, and only a conscientious effort will derail this long black train of thought.

Of course, many people find they cannot do this alone, and there’s no shame in asking for help. Friends and counselors can discuss your situation and come up with a long-term solution, not a quick fix, to the dilemmas that may be triggering your thoughts. These people want to help you, but you have to make the first step. You have to have the courage to recognize your problem and seek help.

Next week: Geo-positioning your teenager? We revisit the ethics of parental oversight in our high tech age.

– Dr. Wes Crenshaw is a board-certified family psychologist and director of the Family Therapy Institute Midwest. John Murray is a Free State High School senior. Opinions and advice given here are not meant as a substitute for psychological evaluation or therapy services. Send your questions about adolescent issues to doubletake@ljworld.com. All correspondence is strictly confidential.