Yesterday, Firstpost reported that the West Bengal police have linked the deaths of two Darjeeling residents in their 20s to the Momo Challenge, an online game that asks people to add a contact — Momo — via WhatsApp, who then ‘challenges’ them and offers instructions on how to commit self-harm or suicide.

Momo is a picture of a creepy girl with bulgy eyes and black hair, who threatens to appear in the night or lay a curse on players if they do not respond, say the Mexican police. They add that besides inciting players to commit suicide, criminals behind the challenge could also be using the game as a means to steal personal information.

India, and the world, has seen this before. Last year, the Blue Whale Challenge made the rounds in a similar way, via social media and targeting young people, and urging a similar outcome. Though the game was never actually proven as the cause of any deaths in India, it was elsewhere, and so captured popular consciousness by preying on parents’ worst fears.

It also did get some young people to harm themselves, if not fatally so. A 22-year-old man in India’s Puducherry recounted his experience playing the game as being in a “virtual death trap.” He said that while he was playing the game, he avoided talking to people at home and remained confined to his room. “It was mentally taxing, though I wanted to get out of the game, I couldn’t do so,” he added. His brother noticed the behavioral changes and informed the police, who intervened before he completed the next challenge of using a knife to etch a whale’s image into his arm.

But self-harm, though not necessarily a precursor to suicide, is still an unhealthy behavior, and raises the question: What might lead a young person to find a game like Momo or Blue Whale appealing?

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Depression, says psychiatrist Dr Harish Shetty, which is more common among teenagers than parents may realize. Mentally healthy teens are unlikely to see the appeal of playing the game, at least not to its conclusion, or experience the same compulsion as the Puducherry man, he adds. In fact, it has little to do with any game; suicide, with or without an online challenge, is a leading cause of death for young people.

According to a 2009 government study, 3 to 9% of teenagers meet the criteria for depression at any one time, and by the end of adolescence, as many as 20% of them report having experienced depression in their lifetime. Challenges like Blue Whale or Momo provide isolated teens with an opportunity to be connected, a part of something that is bigger than themselves, Dr. Shetty adds. “This feeling makes them happy, gives them a sense of accomplishment,” he says.

To dismiss their feelings by saying they’re too young to experience sadness, grief, or anger only isolates them further and makes them more vulnerable to the appeal of these challenges, says Dr Shetty. Teens require validation, respect and independence, and they have a developmental drive to feel a sense of belonging, agency, and autonomy. A challenge like Momo, “with its clear challenge-accomplishment-reward structure, it’s a straightforward path for teens to feel good about themselves. The validation they receive from the administrator, and the recognition and, perhaps, admiration they receive from peer ‘players’ as they progress through increasingly dangerous challenges, feeds their most basic developmental needs,” The Swaddle reported last year when reports of the Blue Whale Challenge surfaced.

Unfortunately, depression can be difficult to spot, especially from general teen moodiness; 30 to 50% of primary care physicians fail to recognize depression in their patients, according to the same 2009 study. Behavior change is a big tip-off — but then, behavior change is a big part of healthy adolescence.

The first signs of depression parents can look for, Dr Shetty says, is if a child is has been unusually quiet, irritable or angry, has problems paying attention, starts performing poorly in school, avoids school, or stops socializing with friends. Talking about death or feelings of hopelessness are even more concerning. In these circumstances, “you need to seek professional help and be there for your children mentally, physically and emotionally,” he says.