Sep
24
2022

When is Someone at Risk for Suicide?

We are asking ourselves: When is someone at risk for suicide? This year’s National Suicide Week was from Sept. 4 through 10, 2022. Every day of each year it is important to be aware of signs and symptoms of impending suicide. However, the purpose of the yearly National Suicide Week is to really bring it to everyone’s attention how common deaths by suicides are. We all can contribute to improve the situation by increasing our awareness.

Some suicide statistics

In the US alone nearly 46,000 persons died by suicide in 2020. This means that there is one death by suicide every 11 minutes. In 2020 nearly 800,000 died by suicide worldwide. About 1.2 million attempted it. The hope is that the public will learn through education to recognize the signs of an impending suicide. This way the suicidal person can get counselling and hopefully not commit suicide.

Abnormal behaviors to watch out for  

People who are getting suicidal may practice with guns, overdosing with pills or handle potentially lethal items. Other behavioral red flags could be giving away cherished items. The suicidal person may sleep too much or not enough. Isolation or withdrawal may be another pointer in a previously sociable person that he or she is becoming suicidal. Revenge thinking, reckless driving, agitation can all be pointers as well that the person is preparing for suicide. Justin Baker is the clinical director of The Suicide and Trauma Reduction Initiative for Veterans at The Ohio State University Wexner Medical Center. He said: ”A lot of times people need to kind of work up to that actual making an attempt because it’s a biologic thing you have to go against, your own survival”.

Watch what people say

When people become suicidal their words often indicate what they want to do. It is a warning sign, if someone is talking about wanting to die, by suicide or otherwise. Some people state that they feel like they have no reason to live. This is an alarm signal that they may be suicidal. Some people say that they feel like they are a burden for the people living around them. Other problematic statements are: “You don’t need me for this anymore” or “I feel like it’d be better if I just wasn’t here.” Someone uttering statements like these should get counseling. This allows them to vent their feelings and to reassess their situation.

Suicide risk factors

Hopelessness: People may express that they feel the future won’t be any better. Or they do not see a way out of the pain that they are in.

Obsession with death and dying: Some people ruminate about dying and they develop a plan what they may want to do to themselves.  

Extreme mood swings: When somebody who usually is depressed and stressed behaves calm or cheery, this is an alarm sign that the person may be suicidal. They may have struggled with their decision to kill themselves, but when they accepted that this is what they want to do it calms their mind.

Past trauma: Abuse, trauma and neglect in the past are risk factors for suicide in the future.

Drug abuse: substance abuse predisposes a person towards being suicidal later on in life.

More suicide risk factors

Severe chronic illness with chronic pain: when a person has a chronic illness, and it is difficult to treat, people lose hope and they feel trapped. At this point suicide appears to be an option.

Mental disorders: people with schizophrenia, anxiety, depression or personality disorders are at a higher risk to turn suicidal. This is particularly so when they did not receive treatment and their mental condition deteriorates.

Family history, other factors and teen suicides

Family history of suicide: when there is a family history of suicide or a personal history of failed attempt of suicides the risk of suicide is much bigger than in the general population.

Other factors: There are many more factors that all can have a bearing on the risk for suicide. Financial loss and loss of a job are examples, but also prolonged stress from bullying or harassment. Divorce, breakup of a relationship, insufficient social support and many other negative emotions can contribute to a risk for suicide as well. A lot depends on the emotional make-up and the resilience of a person.

Teens: Teens are particularly vulnerable to commit suicide. It is important to listen to the teen in trouble and to arrange for counseling and support. More on teen suicide here.

What to do when faced with a person who contemplates suicide?

There are several crisis phones that are important to remember. In 2019 congress in the US has proposed to establish crisis lines with a simple 3-digit number: 988. But not all states have this number activated yet. The national crisis line in the US is: 1-800-273-TALK (1-800-273-8255).

In Canada the crisis hotline is: 1-833-456-4566.

There are counselors who have experience in listening to people in distress and talk to them.

When a person wants to commit suicide call 911. Sometimes a person in mental distress needs to be hospitalized and treated by a psychiatrist. Some people may benefit from electroconvulsive therapy, others from antidepressants. Cognitive therapy and behavioral therapy have a place as well in treating depressed patients. Close follow-up is important to prevent a relapse.

When is Someone at Risk for Suicide?

When is Someone at Risk for Suicide?

Conclusion

This year’s National Suicide Week was from Sept. 4 through 10, 2022. In the US alone nearly 46,000 persons died by suicide in 2020, nearly 800,000 died by suicide worldwide. It is important to recognize the signs of impending suicide. There are several high-risk factors that point to impending suicide, such as hopelessness, obsession with death and dying and extreme mood swings. There are certain constellations that are associated with a high risk for suicide: a history of a mental disorder, a break-up of a relationship, a severe illness with chronic pain and others. It is important to get the person at risk to a counselor or psychiatrist.

Treatment intervention for suicidal person

By talking it out, the pain of suffering gets eased. If there is an underlying depression it can be treated with various treatment modalities. Cognitive behavior therapy may help to change the negative thought patterns. It is important to intervene early. Close follow-up to prevent a relapse is also important.

