Depression: A Risk Factor for Suicide

Losing a loved one to suicide is devastating for family, friends, and can reverberate through a community. We wonder if we should have seen the signs and if there was anything that we could have done to help them. In the United States today, suicide is the eleventh most common cause of death. There are currently over 32,000 suicides annually in the USA – nearly twice the number of homicides; that is approximately 91 per day. Men make up 79% of all suicides in the U.S while women and teens make more suicide attempts.

Disappointments and setbacks in life don’t cause people to commit suicide. Ninety percent of all suicides were committed by people suffering from some form of depression or other chronic medical illness. They usually feel hopeless about their problems getting any better. Men are less likely to discuss feelings of depression and more likely to show symptoms of withdrawal from their relationships, work, and social life. The neurobiology of suicide reveals that people who commit suicide have lower levels of the neurotransmitter serotonin, also found to be low in depressed individuals. Depression is a high risk factor for suicide.

Some warning signs to look for:

• Thinking or talking a lot about death
• Symptoms of depression that persist: loss of interest in daily
activities; sadness or feeling of emptiness; trouble sleeping or
eating;fatigue; suicidal thoughts or behavior
• Risk taking behaviors that tempt fate such as driving at high speeds or
running red lights
• Mentioning suicide or the idea of killing one’s self
• Sudden, unexplainable change in mood from sad to calm or happy;
• Settling one’s affairs i.e. changing a will or visiting people to make
amends or say goodbye
• Making comments about being worthless, being tired and not wanting to be
here anymore.
• Feeling trapped, like there is no way out
• If the person has attempted suicide before and has any of the symptoms
mentioned above, they are an even higher risk. According to the American
Foundation for Suicide Prevention, between 20%-50% of people who commit
suicide have had a previous attempt.

What to do if you are worried that someone is suicidal?
Take time to listen to their feelings and concerns. Take them seriously. You don’t have to be able to solve their problems, just showing them that you are interested and care can help them to feel less alone. People are often afraid to talk about suicide directly as if it is going to give the person the idea. Asking a person if they are thinking about killing themselves will not encourage them to do so. If the answer is affirmative, ask them about their plan. If they have a clear and accessible method for killing themselves, they are a greater risk for doing it. For example, if a person says that they will take a certain amount of pill or poison that would be lethal – and they have them in their possession. It is important not to minimize feelings, thoughts, or their intention to commit suicide.

It’s important to be able to talk about suicide with it having a stigma or judgment around it – suicide is really a medical illness that was not treated in time. Survivors of suicide, family and friends who cared about the person are prone to feeling of shock, guilt, anger, and depression. It’s normal to think, ‘what if I did this or that differently?’ People don’t commit suicide because of losing a job, a boyfriend, or because of the way they were parented. Suicide is an illness that takes hold of the brain – to the point where the person is in pain and they see no way out at that moment in time.

People with suicidal thoughts have usually lost hope that anyone can help them so it may be difficult to convince them to get professional help. You may have to accompany them to the emergency room. Therapy and medicines can help most people who have suicidal thoughts - treatment has been found to be very effective in reducing symptoms of depression and helping improve coping and resiliency skills. It is essential to seek treatment for clinical depression, substance abuse, and other persistent mental and emotional distress –especially if they don’t get better or get worse over time.

The National Survivors of Suicide Day

After a suicide, healing for the survivors involves a more complex grieving process. The National Survivors of Suicide Day is observed every November on the Saturday before Thanksgiving to help in the healing of people who have lost someone by suicide. On that day, two hundred and fifty simultaneous conferences for survivors of suicide loss take place throughout the country and around the world. In the long run, it’s important to remember people who committed suicide, not for their final act of desperation but for the quality life that they led when they were here.

Some resources for Suicide Prevention
The National Suicide Prevention Lifeline If you or someone you know has suicidal thoughts is a free, 24 hour hotline available to anyone in suicidal crisis or emotional distress. 1-800-273-TALK (8255) The American Association of Suicidology The American Foundation for Suicide Prevention (AFSP) (www.afsp.org)
The American Psychological Association (www.apa.org) Survivors of Suicide (www.survivorsofsuicide.com)

This column is intended to be educational and not intended to take the place of medical evaluations or professional treatment.