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Suicide

Suicide is a complex and increasingly significant problem in our society. The alarming increase in suicide among teenagers, young adults and seniors requires more research into societal and stress factors. Some suicidal risk factors can vary with age, gender, and ethnicity, and they may even change over time. The risk factors for suicide often occur in combination. Research reveals that 90% of the people who kill themselves have depression or some other mental or substance abuse disorder, and that changes in the neurotransmitters in the brain, e.g. serotonin levels, are associated with the level of suicidal risk. Diminished levels of this brain chemical are seen in patients with depression, compulsive disorders, or a history of violent suicidal attempts, and also appear in the postmortem brains of suicide victims. When tragic or difficult life events are combined with other risk factors like depression, they become the perfect recipe for suicidal ideation. However, suicide and suicidal behavior are not normal responses to stress. Many people have one or more of these risk factors and are not suicidal. Where an attempted suicide has occurred doctors often find a history of prior suicide attempts; a family history of mental disorder or substance abuse; a family history of suicide or family violence, including physical or sexual abuse; or a family environment where guns are stored in the home. Most suicide attempts are in response to extreme stress, an overwhelming sense of hopelessness, and the need to escape – they are not harmless cries for attention.

If you suspect that a family member or friend is suicidal, you should not leave them alone. Instead you should seek immediate medical and mental health treatment.

There are many more suicidal attempts than completed suicides, but 10% of those who attempted suicide go on to commit suicide at a later date. Studies reveal that 75% of all completed suicides showed signs of despair within a few weeks or months prior to the suicide. Just because the person does not seem to have major problems, does not mean they are not suicidal.

It isn’t how bad the problem is, but rather, how badly the person is hurting that dictates their action.

Suicide claims the lives of more adolescents than any disease or natural cause. Adolescents now commit suicide at a higher rate than the national average of all other age groups. Social changes that may relate to the rise in adolescent suicide include increased incidence of childhood depression, decreased family foundation and stability, and increased access to guns.

Adolescents often try to help a suicidal friend by themselves. They feel bound to secrecy, or they think that adults can’t be trusted. But, if the friend does commit suicide, that adolescent will feel guilty. It is important to talk to teenagers and tell them what they should do and why they should take the action of getting help for a friend, even if it seems like they are being disloyal. A friend can listen to the suicidal and offer support, but then they should insist on getting immediate adult assistance.

What are the symptoms?

• Inappropriate interest in or toying with guns
• Signs of depression
• Loss of pleasure/interest in social and sports activities
• Declining interest in sex, friends and activities
• Changes in weight, appearance, withdrawal from friends
• Increased drug or alcohol use
• Feeling worthless, guilty or out of control
• Decline in school or work performance
• Suicidal talk, previous suicide attempts or thoughts
• Comments like ‘I’m going away for a long time’, ‘You won’t have to worry about me anymore’ ‘I want to go to sleep and never wake up’, ‘Is suicide a sin?’
• Preoccupation with death and dying
• Taking excessive risks
• Giving away special possessions and making arrangements to take care of unfinished business
• Changes in appetite or sleep patterns
• Recent tragic or significant event (divorce, loss of family member or friend, loss of job or home)
• Feeling powerless to change things, sad, anxious or hopeless mood
• Apathetic, irritable, prone to anger
• Making out a will or giving away favorite possessions
• Overwhelming pain from a terminal or debilitating illness
• Inappropriate joking, or saying goodbye, asking for information on euthanasia, telling or writing stories about death

How is it diagnosed and treated?

Suicidal behavior is often associated with depression, attention deficit hyperactivity disorder, substance abuse, or anxiety. Because symptoms of suicide precede the actual attempt, doctors typically see patients who are referred by family or friends. They perform physical and mental evaluations to rule out other disease, and will interview the patient and family members to look for symptoms and signs listed above.

Treatment(s) can include:

• Intervention to mitigate suicidal attempts, possibly with hospitalization
• Family and patient education
• Treatment of secondary disorders like depression
• Psychotherapy if appropriate
• Medication if appropriate: Clozapine, lithium, or antidepressants without reported side effects of suicidal ideation

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If you are in a crisis please call: 1-800-SUICIDE (784-2433) or 1-800-273-TALK (8255)

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