Why Do People Commit Suicide?

Warning Signs of Someone Considering Suicide
Any one of these symptoms does not necessarily mean the person is suicidal, but several of these symptoms may signal a need for help:

• Verbal suicide threats such as, “You’d be better off without me.” or “Maybe I won’t be around.”
• Expressions of hopelessness and helplessness.
• Previous suicide attempts.
• Daring or risk-taking behavior.
• Personality changes.
• Depression.
• Giving away prized possessions.
• Lack of interest in future plans.

Remember: Eight out of ten suicidal persons give some sign of their intentions. People who talk about suicide, threaten to commit suicide, or call suicide crisis centers are 30 times more likely than average to kill themselves.

What To Do If You Think Someone Is Suicidal

• Trust your instincts that the person may be in trouble.
• Talk with the person about your concerns. Communication needs to include LISTENING.
• Ask direct questions without being judgmental. Determine if the person has a specific plan to carry out the suicide. The more detailed the plan, the greater the risk.
• Get professional help, even if the person resists.
• Do not leave the person alone.
• Do not swear to secrecy.
• Do not act shocked or judgmental.
• Do not counsel the person yourself.

The Statistics of Suicide

• Suicide is the eighth leading cause of death in the United States, accounting for more than 1% of all deaths.
• More years of life are lost to suicide than to any other single cause except heart disease and cancer.
• 30,000 Americans commit suicide annually; an additional 500,000 Americans attempt suicide annually.
• The actual ratio of attempts to completed suicides is probably at least 10 to 1.
• 30% to 40% of persons who commit suicide have made a previous attempt.
• The risk of completed suicide is more than 100 times greater than average in the first year after an attempt - 80 times greater for women, 200 times greater for men, 200 times greater for people over 45, and 300 times greater for white men over 65.
• Suicide rates are highest in old age: 20% of the population and 40% of suicide victims are over 60. After age 75, the rate is three times higher than average, and among white men over 80, it is six times higher than average.
• Substance abuse is another great instigator of suicide; it may be involved in half of all cases. About 20% of suicides are alcohol abusers, and the lifetime rate of suicide among alcoholics is at least three or four times the average. Completed suicides are more likely to be men over 45 who are depressed or alcoholic.

Preventing Suicide

Although they may not call prevention centers, suicidal people usually do seek help; for example, nearly three-fourths of all suicide victims visit a doctor in the four months before their deaths, and half in the month before.

Helping a Suicidal Person

No single therapeutic approach is suitable for all suicidal persons or suicidal tendencies. The most common ways to treat underlying illnesses associated with suicide are with medication, talk therapy or a combination of the two.

Cognitive (talk therapy) and behavioral (changing behavior) therapies aim at relieving the despair of suicidal patients by showing them other solutions to their problems and new ways to think about themselves and their world. Behavioral methods, such as training in assertiveness, problem-solving, social skills, and muscle relaxation, may reduce depression, anxiety, and social ineptitude.

Cognitive and behavioral homework assignments are planned in collaboration with the patient and explained as experiments that will be educational even if they fail. The therapist emphasizes that the patient is doing most of the work, because it is especially important for a suicidal person not to see the therapist as necessary for their survival.

Recent research strongly supports the use of medication to treat the underlying depression associated with suicide. Antidepressant medication acts on chemical pathways of the brain related to mood. There are many very effective antidepressants. The two most common types are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). Other new types of antidepressants (e.g. alpha-2 antagonist, selective norepinephrine reuptake inhibitors (SNRIs) and aminoketones), and an older class, monoamine oxidase inhibitors (MAOIs), are also prescribed by some doctors.

Antidepressant medications are not habit-forming. Although some symptoms such as insomnia, often improve within a week or two, it may take three or four weeks before you feel better; the full benefit of medication may require six to eight weeks of treatment. Sometimes changes need to be made in dosage or medication type before improvements are noticed. It is usually recommended that medications be taken for at least four to nine months after the depressive symptoms have improved. People with chronic depression may need to stay on medication to prevent or lessen further episodes.

People taking antidepressants should be monitored by a doctor who knows about treating clinical depression to ensure the best treatment with the fewest side effects. It is also very important that your doctor be informed about all other medicines that are taken, including vitamins and herbal supplements, in order to help avoid dangerous interactions. Alcohol or other drugs can interact negatively with antidepressant medication.

Do not discontinue medication without discussing the decision with your doctor.

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