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Teens turn to social media for attention, even in death

Judge Maria Sampedro-Iglesia threatened to jail a Florida Department of Children & Families lawyer in the Facebook Live teen suicide case.

Modern youth prefer social media platforms such as Instagram, Twitter, and Facebook as a means to express themselves. Youth today are being raised in the digital age where information travels from one end of the globe to another at the push of a button. In my clinical practice of child and adolescent psychiatry, I often encounter patients who are experiencing emotional distress secondary to sharing sexually explicit images of themselves with someone they hope to be in a relationship with. It is only after pressing the send button on their mobile devices that they realize that their private parts are in the public domain because the person they unilaterally confide in often shares them with their contacts.

People have posted suicidal content on Facebook for a decade now, but the difference today is that the post is a video. One of the earliest cases of a live-streamed suicide was Abraham Biggs in 2008 during which he linked to a live-stream site called Justin.tv, where the video showed him overdosing on prescription pills.

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Recently, a Miami teen committed suicide by hanging while streaming on Facebook Live, a Georgia teen committed suicide by hanging while live streaming on live.me, several Russian teenagers reportedly committed suicide as part of a social media game called Blue Whale, and a youth in Mumbai committed suicide by jumping off the Taj Hotel while streaming on Facebook Live. These tragedies invoke strong emotional reactions, such as shock, disbelief, disgust, helplessness, loss, anger, senselessness and numbness in the viewer.

Neuroscience research correlates with what humans have known for centuries: adolescents, as compared to adults, are more susceptible to influence, less future oriented, less risk averse and less able to manage their impulses and behavior. Structural and functional differences between the adolescent and the adult brain have informed recent United States Supreme Court decisions, such as Miller v. Alabama, which abolished mandatory sentences of life without the possibility of parole for juvenile offenders, Roper v. Simmons, which abolished the juvenile death penalty, and Graham v. Florida, which prohibited sentencing juveniles convicted of crimes other than homicide to life without parole.

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Just like there are a myriad of reasons why youth are drawn to suicide, the reasons why some chose to publicly display the deliberate act of killing themselves are not straightforward. Unlike older generations, who view social media as an invasion of their privacy, youth seem particularly susceptible to wanting to live-stream their suicides. Communicating through social networking sites, chat rooms, forums, e-mail lists and discussion boards might make them feel connected to the online community. Cognitive immaturity coupled with spending a large portion of one's day immersed in a medium that provides instant gratification or rejection can possibly instill a sense of disconnectedness from the reality of one's own existence. Social media is a safe haven for teenagers struggling with issues related to self-esteem or abandonment as they instantly get the attention or the validation they are craving for in the form of Facebook "likes" and Twitter "retweets."

Posting to the world the deliberate act of ending one's life can possibly serve different purposes. The combination of the quasi-feeling of connectedness instilled by social media and the feeling that one can control one's actions in the privacy of the bedroom or bathroom might take away the solitary feeling of the suicide act. The combined weight of vulnerability, need for validation and limited decision making capacity might make it difficult for some youth to step back once they have posted something pertaining to suicide on social media. Sharing experiences can turn into an obsession about approval that can wreak havoc on self-image. For some it can ultimately lead to suicide. Katelyn Nicole Davis, a 12-year-old in Georgia girl who killed herself last December on a live-streamed video on Live.me, said during her livestream that she had been sexually abused and had previous videos about dealing with depression. In the Facebook Live video, Arjun Bharadwaj, who jumped off a premier hotel in Mumbai, was heard recording a tutorial about how to commit suicide. Abraham Biggs, a 19-year-old in Florida had been discussing his suicide on an online body-building forum. People kept egging him on by saying things like "go ahead and do it," until he succumbed to an opiate and benzodiazepine overdose.

For teens struggling with issues related to self-esteem and abandonment, broadcasting the suicide act might be a means through which they want others to notice them. Naika Venant, a 14-year-old in Florida who broadcast her suicide on Facebook Live, had a history of physical and sexual abuse. She was put in foster care because of allegations of physical abuse by her mother and went through 14 foster placements. Maybe Naika felt invisible and wanted to be seen and heard.

A primary concern with suicide or self-harm videos is that they may normalize and reinforce self-injurious behaviors. The Blue Whale "suicide game," which news accounts claim has led to several teenage suicides in Russia, is believed to be an online social media group that encourages people to kill themselves. It is believed that a group administrator assigns "daily tasks" to members — such as self-harming, watching horror movies and waking up at unusual hours — which they have to complete for 50 days. On the 50th day, the administrator is believed to instruct the youngsters to commit suicide. It's no coincidence that lately I have come across several patients who are able to relate their misery to Hannah Baker, a fictional character from the Netflix series "13 Reasons Why." Originally a novel written by Jay Asher, "13 Reasons Why" tells the story of why Hannah Baker, from a white picket fence town with an almost perfect family, committed suicide.

If social currency, that is the number of "likes" or "wows" or "retweets" or textual portrayal of a writer's mood in the form of icons (emoji), is a pivotal measure for modern youths' self-esteem, then hanging or jumping off a building or overdosing on pills could seem like no more than the equivalent of entering or exiting the world of virtual reality.

Dr. Shobhit Negi (shobhitnegi@yahoo.com) is a child, adolescent and forensic psychiatrist based in Baltimore.

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