A SUICIDE CAN HURT HIMSELF AND OTHER PEOPLE, YOU CAN PREVENT IT.

“A person commits suicide every 40 seconds, according to the WHO”, and that is why we

return to the importance in this document of making known concepts and statistics that the

World Health Organization contributes to understanding the social problem of suicide. In

addition, it is worth mentioning that the concept of suicide, the stages of suicide, the factors

that increase suicidal behavior, what happens in the brain of the suicide, what happens

with the family of the suicide? and cyberbullying in children and adolescents, which allows

us to understand and identify suicidal behaviors, and also offers effective strategies on how

to prevent the subject from harming himself and those around him "

Keywords: Suicide, brain, family, risk factors and effective prevention strategies.

Suicide
According to the World Health Organization (WHO), suicide is one of the
most important factors of morbidity in young people: it occupies the second
cause of death in the world. Life expectancy in this population has been
reduced by this aspect. It is being seen as catastrophic and difficulties in
coping and problem solving are believed to be some of the most relevant
factors. Therefore, according to current studies, most of it is considered a
public health problem that is preventable if timely and timely interventions are
made with multisectoral and comprehensive strategies. Suicidal ideation and
attempts are more frequent in the female population and completed suicide in
the male population.
Since the phenomenon is increasingly present in young people, studies have
focused on this population, as is the case of research carried out on university
students in Australia, where a 52% frequency of suicide attempts was found.
Similarly, in research conducted with 165 young people with an average age
of 20 to 23 years from a Portuguese university, it was determined that age and
depression were directly related to suicide risk. In Taiwan, the profile of
multiple suicide attempts occurred in women between 25 and 44 years of age,
being associated with continuous contact with Mental Health services.

The number of people around the world dying by suicide is declining, but still
one person commits suicide every 40 seconds, according to new figures from
the World Health Organization, which has urged countries to do more to stop
these deaths. preventable deaths.
Between 2010 and 2016, the global suicide rate fell by 9.8%, the UN health
body said in its second report on the subject. The only region that saw an
increase was the Americas.
"Each death is a tragedy for family, friends and colleagues. However, suicides
can be prevented. We call on all countries to steadily incorporate proven
strategies for prevention into their national health and training programmes. of
suicide," said WHO Director-General Dr Tedros Adhanom Ghebreyesus.
The WHO said nearly 800,000 people die by suicide each year, more than die
from malaria, breast cancer or from war or homicide, calling it a "serious
global public health problem." The UN body said only 38 countries have
suicide prevention strategies.
Suicide rates were higher than the age-standardized global average (10.5 per
100,000 people) in Africa, Europe, and Southeast Asia.
Worldwide, more men than women have committed suicide, the WHO said,
with 7.5 suicide deaths per 100,000 women and 13.7 suicides per 100,000
men. The only countries where the suicide rate was estimated to be higher in
women than in men were Bangladesh, China, Lesotho, Morocco and
Myanmar.
"Almost three times as many men as women die by suicide in high-income
countries, in contrast to low- and middle-income countries, where the rate is
more equal," the WHO statement said.
"Suicide was the second leading cause of death among young men aged 15 to
29, after traffic accidents. In adolescent girls aged 15 to 19, suicide is the
second leading cause of death (after maternal conditions). ) and the third
among children (after traffic accidents and interpersonal violence)," added the
WHO.

The organization said one way to reduce the global suicide rate would be to
limit access to pesticides, which, along with hanging and firearms, are the
most common methods people use to commit suicide. For example, in Sri
Lanka, a series of bans on highly dangerous pesticides led to a 70% decrease
in suicides, saving an estimated 93,000 lives between 1995 and 2015.
Similarly, in South Korea, the ban on the herbicide paraquat it was followed
by a 50% decrease in suicide deaths from pesticide poisoning between 2011
and 2013.

"A more recent case of deaths was the massacre in the state of Texas in the
United States of 19 children and 2 teachers in a school classroom,
perpetrated by a young man with possible mental health problems, who was
not identified or treated. on time by the authorities in charge of health. In this
case you can see a subject who possibly did not want to live anymore, nor did
he want 21 people to live. So the risk factor was the lack of health care and
deliberate sale of firearms without any control. The question is, how do I
identify suicidal behavior and how to prevent more deaths from this mental
health problem?"

Thus, it is recommended that the person knows and identifies what suicidal
behavior is, the stages of suicide, the factors that increase suicidal behavior,
and the external events that influence the subject to take such a decision to
take his own life or of taking other people's lives. These concepts are listed
below in this document. It should be noted that, if the person observes strange
behaviors, or changes in behavior in the subject, which are not normal, the
health and police authorities must be notified, so that they take charge of the
case. (This action helps prevent deaths.)
Likewise, to know the physical and psychological conditions of the subject,
such as: Subject with psychiatric pathology, terminal illness, sentimental,
economic, school, violence, bullying, discrimination, loss of a loved one,
consumption of intoxicating drinks, consumption of psychoactive substances,
due to a history of suicide, and displacement, among others; It is very
important, since these are some of the characteristics for a possible suicidal
behavior and one must be alert.

