Over 36,000 people in the United States die by suicide every year, making it the country's 10th leading cause of death. More frighteningly, over one million people every year attempt suicide. While women are three times more likely to attempt suicide, men are over five times more likely to die from suicide. People aged 45-54 are the group that most often dies from suicide.
Nine out of every ten people who commit suicide will have a diagnosable and treatable psychiatric illness at the time of their death, such as bipolar disorder, major depression, or schizophrenia. Other risk factors include abuse of drugs or alcohol (especially when combined with depression), post-traumatic stress disorder, bulimia/anorexia, and personality disorders such as antisocial personality disorder and borderline personality disorder. People who have previously tried and failed to commit suicide are also at greater risk for a second successful attempt.
Most people who are at risk of attempting suicide have warning signs that can help identify someone at risk. In addition to the signs of serious depression (desperation, anxiety, unremitting low mood, hopelessness, sleep problems and withdrawal), people at risk may display increased alcohol and drug use, recent impulsiveness and unnecessary risk taking, expressing a death wish, and making a plan for their death, such as purchasing a gun or lethal medications, and giving away their possessions.
The emotional signs that usually precede suicide are often recognizable and treatable. Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is rather expressed as a loss of pleasure or withdrawal from activities that had been enjoyable. One can help prevent suicide through early recognition and treatment of depression and other psychiatric illnesses.
Recognizing the risk factors is essential to helping someone who may be at risk, as 50%-75% of all suicidal people give warnings and make their intentions clear to a friend or family member. Listening to what the person has to say is essential. Let the person know that you care about them and that they are not alone and help is available. Offer to take them to a treatment facility or a reputable therapist or psychiatrist. If someone is in an acute suicidal crisis and saying they have plans to harm themselves at the current moment, never leave them alone. Remove all guns, knives, or potentially harmful medications from the vicinity, or transport them to a safe place. Take the person to an emergency department of a hospital, call 911, or or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
The following are some of the symptoms you might notice in yourself or a friend that may be reason for concern:
- Feelings of hopelessness or worthlessness, depressed mood, poor self esteem or guilt
- Not wanting to participate in family or social activities
- Changes in sleeping and eating patterns: too much or too little
- Feelings of anger, rage, need for revenge
- Feeling exhausted most of the time
- Trouble with concentration, problems academically or socially in school
- Feeling listless, irritable
- Regular and frequent crying
- Not taking care of yourself
- Reckless, impulsive behaviors
- Frequent physical symptoms such as headaches or stomach aches
What are some of the risk factors for suicide?
Risk factors vary with age, gender, or ethnic group. They may occur in combination or change over time. Some important risk factors are:
- Depression and other mental disorders, substance-abuse disorder (often in combination with other mental disorders)
- Prior suicide attempt
- Family history of suicide
- Family violence including physical or sexual abuse
- Firearms in the home
- Incarceration
- Exposure to suicidal behavior of others, such as family members or peers
However, it is important to note that many people who have these risk factors, are not suicidal.
Ninety percent of people who attempt suicide are depressed. Symptoms of major depression can be subtle, but identifying them in yourself or others is paramount to preventing suicide.
If you feel depressed, please consult with your doctor, therapist, or psychiatrist.
Effective suicide prevention is based on sound research. Programs that work take into account people’s risk factors and promote interventions that are appropriate to specific groups of people. For example, research has shown that mental and substance abuse disorders are risk factors for suicide.Therefore, many programs focus on treating these disorders in addition to addressing suicide risk specifically.
Medications
Some medications may help with suicide prevention. For example, the antipsychotic medication clozapine is approved by the U.S. Food and Drug Administration for suicide prevention in people with schizophrenia. Other promising medications and psychosocial treatments for suicidal people are being tested.
Still other research has found that many older adults and women who die by suicide saw their primary care providers in the year before death.Training doctors to recognize signs that a person may be considering suicide may help prevent even more suicides.
Therapies
Psychotherapy, or “talk therapy,” can effectively reduce suicide risk. One type is called cognitive behavioral therapy (CBT). CBT can help people learn new ways of dealing with stressful experiences by training them to consider alternative actions when thoughts of suicide arise.
Another type of psychotherapy called dialectical behavior therapy (DBT) has been shown to reduce the rate of suicide among people with borderline personality disorder, a serious mental illness characterized by unstable moods, relationships, self-image, and behavior.A therapist trained in DBT helps a person recognize when his or her feelings or actions are disruptive or unhealthy, and teaches the skills needed to deal better with upsetting situations.
Suicide does not discriminate. People of all genders, ages, and ethnicities are at risk for suicide. But people most at risk tend to share certain characteristics.The main risk factors for suicide are:
- Depression, other mental disorders, or substance abuse disorder
- A prior suicide attempt
- Family history of a mental disorder or substance abuse
- Family history of suicide
- Family violence, including physical or sexual abuse
- Having guns or other firearms in the home
- Incarceration, being in prison or jail
- Being exposed to others’ suicidal behavior, such as that of family members, peers, or media figures.
The risk for suicidal behavior also is associated with changes in brain chemicals called neurotransmitters, including serotonin, which is also associated with depression. Lower levels of serotonin have been found in the brains of people with a history of suicide attempts.
Many people have some of these risk factors but do not attempt suicide. Suicide is not a normal response to stress. It is however, a sign of extreme distress, not a harmless bid for attention.
Talk to Someone. You are not alone. Contact any of the following if you need help with suicide prevention:
- A community mental health agency
- A school counselor or psychologist
- A suicide prevention/crisis intervention center
- A private therapist
- A family physician
- A religious/spiritual leader
What should I do if someone I know is considering suicide?
If you know someone who is considering suicide, do not leave him or her alone.Try to get your loved one to seek immediate help from his or her doctor or the nearest hospital emergency room, or call 911. Remove any access he or she may have to firearms or other potential tools for suicide, including medications.
If you know someone whom you think may be suicidal, show that you care by:
- Listening to them with sincere concern for their feelings. Do not offer advice, but let them know that they are not alone.
- Sharing your feelings with them. If you feel that they may make a reckless decision, tell them that you are concerned. They need to know that they are important to you and that you care.
- Inquiring if they have had suicidal thoughts or if they have made a suicide plan in a straightforward and caring manner. If you feel you cannot ask the question, find someone who can.
Help is available anytime, anywhere.The National Suicide Prevention Lifeline is a free and confidential service for those who are seeking help when they feel like there is nowhere to turn. 1-800-273-TALK (8255) can be dialed toll free from anywhere in the United States 24 hours a day, 7 days a week. Trained crisis center
staff are available to listen to your needs and offer:
- Crisis counseling.
- Suicide intervention.
- Mental health referral information.
The Suicide Prevention Resource Center offers an entire library of the most recent resources available for suicide prevention, available at:
What to do if someone you know exhibits warning signs of suicide:
- Do not leave the person alone
- Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt
- Call the U.S. National Suicide Prevention Lifeline at 1-800-273-TALK (8255), a free, 24/7 service that can provide suicidal persons or those around them with support, information and local resources
- Take the person to an emergency room or seek help from a medical or mental health professional
When someone ends their life by suicide, the pain in their life may be over, but the surviving friends and family of the victim will have to life with the aftermath forever. The group SAVE (Suicide Awareness Voices of Education) offers resources for the surviving families and friends of suicide victims, available at:
