Suicide is the 10thleading cause of death in the United States, and the second leading cause of death among individuals between the ages of 10 and 34. 1 To be exact, approximately 45,000 people in the United States are documented to have ended their lives in 2016. 2 This number is likely to rise even higher in the years to come.
Suicide is a deadly killer and occurs across the entire lifespan; suicide occurs among the very young child to the elderly aging man or woman. If you have not personally experienced the devastating effects of suicide, it is possible you know someone who has. Suicide has no respecter of persons. No one is exempt from suicide; not even the smartest, richest, most intelligent, attractive, accomplished, successful, religious or spiritual person alive is exempt from suicide.
Unfortunately, it is often mistaken that suicide is restricted to individuals who have a mental illness. Studies reveal that half of those who die by suicide do not have a known or documented mental illness. 3 It is also easily mistaken that individuals who think about, attempt, or complete suicide do so with no warning at all. Under rare circumstances do individuals impulsively kill themselves. There are many cases where suicide is the result of long contemplation, careful calculation, and an individual’s readiness to end it all.
Because suicide is so widespread, increased awareness and a readiness to respond to this national crisis can make the difference in saving one life. Below are a few thoughts for you to consider just in case you or someone you know may be impacted by suicide and its devastating effects.
Q: Why do people commit suicide?
A: There are many factors that lead to suicide. Among mental illness, conditions such as depression, bipolar disorder, schizophrenia, as well as substance use disorders have been linked to suicidal thoughts and behaviors. In addition to mental health concerns, non-mental health factors can also influence suicidal thoughts and behaviors. Examples may include divorce, financial difficulties, legal troubles, as well as complicated medical conditions, just to name a few. Sometimes, individuals may feel so overwhelmed when faced with these situations that they become convinced the only way out is to escape by death by suicide.
Q: How do I know if someone is in danger of attempting suicide?
A: It is not easy to pinpoint beforehand who will die by suicide. However, warning signs and risk factors identify individuals that may have suicide concerns. Individuals who experience the following may be considered at higher risk for suicide: unsuccessful prior suicide attempt(s), recent psychiatric hospitalization, severe depression, social isolation and withdrawal, making comments about death (vague or explicit), unusual changes in behaviors, and giving personal belongings away, just to name a few.
Q: What do drugs have in common with suicide?
A: There are many suicide cases that have been linked to alcohol and/or drug overdose. Irresponsible alcohol and drug use is a risk factor for suicide. When individuals are under the influence of drugs and alcohol, they tend to lose the ability to make rational or responsible decisions, and are likely to engage in impulsive behaviors to include suicide.
Q: What are the differences between suicide thoughts, suicide plan, and suicide intent?
A: One way to directly understand where a person stands with regard to wanting to end their life is to simply ask them. Things you may consider asking include, “Are you having thoughts of wanting to end your life? Do you have a plan to end your life, and if so what is your plan? And finally, “Do you have any specific intention on following through on this plan?”
Suicidal Thoughts: The human typically thinks thousands upon thousands of thoughts daily. Someone who has a fleeting thought of not being alive does not necessarily imply they want to kill themselves. However, a person who has increasing suicidal thoughts, and thinks about it multiple times in a day or week, poses serious risks for engaging in suicidal behaviors. Examples of this might include recurring thoughts such as, “I wish I were dead. I’m okay if something bad happens to me. I don’t want to live anymore. My family would be better off without me.”
Suicidal Plan: This refers to a specific method on how one might plan to end their life. Sometimes this might include thoughts an individual keep to him or herself. Other times this might include thoughts that are shared in writing, such as a letter or note, or even thoughts shared with others in passing.
Suicide Intent: This refers to a commitment to follow through on a plan. This can include identifying a specific day, time, or location to attempt to end one’s life.
Any one of these examples above raise serious concern; however, if all of these examples are present then this is a true psychiatric emergency, and emergency medical services should be activated immediately.
Q: What do I do to help someone who has suicide concerns?
A: This depends on the seriousness of the situation. If the situation is not imminent, the individual may be assisted through conversation, comfort, and connection with behavioral health services. If the situation is imminent, then emergency medical services should be activated immediately: call 9-1-1 or go to the nearest emergency department.
Q: What do I do if I know someone is of concern, but I do not want to make them uncomfortable by asking if they have suicidal thoughts?
A: I’ve often heard people say, “I don’t want to get involved,” “I don’t want to embarrass them,” or “I don’t want to make them upset with me.” Personally, I would rather put myself in an uncomfortable situation, in order to save someone else’s life than to remain comfortable at the expense of someone else losing their life. One approach to show concern is to do so with respect and dignity.
September is National Suicide Prevention Awareness month. Please take time this month to check on a friend, co-worker, or loved one that may exhibit warning signs described above. A simple, “How are you? Are you having thoughts of not being alive?” can be the matter of life or death for that individual.
1. National Institute of Mental Health. (2017, March). Suicide Prevention. Retrieved from https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml
2. Centers for Disease Control and Prevention. (2018, June). Suicide Rising Across the U.S. Retrieved from https://www.cdc.gov/vitalsigns/suicide/index.html
3a. Brent, D. A., Baugher, M., Bridge, J., Chen, T., & Chiappetta, L. (1999). Age- and sex related risk factors for adolescent suicide. Journal of the American Academy of Child Adolescent Psychiatry, 38(12), 1497–150.
3b. Mertens, B., & Sorenson, S. B. (2012). Current considerations about the elderly and firearms. American Journal of Public Health, 102(3), 396–400.