Stress and Adolescent Suicide: What Can We Learn from the Body?

Adam Bryant Miller, Ph.D., University of North Carolina-Chapel Hill

(originally published 8/22/2019)

Ask any teenager if they feel occasional stress in their relationship with their parents, peers, or romantic partners; you will be hard pressed to find a teen who says no. That is because relationship stress is a normal part of a teenager’s development. There is a good reason for this. When teens start going through puberty, biological systems responsible for responding to stress undergo rapid changes that make teens more reactive to stressors compared to when they were kids. It also is harder for them to calm their bodies down compared to children or adults. This is a perfect recipe for intense feelings of distress. The good news is that many teens weather these developmentally typical storms without any problems. The bad news is that some teens have such intense reactions to stress that they experience suicidal thoughts and engage in suicidal behaviors in the moments after they experience acute stress.  Research from our lab and others has begun to take a closer look at how teenagers’ bodies respond to stress to better understand which teens are at risk for suicidal behavior and when they may be at risk. 

Imagine a time where you came across a spider or when a car pulled out in front of you, causing you to slam on your brakes. What do you remember from those experiences? Chances are you recall a nearly instantaneous reaction in your body, which may have included any of the following: rapid increase in heart rate, a sharp inhale or increase in breathing rate, tightness in your muscles, and reflexive actions (slamming on brakes). A few minutes later, you probably remember feeling your heart slamming in your chest or some soreness or tingling in your muscles. What you may not have been aware of are the multiple biological systems working to coordinate these responses. The system that causes the immediate responses to stress is sometimes known as the “fight-or-flight” response. This is the sympathetic branch of the autonomic nervous system that responds nearly instantly, and it is regulated by the parasympathetic nervous system. While the autonomic nervous system causes heart rate and breathing to increase, the parasympathetic nervous system helps calm down those bodily responses. The soreness or tingling in your muscles in the few minutes after being exposed to a stressor comes from a slower-acting stress system known as the HPA-axis, or hypothalamic-pituitary-adrenal axis. These responses are normal, and as mentioned above, they are heightened during adolescence. 

Psychologists have discovered that both of these stress response systems may be altered in teenagers at risk for mental health problems more generally, and they may be specifically linked to risk for suicidal behavior among teenagers. Researchers have shown that teenagers who are at risk for suicidal thoughts and behaviors may not respond the same way to stressors as their typically-developing peers. In our work, we bring teenagers into the lab to observe how they respond to stressful tasks. We have found that teenagers who are at risk for suicidal behavior do not show a typical stress response. In fact, it looks like these teens may either respond too much or too little to stress. Both of these scenarios have been linked with suicidal behavior.  

It is also important to note that the environment plays an important role in how our bodies respond to stress. Chronic stress faced by teens from minority backgrounds, such as systematic discrimination, bullying, or social rejection, directly affects how well their bodies are able to handle stress. Although a multitude of factors are likely involved, understanding biological responses to acute stress may help us identify why some subgroups of youth are more at risk for suicidal behavior than others. 

Although we have a lot more research to do, these emerging findings about the role of biological responses to stress may help us target which teenagers are at risk for suicidal behavior.