There were problems with school -- transfers, expulsions, withdrawals -- and with friends turned disloyal or taunting. Fights with a drunken father. The shooting death, ruled a suicide, of an older sister. Experimentation with drugs.
One night, dissatisfied with the way her boyfriend cut her share of cocaine, Linda (not her real name) told him, "Look, if you don't stop treating me like crap, I'm going to kill myself . . . If my sister could do it, I can do it." When he broke a date the next day, the Aspen Hill girl downed 38 muscle relaxers and lapsed into unconsciousness.
She was 16.
Today, three harrowing years later -- after extended hospitalizations, medication and individual and family therapy -- Linda can finally vent some of the feelings that nearly made her part of the nationally soaring statistic of teen suicides.
"I just didn't want to live anymore," says this pale-skinned, attractive teen-ager between nervous drags on a cigarette. "I just wanted to crawl in a hole. Everybody hated me. Nobody cared. Nobody loved me. I thought I just wasn't any good.
"Now I know things will change. It'll get better. I just have to feel through this hard time. Then I didn't know that . . .
"Suicide," she says, "is not the answer."
The issue that mental health professionals and the schools are grappling with is how to extend that conviction. About 6,000 teen-agers a year are killing themselves (in verifiable cases), a rate three times that of the 1950s.
For every successful suicide, some researchers say there are 100 attempts. Officially, the National Center for Health Statistics ranks suicide as the third leading cause of death (behind accidents and homicides) for teens in this country. But because teen suicides are often disguised as accidents, many believe the rate could be twice as high as reported: Some say it's the leading cause of teen-age death.
The extent of the problem is also evident from the amount of attention it is receiving.
Last week a Senate subcommittee heard testimony geared to devising a federal government intervention program. New York State, where Westchester County was the site of an alarming rash of teen suicides in February, just formed a youth suicide prevention council to report to the governor and state legislature. The California legislature this year mandated a suicide prevention program for all teen-age students.
In the Washington area, the Montgomery County school system has just won a state suicide prevention grant to sensitize staff -- as Fairfax County schools have done for three years -- to signs of depression in teens.
Nationally, the TV networks are getting into the act with three upcoming made-for-TV movies on the subject of adolescent suicide. The first, a CBS production called "Silence of the Heart," will air this month.
But the institution with perhaps the biggest stake in the campaign against teen suicide is the public school. According to the Denver-based American Association of Suicidology, school involvement is growing nationally.
"A suicide does affect the school as a community," says Beatrice Cameron, assistant superintendent for student services and special education in the Fairfax public schools, where 11 recorded (and more suspected) teen suicides rocked the system three years ago. (The drop to three school-year suicides last year has been credited by some to the system's early detection program, in which specially-alerted staff try to refer depressed students quickly to private therapists.)
"Staff and parents deal with the aftermath, the emotional effects generated by a crisis like suicide," says Cameron. "Students who are friends of the person who has taken his life feel terribly upset by that. People close to him as adults have feelings generated about their own involvement, guilt: 'Could I have prevented this?' "
Even socially remote classmates of a suicide are often affected.
"There was a boy, a classmate, who hung himself in his basement last spring. That's all I know," recounts a Silver Spring teen-ager. "I was upset. It shocked me. I didn't think anyone my age had that many problems."
Then, adds Cameron, "in an adolescent community, there's the contagion of a crisis . . ."
Contagion. The unsettling theory arose after recent clusters of teen suicides in communities like Plano, Texas (seven dead in a year), and Westchester County (five dead in a month). Suicide, posit some experts, may be "catching" for vulnerable teen-agers. How much the media contributes to the phenomenon through its reporting of suicides is also in question.
"Perhaps," says psychiatrist Susan Blumenthal, head of the suicide research unit at the National Institute of Mental Health, "a young person who's feeling very anonymous and feeling a loss of self-esteem may feel that a young person who suicided achieved a kind of heroic stature."
Further tending to support the theory is research showing that kids in families where there's been a suicide or attempt are at much greater risk (six times greater, according to the NIMH) of committing suicide themselves.
But the lack of firm evidence on how public discussion affects vulnerable teens, plus adults' own discomfort with the subject, has made some school officials wary of confronting the subject head on.
"People are not comfortable talking about death with kids," says Fairfax schools social worker Myra Herbert.
Her way around the problem? "I started doing something called 'adolescent stress programs,' in which we isolated issues troublesome to kids -- moving, divorce, being from another culture, academic pressure, social pressure, death in the family. We got together a large group of kids from a couple of high schools. The kids then formed a panel to talk with other kids about these issues.
"They don't mention suicide. They talk about the kinds of things that put them under pressure. Those are the kinds of things that sometimes lead them to an impulsive act."
After a suicide has occurred, however, this may not be enough. Then, adults' unwillingness to help air teen-agers' specific fears and concerns about suicide can foster more confusion and distress, says Rockville psychiatric social worker Mila Kagan.
But even for determined school systems, confronting the issue is often difficult.
In Prince George's County, for example, a junior high student died last year when he was struck by a B & O commuter train. The medical examiner classed it a suicide, based on his interview with the train engineer, who said he saw the boy run onto the tracks facing the train and throw up his hands. According to county school officials, the family said it was an accident.
There were no special programs to help classmates deal with their confusion or upset. "The school," explains Mike Schaffer, health education specialist for Prince George's County schools, "was reluctant to do anything about calling it a suicide because of the feelings of the family."
The family's reaction was not unusual. So many of his findings in such cases are contested that Dr. John Rogers, medical examiner for northern Prince George's County and eastern Montgomery County, does not release names of adolescent suicides within his jurisdiction for fear of lawsuits.
Schaffer also has run into the problem of denial. "It's one of the few remaining taboos for schools, certainly for families. I personally had a friend who killed himself . His family didn't want to talk about it to the extent that they didn't publicize his death . . . They didn't want anyone to know about his death at all because he died a suicide. I think there's guilt because they parents think, 'What if I had done this? Would it have saved him?' "
Kagan suggests that in such cases school officials ask a member of the clergy to talk with bereaved families and persuade them that, "If there's ld chills." children."
So far, at least, the extent of a school system's involvement in anti-suicide programs has tended to reflect the severity of the local community's teen suicide problem. Thus, schools in the District -- where the teen suicide rate is low -- have no suicide prevention program per se.
In those communities with a growing rate of teen suicide, the problem is how to increase exposure to programs originally designated for only a portion of the student body. In Prince George's County schools, for example, a hard-hitting film about teen suicide is seen by only the eight-to-10 percent of high school students (most frequently not college-bound) who elect to take health education classes.
"Pressures are put on the non-college bound too," says health-education specialist Schaffer. "They need to get into trade schools, get on the football team, need to get a job. Those problems are indigenous to the entire student population.
"I just think more students need to be exposed to it."