Suicide Risk

This past week, two people with familiar names to us, have apparently taken their lives by suicide. These sad events shock and confuse us. Questions such as “How could she leave her daughter?” in Kate Spade’s case or “How could there be anything wrong in the exciting life led by Anthony Bourdain?”

Of course, we have no idea what was going on in their lives or minds. You might ask the same questions if a loved one or colleague’s suicide has impacted your life. You inevitably ask yourself if you missed warning signs, should you have done more and suffer deeply because you would give anything to change the outcome.

Suicides in the public eye do bring the subject into the open which can have a beneficial effects. This is particularly important because the suicide rate has increased 25% in the past decade. Suicide rates for women are rising faster than those for men particularly in the 45 to 64 age range.  Researchers cannot pinpoint any one factor causing this rise but do believe that increased social isolation could be a factor. As people have more online contacts many have fewer close friends or relatives close by.

It is estimated that 50% of deaths by suicide are by people without a mental health diagnosis. This may simply mean that a large number of people are not sharing mental health issues with their primary care doctors or are not seeing a counselor. Or they may not be expressing the depth of their despair if they are receiving care.

The following information on important factors to look out for is provided by the American Foundation for Suicide Prevention (afsp.org).

Something to look out for when concerned that a person may be suicidal is a change in behavior or the presence of entirely new behaviors. This is of sharpest concern if the new or changed behavior is related to a painful event, loss, or change. Most people who take their lives exhibit one or more warning signs, either through what they say or what they do.

If a person talks about:

•Killing themselves

•Feeling hopeless

•Having no reason to live

•Being a burden to others

•Feeling trapped

•Unbearable pain

Behaviors that may signal risk, especially if related to a painful event, loss or change:

•Increased use of alcohol or drugs

•Looking for a way to end their lives, such as searching online for methods

•Withdrawing from activities

•Isolating from family and friends

•Sleeping too much or too little

•Visiting or calling people to say goodbye

•Giving away prized possessions

•Aggression

•Fatigue

People who are considering suicide often display one or more of the following moods:

•Depression

•Anxiety

•Loss of interest

•Irritability

•Humiliation/Shame

•Agitation/Anger

•Relief/Sudden Improvement

•Feeling trapped

•Unbearable pain

People may be experiencing  one of the following mental health conditions:

◦Depression

◦Substance use problems

◦Bipolar disorder

◦Schizophrenia

◦Personality traits of aggression, mood changes and poor relationships

◦Conduct disorder

◦Anxiety disorders

•Serious physical health conditions including pain

•Traumatic brain injury

•Access to lethal means including firearms and drugs

•Prolonged stress, such as harassment, bullying, relationship problems or unemployment

•Stressful life events, like rejection, divorce, financial crisis, other life transitions or loss

•Exposure to another person’s suicide, or to graphic or sensationalized accounts of suicide

•Previous suicide attempts

•Family history of suicide

•Childhood abuse, neglect or trauma

If the above information speaks to you or someone you know do reach out for help.

The National Suicide Prevention Lifeline is available 24 hour a day (1 800 273 8255, 1 800 273 TALK).

If you have serious concerns about suicidal ideation or the chance of suicide call 911 or take your loved one to the nearest emergency room. Sometimes hospitalization will be required to stabilize mood.

More men than women die by suicide partly because men tend to use more lethal methods, particularly firearms. Removing any weapons from the house is an important step that might avert a suicide.

Two excellent books written by people who have experienced major depression are

An Unquiet Mind: A Memoir of Moods and Madness

by Kay Redfield Jamison and

Darkness Visible: A Memoir of Madness

by William Styron.