Introduction

Suicide is an irrational desire to die. We use the term “irrational” here because no matter
how bad a person’s life is, suicide is a permanent solution to what is nearly always a
temporary problem. Suicide’s effects are tragic and felt long after the individual has
taken his or her own life. It is usually the second or third leading cause of death among
teenagers, and remains one of the top ten leading causes of death well into middle age.
A person who dies by suicide leaves behind them a tangled confusion of family
members and friends who try to make sense of a senseless and purposeless act.

Most people who think about suicide, however, never make a “serious” attempt at it
(every attempt, though, is viewed as “serious” by the person making it). For every
attempted suicide, there is thought to be one or more people where the thought of
suicide has never translated into an actual attempt. With over a half a million people
making a suicidal attempt each year, this translates into a huge problem that society
largely ignores or tries to sweep under the rug. Prevention efforts largely target
teenagers, but few professionals feel comfortable dealing with people who are actively
suicidal. In most communities, the health care system also is not well-equipped to deal
with the magnitude of the problem or the specific needs of a person who is suicidal.

Definition

Suicide is the act of killing yourself, most often as a result of depression or other mental
illness. - American psychology associations

the act or an instance of taking one's own life voluntarily and intentionally.
- Merriam Webster
Suicide is the act of intentionally causing one's own death.

-Wikipedia
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Warning signs that someone may attempt suicide

You can’t see what a person is feeling on the inside, so it isn’t always easy to
identify when someone is having suicidal thoughts. However, some outward
warning signs that a person may be contemplating suicide include:

 talking about feeling hopeless, trapped, or alone

 saying they have no reason to go on living
 making a will or giving away personal possessions
 searching for a means of doing personal harm, such as buying a gun
 sleeping too much or too little
  eating too little or eating too much, resulting in significant weight gain or
loss
 engaging in reckless behaviors, including excessive alcohol or drug
consumption
 avoiding social interactions with others
 expressing rage or intentions to seek revenge
 showing signs of extreme anxiousness or agitation
 having dramatic mood swings
 talking about suicide as a way out.

Sign & Symptoms

A person who is experiencing or could experience suicidal thoughts may show

the following signs or symptoms:

 feeling or appearing to feel trapped or hopeless

 feeling intolerable emotional pain
 having or appearing to have an abnormal preoccupation with violence,
dying, or death
 having mood swings, either happy or sad
 talking about revenge, guilt, or shame
 being agitated, or in a heightened state of anxiety
 experiencing changes in personality, routine, or sleeping patterns
 consuming drugs or more alcohol than usual, or starting drinking when
they had not previously done so
 engaging in risky behavior, such as driving carelessly or taking drugs
 getting their affairs in order and giving things away
 getting hold of a gun, medications, or substances that could end a life
 experiencing depression, panic attacks, impaired concentration
 increased isolation
  talking about being a burden to others
 psychomotor agitation, such as pacing around a room, wringing one’s
hands, and removing items of clothing and putting them back on
 saying goodbye to others as if it were the last time
 seeming to be unable to experience pleasurable emotions from
normally pleasurable life events such as eating, exercise, social
interaction, or sex
 severe remorse and self criticism
 talking about suicide or dying, expressing regret about being alive or
ever having been born

A significant number of people with suicidal ideation keep their thoughts and
feelings a secret and show no signs that anything is wrong.

Causes

Suicidal ideation can occur when a person feels they are no longer able to
cope with an overwhelming situation. This could stem from financial problems,
death of a loved on, a broken relationship, or a devastating or debilitating
illness.

The most common situations or life events that might cause suicidal thoughts
are grief, sexual abuse, financial problems, remorse, rejection, a relationship
breakup, and unemployment.

