What is the second-leading cause of death among college students, the third-leading cause of death among those aged between 15 and 24 years, and the fourth-leading cause of death among those aged between 10 and 14 years?

It’s not accidents or cancer or heart disease: It’s suicide. According to the National Alliance on Mental Illness, more teenagers and young adults die by suicide each year than from cancer, heart disease, AIDS, birth defects, pneumonia and influenza, and chronic lung disease combined.

When I consider any parenting issue, the question I often ask myself is: Is this different than it was 30 years ago, 20 years ago, or 10 years ago? I sometimes casually compare current issues to those that seemed pressing during my own childhood, but most importantly I try to find statistics to answer the questions that I have.

According to NAMI, the incidence of suicide among teenagers and young adults nearly tripled between 1965 and 1987, before beginning to slowly decline in 1992. But what is alarming is that after nearly a decade of decline, the suicide rate among teenagers rose 18%, to 1,985 deaths from 1,737, between 2003 and 2004, according to the researchers at the Centers for Disease Control and Prevention.

“There’s no single clear answer for this increase,” an Upper West Side child psychiatrist said. “But one explanation is the controversy surrounding teenagers and antidepressants. When the FDA issued a warning that antidepressants may cause suicidal thoughts in teenagers, prescriptions of antidepressants for children dropped nearly 5%.”

“I see parents now who are petrified to give their children antidepressants,” the psychiatrist continued. “And of course I understand why. But parents of teenagers and young adults themselves need to understand that sometimes it would be scarier not to try antidepressants. We want people to know that depression is a treatable disease. There are all sorts of different treatments to try. Sometimes that includes medicine. And sometimes it can take a little while to find the right medicine,” he said.

Mental health professionals and college officials, are beginning to recognize the high prevalence of young adult suicides, as are New Yorkers. Five hundred of them will gather tomorrow at Central Park’s Tavern on the Green, when the country’s leading nonprofit organization dedicated to preventing suicide and improving the mental health safety net provided to college students, the Jed Foundation, holds its annual gala.

The foundation’s program director, Dr. Joanna Locke, says that even before the events at Virginia Tech, colleges were taking the issue of mental health far more seriously. “Students’ mental health is no longer just the problem of the mental health center,” she said. “The whole campus is taking it seriously. A lot of colleges even offer orientations for mental health issues. It’s a much more openly discussed topic than it used to be.”

The stigma of mental illness may be on the decline, especially in New York, but that doesn’t necessarily help the thousands of teenagers who are suffering from depression. While the CDC puts the annual number of teenage suicides at roughly 2,000, this number is dwarfed by the annual number of attempted suicides: According to the National Institute of Mental Health, there may be between eight and 25 attempted suicides for every suicide death.

I was shocked to learn that in a 2001 survey of high school students, the National Youth Violence Prevention Resource Center found that almost 1 in 5 teenagers had thought about suicide, about 1 in 6 teenagers had made plans for suicide, and more than 1 in 12 teenagers had attempted suicide in the last year. Even more disturbing is the increase in the number of suicides among children between the ages of 10 and 14. According to this same resource center, the suicide rate for this cohort increased by more than 100% between 1979 and 1998.

So, back to my original question: Are things so different than they were a generation or two ago? Yes.

“Teenagers really do have it rougher than we did,” a social worker who works in a public school said. “More parents are working, more parents are divorced, there’s less financial stability, there’s academic pressure at an earlier age, these kids are exposed to much more violence, and it’s easier than ever to get a gun,” she said.

While girls are more likely to attempt suicide, boys are far more like to successfully commit suicide — in large part because boys are more likely to use a gun.

“The most important piece of advice I wish I could tell parents of teenagers who are depressed is to listen to your child,” the social worker said. “Suicidal teenagers often give warning signs. They say nothing matters anymore. They say they won’t be your problem for much longer. Don’t fight with your children when they say these things. Don’t act angry or shocked. Try to listen,” she said.

Nearly a third of all teenagers who commit suicide had made a previous attempt, and four out of five teenagers give family members or close friends warning before trying to kill themselves.

“Look for the typical warning signs,” the psychiatrist said. “Depression, substance abuse, family history, stressful situations at school or home, domestic abuse, a friend’s suicide, a coming to terms with sexual orientation — these are all classic precursors to suicide, and parents should take them seriously. People don’t like to acknowledge this but many suicides — especially teenage suicides — are preventable.”

“Get rid of a gun if it’s in your house. Get rid of the pills. Don’t leave this kid alone for a second. Ask your child if he’s depressed. Remind this kid that no matter how bad things seem, there are plenty of ways things can work out. Tell them that you love them. Listen. Don’t let them feel isolated,” he said.

saraberman@aol.com