MITIGATE RISK FACTORS.

"Collect all the elements that can be useful to the subject to harm himself or
others, such as: Poisons, substances with high contractions of acids such as
chlorine, disinfectants, pesticides, medical control medications, ropes, blades,
knives. , machetes and firearms; all these elements must be kept in a safe and
locked place by a responsible and sane person, so that this person is the one
who handles said elements, if it is the case of a possible suicidal behavior at
home. firearms must also be left unloaded and ammunition in another safe
and locked place”.

Another important action is that if there is a patient with a psychiatric

pathology, they must have support from a family member or caregiver, who is
in charge of managing and accompanying the subject to psychiatric medical
check-ups; In addition to this, he must handle the medications and deliver only
the dose recommended by the health professional, to the patient who is going
to take the medication and verify that he takes it, because in some cases, the
patient retains it under the tongue and then vote the drug; causing this
psychiatric or disruptive behaviors that can trigger suicidal acts and danger to
those around him.

Activating the health care route in the case that warrants it is of vital
importance. I reiterate again to activate the care route, it could be done as
follows: Transfer the patient or subject to the nearest health center or hospital,
in cases of emergency call or notify the police and entities in charge of health
such as doctors, psychologists or psychiatrists.

Another important point referred to by the WHO to help reduce suicides. It's
that the media must be educated on how to provide responsible reporting on
suicide, identify people at risk early, and help young people develop skills to
help them cope with the stresses of life.

Victims of cyberbullying
Although the reasons why American children and adolescents are having more
episodes of suicidal ideation or suicide attempts are not clear, experts agree
that it may be due to the proliferation of social networks and cyberbullying,
which degenerate into anxiety and depression.
Suicidal ideation
Suicidal ideation is the initial phase of the suicidal process, or thoughts about
the will to take one's life, with or without planning or method. The suicidal
threat is considered the verbal or non-verbal expression, which shows the
possibility of suicidal behavior in the near future.
In this case, it is important to keep in mind that the health professional must
explore and try to find out what was the reason why the suicidal thought was
generated, in order to mitigate or control the risk factors that are occurring. in
the patient and if the case is meritorious, activate the care route and refer him
to the specialist in this case to psychiatry.

Passive suicidal ideation

There are two types of suicidal ideation: passive and active. Passive suicidal
ideation occurs when you wish you were dead or could die, but you don't
really have plans to kill yourself. You just want to stop feeling pain because of
the crisis you are going through.

Active suicidal ideation

It is the desire and act of attempting against one's own life, to cause death.
Likewise, for this case, it is important to take into account that the health
professional must explore and try to find out what was the reason for which
the suicidal thought was generated, in order to mitigate or control the risk
factors that occur. are presenting in the patient and if the case merits, activate
the care route and refer him to the specialist in this case to psychiatry.

Suicidal self harm

Suicidal self-harm is the act of deliberately harming one's own body, such as
cutting or burning oneself, among others, to deal with emotional pain, intense
anger, and frustration.
In general, self-harm can be the result of the following factors: Poor ability to
cope with challenges or situations. Nonsuicidal self-injury is usually the result
of an inability to deal with psychological pain in a healthy way and difficulty
controlling emotions.

Psychological pain.
According to Schneidman in the context of the suicide theory. For this author,
DP is caused by frustrated essential needs in the individual, for example, to be
loved, to have control, to protect one's own image, to avoid shame, to feel
safe, to feel known. Without their satisfaction the subject could not continue to
live. The frustration of those needs causes a series of emotions such as guilt,
shame, defeat, humiliation, disgrace, pain, hopelessness and anger. When the
pain reaches a high intensity and when he believes that his future cannot be
changed or transformed, the suicidal person seeks to escape from that pain by
committing suicide.

Parasuicidal behaviors
Parasuicidal behavior is when the person inflicts injuries on himself, often
with the sole intention of harming himself and not going any further (no clear
intent to kill). In many cases they are considered a wake-up call with
manipulative intent.

Suicide attempt
Attempted suicide is defined as a suicidal act whose result did not involve
death. Suicidal behavior is a complex behavior caused by a combination of
factors (psychiatric disorders, genetic, biological, family and sociocultural
factors).

Completed suicide.
Consummated Suicide: Intentional act of self-harm resulting in death.

The brain of a suicidal person

According to Ana G. Gutiérrez García, Carlos M. Contreras, 2008. Suicide is
a complex and multifactorial phenomenon. Although several of the risk
factors have already been identified, the neurobiological bases of suicide have
not been fully clarified, although they have focused particularly on the
dysfunction of the serotonergic system. Early studies indicated that reduced
levels of hydroxyindole-acetic acid, the major metabolite of serotonin, are
found in cerebrospinal fluid in subjects with suicide attempts.