The following risk factors may have an impact on the probability of someone
experiencing suicidal ideation:

 a family history of mental health issues

 a family history of substance abuse
 a family history of violence
 a family history of suicide
 a feeling of hopelessness
  a feeling of seclusion or loneliness
 being gay with no family or home support
 being in trouble with the law
 being under the influence of alcohol or drugs
 for children, having disciplinary, social or school problems
 having a problem with substance abuse
 having a psychiatric disorder or mental illness
 having attempted suicide before
 being prone to reckless or impulsive behavior
 possessing a gun
 sleep deprivation
 knowing, identifying, or being associated with someone who has
committed suicide

Conditions that are linked to a higher risk of suicidal ideation include:

 adjustment disorder
 anorexia nervosa
 bipolar disorder
 body dysmorphic disorder
 borderline personality disorder
 dissociative identity disorder
 gender dysphoria, or gender identity disorder
 major depressive disorder
 panic disorder
 post-traumatic stress disorder (PTSD)
 schizophrenia
 social anxiety disorder
 generalized anxiety disorder
  substance abuse
 exposure to suicidal behavior in others

Genetic factors may increase the risk of suicidal ideation. Individuals with
suicidal thoughts tend to have a family history of suicide or suicidal thoughts.

Risk factors

What increases the risk of suicide?

There’s usually no single reason someone decides to take their own life.
Several factors can increase the risk of suicide, such as having a mental
health disorder.

Depression is the top mental health risk factor, but others include bipolar
disorder, schizophrenia, anxiety disorders, and personality disorders.

Aside from mental health conditions, other factors that increase the risk of
suicide include:

 incarceration
 poor job security or low levels of job satisfaction
 history of being abused or witnessing continuous abuse
 being diagnosed with a serious medical condition, such as cancer or
HIV
 being socially isolated or a victim of bullying or harassment
 substance use disorder
  childhood abuse or trauma
 family history of suicide
 previous suicide attempts
 having a chronic disease
 social loss, such as the loss of a significant relationship
 loss of a job
 access to lethal means, including firearms and drugs
 being exposed to suicide
 difficulty seeking help or support
 lack of access to mental health or substance use treatment
 following belief systems that accept suicide as a solution to personal
problems

Those who have been shown to be at a higher risk for suicide are:

 men
 people over age 45
 Caucasians, American Indians, or Alaskan Natives.

Prevention

Family and friends may notice through a person’s speech or behavior

that they could be at risk.
They can help by talking to the person and by seeking appropriate
support, for example, from a doctor.
The National Institute for Mental Health (NIMH) suggests the following
tips for helping someone who may be going through a crisis:

- Asking them if they are thinking about suicide. Studies show that
asking does not increase the risk.
- Keeping them safe by staying around and removing means of
committing suicide, such as knives, where possible
 - Listening to them and being there for them
- Encouraging them to call a helpline or contacting someone the
individual might turn to for support, for example, a friend, family
member, or spiritual mentor
- Following up with them after the crisis has passed, as this
appears to reduce the risk of a recurrence

Treatment

Talk therapy

Talk therapy, also known as psychotherapy, is one possible treatment method

for lowering your risk of attempting suicide. Cognitive behavioral therapy
(CBT) is a form of talk therapy that’s often used for people who are having
thoughts of suicide.

Its purpose is to teach you how to work through stressful life events and
emotions that may be contributing to your suicidal thoughts and behavior.

A similar technique, called dialectical behavioral therapy (DBT), may also be

used.

Medication

If talk therapy isn’t enough to successfully lower risk, medication may be

prescribed to ease symptoms, such as depression and anxiety. Treating these
symptoms can help reduce or eliminate suicidal thoughts.

One or more of the following types of medication could be prescribed:

 antidepressants
 antipsychotic medications
  anti-anxiety medications

Lifestyle changes

In addition to talk therapy and medication, suicide risk can sometimes be

reduced by simply adopting certain healthy habits. These include:

 Avoiding alcohol and drugs. Staying away from alcohol and drugs is

critical, as these substances can lower inhibitions and may increase the
risk for suicide.
 Exercising regularly. Exercising at least three times per week, especially
outdoors and in moderate sunlight, can also help. Physical activity
stimulates the production of certain brain chemicals that make you feel
happier and more relaxed.
 Sleeping well. It’s also important to get enough quality sleep. Poor sleep
can make many mental health symptoms much worse. Talk to your
healthcare provider if you’re having trouble sleeping.