SUICIDE




The majority of people who commit suicide are elderly men and late-middle-age women, but suicide is a leading cause of death among teenagers and young adults

Women make more suicide attempts than men, but men are more likely to succeed

Successful suicides are usually the result of fatal overdoses or firearms

Most patients who commit suicide had a history of suicide attempts

Most patients (98%), when asked one year after a failed suicide, are glad to still be alive


Risk Factors

Behavioral Indicators

History of suicide among family members

Feelings of hopelessness--problems seem unsolvable

Previous suicide attempts

Talk about, or threats of, suicide or preoccupation with death

Inadequate treatment of  psychiatric disorder

Depression that suddenly seems to get better

Recent death or terminal illness of loved one

Giving away of belongings or putting affairs in order

Divorce, separation, significant family stress

Self destructive behavior, alcohol and drug use

Loss of health/diagnosis of serious illness

Declining performance at school or work

Loss of job, home, money

 

Alcohol or drug abuse

Unwanted pregnancy

Access to firearms or dangerous medication



Suicide and mental illness

Excluding those that commit suicide while psychotic (due to drugs or schizophrenia) most/all have depression.The patient may have had a long history of depression or is depressed by stressful events (overwhelming debt, diagnosis of serious disease, death of spouse). Many people with schizophrenia attempt to commit suicide during a relatively lucid period, unable to bear the thought of returning to their illness. Many people with depression seem to get better right before they kill themselves. This might be that they are relieved to have made a decision to end their problems, or that their depression is starting to get better, so they now have the energy to follow through on their plan, and have decided that they cannot bear the likelihood that their depression will return.


Treatment

Take all threats of suicide seriously, the patient needs professional psychiatric care. Suicide attempts are usually not patients who “just want attention” (if they need attention that badly, something’s wrong) but are patients who are unsure whether they want to live or die, or who have already decided that they’d prefer to die. Some health care providers feel that the suicide attempter should be treated roughly in the ER, making the experience unpleasant with the theory that it will make the patient less likely to repeat the attempt. There is no evidence that this is successful, and it is unethical to purposely cause harm or discomfort to a patient, or to subject the patient to unnecessary procedures. Like all patients, a patient who has attempted suicide should be treated with compassion and professionalism.


Suicide hotline: Call 1-800-SUICIDE in the U.S.





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Introduction
Depression
Bipolar Disorder
Schizophrenia
Anxiety Disorders
Personality Disorders
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