Through studies with positron emission tomography, it was determined that in

subjects with suicide attempts there is a hypofunctionality of the ventromedial
prefrontal cortex, which has been associated with impulsivity and planning to
attempt suicide.
Brain structures that integrate the affective state, emotional memory,
impulsiveness and decision-making participate in suicide.

What about the family of a suicide?

Families in which a suicide has occurred are exposed to a greater probability
of breakdown, disorganization and pathological expressions in their members.
Make a reduced narrative review, circumscribed and restricted to the
relationship between suicide and the elaboration of mourning in the family.

Likewise, the health professional must approach the family, and identify
which are the most affected people and which of these require specialized
attention, and activate the care route of completed suicide, so that said suicidal
behavior is not repeated. caused by the crisis. It is worth mentioning that
public health professionals provide support for coping with grief to the
relatives of the deceased person. In addition, explore whether risk factors and
mechanisms or elements persist at home that serve for the suicidal act such as
firearms, poisons, ropes, blades, medications, psychoactive drugs, acids,
among others, to try to control them. Another aspect to take into account for
suicidal behavior is depression and anxiety.

Anxiety symptoms.
• Feeling nervous, agitated, or tense.
• Sensation of imminent danger, panic or catastrophe.
• Increased heart rate.
• Fast breathing (hyperventilation)
• Sweating.
• Tremors.
• Feeling weak or tired.
• Trouble concentrating or thinking about anything other than the current
concern.

Symptoms of depression
Mood: loss of interest or pleasure in activities, emotional ups and downs,
anxiety, apathy, guilt, general discontent, hopelessness, loss of interest, or
sadness
Behavior: agitation, social isolation, irritability, or excessive crying
Sleep: early awakening, insomnia, excessive sleepiness, or restless sleep
Whole body: fatigue, excessive hunger, or loss of appetite
Cognitive: slowness to perform activities, lack of concentration or thoughts of
suicide

Weight: weight gain or weight loss

Also common: repeated analysis of thoughts or poor appetite.

Risk factors for suicidal behavior

Is depression and anxiety the only risk factor for suicide? Are there any
experiences in the subject's life that put him or her at greater risk for suicidal
behavior? Although some of these risk factors cannot be changed, it is
important to know that they can increase the chance of a suicide attempt.
Some of the main risk factors that can increase the risk of suicide in children
and adolescents are:

• Family history of depression or suicide

• Psychological disorder, especially depression, bipolar disorder and/or
alcohol and drug abuse disorder
• Previous suicide attempt
• Access to a firearm
• Stressful life events or losses and lack of family support
• Serious medical condition and/or severe pain
• Concerns about sexual identity
• History of abuse or having suffered severe harassment.
• Impulsive behavior.
• Grief or loss of a loved one
• Bullying (eg, cyber bullying, social rejection, discrimination, humiliation,
ridicule).
• Depression (especially when accompanied by anxiety, as part of bipolar
disorder or associated with recent hospitalization) and other mental disorders
• Drug or alcohol use disorders
• Feelings of sadness or hopelessness (when they persist).
• Financial stress due to economic downturns, debt or underemployment
• Person living alone
• Medical illness, particularly one that is painful or disabling or that affects the
brain
• Relationship conflict
• Suicide, including current concern about suicide, having well-defined plans
for suicide, family history of suicide, and/or previous suicide attempts
• Traumatic childhood experiences, including physical or sexual abuse
• Breaks in work (for example, unemployment) and transition periods (for
example, moving from active duty to veteran status, retirement.
 Bibliographic references

Retrieved from https://www.scielo.cl/scielo.php?

script=sci_arttext&pid=S0717-92272019000200176

Retrieved https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0211-
57352002000400004

Retrieved from https://www.scielo.cl/scielo.php?

script=sci_arttext&pid=S0719-15292019000200028

Retrieved https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-
76322018000400014

Retrieved https://cnnespanol.cnn.com/2019/09/09/una-persona-se-suicida-
cada-40-seconds-according-to-oms/

Retrieved from
https://www.cincinnatichildrens.org/espanol/temas-de-salud/alpha/d/
depression-suicide

Retrieved https://www.msdmanuals.com/es-co/hogar/trastornos-de-la-salud-
mental/conducta-suicida-y-autolesiva/conducta-suicida#:~:text=Suicidio
%20consumado%3A% 20intentionally%20self-injurious%20act, to
%20injuries%2C%20but%20not%20necessarily.

Retrieved from http://www.scielo.org.mx/scielo.php?

script=sci_arttext&pid=S0185-33252008000400009#:~:text=Por%20medio
%20de%20estudios%20con,la%20planaci%C3%B3n%20para% 20attempt
%20to commit suicide.

Retrieved https://www.fundacioncadah.org/web/articulo/psicoeducacion-base-
en-el-tratamiento-del-trastorno-por-deficit-de-attencion-e-hiperactivity.html

Retrieved https://www.unir.net/educacion/revista/psicoeducacion/