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Sep
19
2021

World Suicide Prevention Day is on September 10

A CNN article points out that world suicide prevention day is on September 10.

Some statistics regarding suicides

According to the WHO more than 700,000 People die from suicide every year.

In the US suicide rates have risen between 1999 and 2018. President Joe Biden stated: “In 2019, suicide was the 10th leading cause of death in the United States, and the second leading cause of death for young people between the ages of 10 and 34.”

This was further underlined by a study from the CDC. It pointed out the emergency room visits started to climb in May 2020 for attempted suicide in youth. The CDC stated: “The mean weekly number of these visits was 26.2% higher during summer 2020 and 50.6% higher during winter 2021 compared with the corresponding periods in 2019”.

Triggering factors that make people commit suicide

Suicidal thoughts start when a vulnerable person encounters stressful events. The life situation can become so painful that in their way of thinking suicide is the only way to stop the pain. There are huge differences of opinions: what may be meaningless to one person, may feel devastating to another.

Common triggering factors are as follows.

  • Illness and physical discomfort
  • Conflicts with family or friends
  • Illness of family members
  • Death of family member or friend
  • Loneliness

In a study 50% expressed two of these 5 triggers, 37.5% expressed one of the 5 triggers. 12.5% expressed three of the 5 triggers.

With the Covid-19 epidemic there are new pressures on people. They cannot freely move around or travel. He/she may have lost a friend or relative to Covid. And people may be anxious about their own survival. I described this here before.

Biochemical changes in the brain with depression

In the past low serotonin levels in the brain were thought to be the main cause of depression. But researchers realized later those medications that increased serotonin levels did not always help depression. They found that dopamine and norepinephrine are also important brain transmitters that play a role in depression. When dopamine levels are low, depression occurs. Similarly, when norepinephrine is low, the patient can develop depression. On the other hand, in bipolar disorder the brain produces too much norepinephrine, which causes manic episodes. https://www.verywellmind.com/the-chemistry-of-depression-1065137 The physician needs to take a thorough history and note from that which brain transmitter system would be mainly affected. This helps the physician later to decide which antidepressant to choose from to rebalance the brain transmitters.

How to detect stress signals

There are a number of risk factors, which the CDC has outlined, for which the health professional or a family member wants to look in order to assess the suicide risk.

Does the patient have a history?

People with a mood or anxiety disorder, or with an alcohol or substance abuse disorder are at a higher risk of developing depression and suicide.

Did the person experience a loss?

A loss can be a death in the family, a loss of a job or the loss of an important person in a relationship. This is particularly bad when there is social isolation and a lack of support. With Covid-19 millions of people have suffered the loss of a job, social isolation and having to quarantine.

Is it easy for the distressed person to get a gun?

Firearms are a common means for people to kill themselves. When there is easy access to a gun, there is a high probability that the person uses it in times of distress.

History of previous suicide attempt

When a person attempted to commit suicide, but failed, there is a higher risk for them to repeat a suicide attempt and succeed. Also, there is a copycat phenomenon when the news comes out that a famous personality committed suicide. For instance, when the comedian Robin Williams committed suicide in 2014 there was a 10% rise in suicides in the following months all over the US.

Belief system that honours personal sacrifice

Some religious or cultural groups consider suicide a noble solution to a personal dilemma.

A person from this background is at a much higher risk to commit suicide.

Warning signs of pending suicide attempt

There are a number warning signs that point to a higher risk of possibly planning suicide.

  • A person may talk about wanting to die or kill themselves.
  • Searching online for ways to kill oneself or buying a gun.
  • Feeling trapped or feeling unbearable pain.
  • Talking about feeling hopeless and having no reason to live.
  • Stating that they feel they are a burden to others.
  • Drinking more alcohol and using more drugs.
  • Acting agitated or anxious. Reckless behavior.
  • A person withdrawing or isolating themselves.
  • A person sleeping too much or too little.
  • Extreme mood swings.
  • Talking about seeking revenge or showing rage.

These are all red flags that should alarm you to ask for help. Not all of these alarm signs are present all the time with people who are considering to attempt suicide. When you have suicidal thoughts in the US, call the National Suicide Prevention Lifeline at 800-273-8255. For Spanish crisis support call: 888-628-9454.

World Suicide Prevention Day is on September 10

World Suicide Prevention Day is on September 10

Conclusion

World suicide prevention day is on September 10. This reminds us every year that suicide is a colossal problem of society. Stress, loss of health, losing a loved one, a broken marriage and financial loss can all contribute to depression. If patients with mental distress do not receive timely intervention and treatment, the life situation can become so painful that in the patient’s way of thinking suicide is the only way to stop the pain. The key is for the loved ones in the circle of friends to pay attention to the warning signs and bring the suicidal person to the attention of the psychiatric health professionals. Sometimes an in-patient admission to a psychiatric facility may be required to interrupt the negative thinking pattern. Ignoring the warning signs can have devastating consequences. Prevention is the only way to avoid suicide.