25.08.2011
Suicide 101
In the United Sates, over 34,000 people die by suicide every year, making suicide the 11th leading cause of death. Every day, approximately 95 Americans take their own life, and 2,370 more attempt to do so. This means that a person dies by suicide about every 15 minutes. Firearms are the most frequent method of suicide among adults.
In youth, suicide is the second leading cause of death among college students and the third leading cause of death among individuals 15–24 years old. Interestingly, studies indicate that youth suicide rates vary widely among different racial and ethnic groups. For example, white youth have a suicide rate of 10.3 per 100,000, compared to rates of 6.0 for African-Americans, 7.0 for Hispanics, and 8.5 for Asian-Americans.
Although it is commonly believed that suicide usually happens with no warning, in fact, eight out of ten people who kill themselves give some sort of warning or clue to others. Sometimes they talk as if they are saying goodbye or going away, and may arrange to put their affairs in order. Other signs of contemplating suicide include giving away articles they value, paying off debts or changing a will. People who talk about wanting to die are often considered “attention-seeking.” However, more than 70% of people who kill themselves have either previously threatened or actively attempted to do so.
Over 90 percent of people who die by suicide had at least one psychiatric illness at the time of death. The most common diagnoses are depression and drug and/or alcohol abuse. Alcoholism is a factor in about 30 percent of all suicide deaths. In addition, certain personality disorders, such as borderline and antisocial personality disorders, appear to carry high risk for suicide. Impulsivity also appears to be a risk factor for suicide. Thus, early recognition and treatment of depression and other psychiatric illnesses appears to be the best way to prevent suicide.
Any suicide attempt should be treated as though the person intended to die and should be taken seriously. Certain warning signs can accompany suicide such as preoccupation with death or dying; drastic changes in behavior and personality; a recent severe loss (such as a relationship); loss of interest in personal appearance; increased use of drugs or alcohol; and/or uncharacteristic risk-taking or recklessness. Recently, attention has been drawn to the fact that some people become suicidal after beginning antidepressant medication. In addition, there have been instances in which people that are coming out of a deep depression sometimes begin to feel better, get energy, and then attempt suicide. As with any significant mental disorder, people with depression must be monitored closely by professionals that have experience in the signs and symptoms of depression.
Risk assessment for suicidal thoughts and behaviors performed by mental-health professionals often involves an evaluation of the presence, severity, and duration of suicidal thoughts and feelings in the individuals they treat as part of a comprehensive evaluation of the person’s mental health. Therefore, in addition to asking questions about family mental-health history and about the symptoms of a variety of emotional problems (for example, anxiety, depression, mood swings, bizarre thoughts, substance abuse, eating disorders, and any history of being traumatized), practitioners frequently ask about any past or present suicidal thoughts, dreams, intent, and plans. If the individual has ever attempted suicide, information about the circumstances surrounding the attempt, as well as the level of dangerousness of the method and the outcome of the attempt, may be explored. Any other history of violent behavior might be evaluated. The person’s current circumstances, like recent stressors (for example, end of a relationship, family problems), sources of support, and accessibility of weapons are often probed. What treatment the person may be receiving and how he or she has responded to treatment recently and in the past, are other issues mental-health professionals tend to explore during an evaluation.
In the effort to cope with suicidal thoughts, silence is the enemy. Suggestions for helping people survive suicidal thinking include engaging the help of a mental health professional or by immediately calling a suicide hotline or going to the closest emergency room or mental-health crisis center. In order to prevent acting on thoughts of suicide, it is often suggested that individuals who have experienced suicidal thinking keep a written or mental list of people to call in the event that suicidal thoughts come back. Other strategies include having someone hold all medications to prevent overdose, removing knives, guns, and other weapons from the home, scheduling stress-relieving activities every day, getting together with others to prevent isolation, writing down feelings, including positive ones, and avoiding the use of alcohol or other drugs.
Treatment of suicidal thinking or attempts involves adapting immediate treatment to the sufferer’s individual needs. Those with a strong social support system, who have a history of being hopeful and have a desire to resolve conflicts, may need only a brief crisis-oriented intervention. Those with more severe symptoms or less social support may need hospitalization and/or long-term outpatient mental health services. Treatment of underlying emotional problems, using a combination of psychotherapy, safety planning, and medication remains the best approach to preventing suicide. For information, evaluation, or treatment contact Chrysalis Health.
