Dr. Petra Steinbuchel understands what it's like to be a 12-year-old grappling with suicidal feelings.

As medical director of mental health and child development at UCSF Benioff Children’s Hospital Oakland, Steinbuchel counsels such patients as they experience sadness, anxiety and depression. Sometimes they talk about the hopelessness of poverty; others feel the crushing pressure of high expectations.

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They watch as images of wealth and perfection float by on social media, wondering if they'll ever achieve greatness and feel less lonely. Their phone may become an unpredictable enemy, delivering surprise cyber-bullying attacks.

These experiences alone don't lead to suicide, says Steinbuchel, but they might have a tragic impact when combined with proven risks like social isolation and mental illness.

Researchers may now start playing closer attention to that dynamic. On Friday, the National Center for Health Statistics released data showing an increase in the suicide rate amongst females and males in every age group under 75.

While researchers expected to see an increase in suicides among middle-aged Americans, they did not anticipate such a sharp rise amongst 10- to 14-year-old children, says statistician and study author Sally C. Curtin.



"Hopefully it does raises awareness that [suicidal ideation] happens at these ages."

From 1999 to 2014, the number of suicides among girls in that demographic tripled to 150.

The number of suicides increased for young boys as well, though less significantly. In total, 425 children between the ages of 10 and 14 died by suicide in 2014 compared to 242 in 1999. Most of the deaths involved 13- and 14-year-olds.

Curtin says it's important to note that the absolute suicide rate for each group barely increased to 1.5 per 100,000 for girls and 2.6 per 100,000 for boys, aged 10 to 14. In contrast, the national rate over all age groups is now 13 per 100,000.

Yet, because the data is drawn from a massive national sample it can reveal trends that may be imperceptible at the local or state level. The NCHS research also doesn't account for suicide attempts that resulted in emergency room visits and hospitalization.

"We know that completed suicides are but the tip of the iceberg," Curtin says. "Hopefully it does raises awareness that [suicidal ideation] happens at these ages. The general public might just say, 'This is too young.'"

Experiencing thoughts of suicide? We're here. Text HELLO to 741741. https://t.co/p8kE6lHiv5 — Crisis Text Line (@CrisisTextLine) April 22, 2016

It's unclear why the number of suicides spiked for young girls.

Rachel Simmons, author of three books on girlhood and cofounder of Girls Leadership, a national nonprofit organization, says the early onset of puberty may be exposing girls to emotional and physical changes before they're prepared to handle them. Studies have shown girls are experiencing breast growth, for example, at younger ages.

"It’s a lot for a very young person to deal with," says Simmons. "Middle school is already a challenging time...It might be harder to get help if you’re trying so hard to fit in."

Simmons also says that girls may turn to visual platforms like Facebook and Instagram to seek validation of their appearance, but develop worse self-esteem as a result. She doesn't see a direct link between social media use and suicidal feelings, but believes using such platforms can "exacerbate the vulnerabilities girls already bring to the table."

"There's so much emphasis on other kids having the perfectly fabulous life."

Steinbuchel says her adolescent patients often have an underlying mental health condition like substance abuse, depression or anxiety, and also frequently experience bullying. Many are trying to cope with the effects of persistent financial strain in an economy that hasn't favored lower-income workers.

Steinbuchel urges parents to monitor their child's moods and ask about drastic changes. In early adolescence, she says, children may or may not understand the finality of suicide or realize their symptoms are treatable.



At the same time, their relationships may be frayed by the outsized role of social media in their lives. While that can foster connection, Steinbuchel says she often sees kids sitting next to each other and texting instead of engaging in person and develop social and emotional skills like being able to read facial expressions.

The looking-glass effect of observing other people's lives also takes its toll.

"There's so much emphasis on other kids having the perfectly fabulous life," Steinbuchel says. "It can create feelings of isolation and hopelessness."

If you want to talk to someone or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. For international resources, this list is a good place to start.

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