She is 15 years old and her boyfriend says he doesn't like her anymore. Her friends tease her and she can't talk to her parents about the hopelessness she feels. She begins to miss school but no one notices anything particularly wrong. One day she goes to the medicine cabinet, takes all of her mother's tranquilizers and lies down, longing for the relief of sleep.

He is 19 and has just graduated from high school but has no idea what he wants to do now. The depression he has struggled with all his life returns. It is especially severe in light of the fact that he suspects he may be gay, stemming perhaps from being sexually abused when he was a child. Feeling isolated and afraid, he takes his father's gun from the closet and walks into the woods.

These fictional stories represent potential profiles of youth, who take their own lives in growing numbers in America. A newly-released study from the US Centers for Disease Control and Prevention (CDC) reveals that the suicide rate for 10 to 19-year-old females and 15 to 19-year-old males increased by eight per cent between 2003 and 2004 after declining over the previous four years.

"This is the biggest annual increase we've seen in 15 years," says Dr Ileana Arias, Director, CDC's National Center for Injury Prevention and Control. "We don't know yet if this is a short-lived increase or if it's the beginning of a trend. Either way, it's a harsh reminder that suicide and suicide attempts are affecting too many youth and young adults. We need to make sure suicide prevention efforts are continuous and reaching children and young adults."

According to the American Association of Suicidology, suicide ranks as the third leading cause of death for young people (aged between 15 and 24 years), accounting for more than 12 per cent of all deaths in that age group. Only accidents and homicides occur more frequently. In 2001, nearly 4,000 youth killed themselves. In the past 60 years, the suicide rate has quadrupled for males and doubled for females. And for every completed suicide it is estimated that 100 to 200 attempts are made, making youth suicide a major public health problem in the country.

Suicide is a complex behavior that is usually caused by a combination of factors. The Virginia-based National Alliance on Mental Illness claims that more than 90 per cent of youth suicide victims have at least one major psychiatric problem, especially depression or other mood disorders. Other important risk factors include alcohol or substance abuse, family history of suicide, parental psychopathology, impulsive or aggressive tendencies, history of sexual abuse, same-sex orientation, or specific life stressors such as interpersonal loss or disciplinary problems.

As the Canadian Mental Health Association (CMHA) points out, "Adolescence is a time of dramatic change. The journey from child to adult can be complex and challenging. Young people often feel tremendous pressure to succeed at school, at home and in social groups. At the same time, they may lack the life experience that lets them know that difficult situations will not last forever." Youth, the CMHA says, seek relief from pain in suicide. "It's about escape. Someone who thinks seriously about suicide is experiencing pain that is so crushing they feel that only death will stop it."

Several myths prevail around youth suicide. One is that young people rarely think about suicide, when, in fact, teens and suicide are more closely linked than adults expect. Another is that suicide is sudden and unpredictable. But, in fact, it is usually a process rather than an event; talking about it calmly can bring relief to someone feeling isolated. A third myth is that suicidal youth are only seeking attention or being manipulative. But all suicide threats must be taken seriously.

Scientists now believe there are biological factors that influence both depression and suicidal behavior and that genetic factors may also play a role. Major depression is known to increase suicide risk. There are also dramatic gender differences in lifetime risk of suicide in depression. About seven per cent of males with a lifetime history of depression die by suicide. Only one per cent of females with a lifetime history do.

Suicide contagion is also a serious concern. The exposure to suicide in a family, among a peer group, or through media reports can result in increases in suicidal behavior, especially among adolescents and young adults.

The Keep Kids Healthy organization urges adults to take distress in youth seriously, to listen non-judgmentally, and to help them get professional help. Dr Keri Lubell, a behavioral scientist at CDC agrees. "It's important for parents, health care professionals, and educators to recognize the warning signs of suicide in youth. Parents and other caring adults should look for changes in youth, such as talking about taking one's life, feeling sad or hopeless about the future. Also, look for changes in eating or sleeping habits and even losing the desire to take part in favorite activities," she says.

The CMHA adds, "No one can solve another person's problems. But sympathy and support can help. Knowing that someone else has faced similar tough times and survived can help a suicidal person see a light at the end of a very dark tunnel."