Suicide rates among teens and young adults have reached their highest point in nearly two decades, a new study reports. Suicides among teens have especially spiked, with an annual percentage change of 10% between 2014 and 2017 for 15- to 19-year-olds, researchers said.

"It really is an unprecedented surge," said lead author Oren Miron, a research associate at Harvard Medical School in Boston, MA. "You can go back decades and you won't find such a sharp increase."

Suicide rates for 15- to 19-year-olds and those between 20 and 24 are at their highest level since 2000, Miron said. The surge is particularly strong among teen boys, up 14% a year between 2015 and 2017. Suicide rates for teenage girls, meanwhile, rose 8% annually between 2000 and 2017.

"Parents and teachers need to be aware that the rates have reached their highest recorded level, and they need to be on the lookout for both boys and girls," Miron said. He said the opioid epidemic might be fueling part of the rise, and social media is another likely contributor. "It's much easier to bully," Miron said. "The apps are getting smarter and smarter at providing anonymity and hiding activity from grown-ups."

Today's youth face many pressures and some may hit the breaking point, said Pamela Cantor, a clinical psychologist in Natick, MA, who specializes in suicide prevention. She wasn't involved with the new study. Cantor said some kids are "intensely programmed" to achieve and have too little time to just enjoy their youth.

Other issues include family instability, competition, social pressures, and "parents who try to smooth the way so that when their children hit a snag they do not know how to cope," she said. These teens are often exposed to violence, from "horrifying" school shootings to more frequent "socially sanctioned expressions of hatred," Cantor said. "It's difficult for them to imagine having a life as comfortable as the previous generation," she said.

On top of that, it's all too easy to get a gun if a teen is suicidal, Cantor said. Drugs and alcohol are readily available, and can deepen suicidal feelings or thoughts.

For this study, Miron and his colleagues analyzed death certificate data gathered by the US Centers for Disease Control and Prevention. They found that the overall suicide rate in 2017 was nearly 12 deaths for every 100,000 15- to 19-year-olds, compared with 8 deaths per 100,000 in 2000. For 20- to 24-year-olds, the 2017 suicide rate was 17 per 100,000, compared with 12 per 100,000 in 2000.

According to the Mayo Clinic, the warning signs of teen suicide include:

• Talking or writing about suicide
• Withdrawing from social contact
• Experiencing sudden mood swings
• Using alcohol or drugs more frequently
• Expressing a sense of hopelessness
• Taking part in risky or self-destructive behavior
• Changing eating or sleeping patterns
• Giving away belongings for no apparent reason

The new study was published June 18, 2019, in the Journal of the American Medical Association.