Suicide

Overview, Causes, & Risk Factors

Suicide is the act of taking one's own life on purpose. Suicidal behavior can range from thoughts of killing oneself to actually going through with the act.

What is going on in the body?

An individual who thinks or talks about suicide is considering ending his or her life. In some cases, thoughts of suicide are never acted upon. In other cases, suicidal thoughts lead to an attempt at ending one's life.

People who are more prone to commit suicide are:

white men

15 to 24 years old or over 65 years old

living alone or have no children under age 18 living in the house

suffering from major life stress such as the death of a loved one, the loss of a job or a divorce

Eighty percent of completed suicides are men. However, most people who try to commit suicide but don't actually die are women between the ages of 25 and 44 years old. Suicide is one of the leading causes of death among children 10 to 19 years old.

What are the causes and risks of the condition?

Risks for suicide vary greatly. A mental disorder such as severe depression or alcoholism is a common risk factor.

Other risk factors include:

previous suicide attempts or a family history of suicide attempts

history of psychiatric disorders. This can include including major depression, alcohol or drug abuse, schizophrenia, panic disorders, and borderline personality disorder.

antisocial, aggressive or impulsive behavior in teenagers

serious medical illness, such as cancer, accompanied by psychiatric illness

A combination of biological, emotional, intellectual and social factors play a part in suicide risk. Factors that may contribute to teenage suicidal risk include:

sadness

stress

poor school performance

peer pressure

grief

learning disabilities

illness or physical disabilities

desire to be perfect

lack of friends

questions about sexual identity

feelings of being disliked

Symptoms & Signs

What are the signs and symptoms of the condition?

Symptoms associated with suicide include:

feelings of hopelessness

problems concentrating

problems sleeping

difficulty finding happiness in things that previously would have made the person happy

severe anxiety, leading to panic

"accidents" occurring after expressing thoughts of suicide

statements indicating a desire to commit suicide

depressed feelings

sudden efforts directed at getting one's "life in order"

giving away of possessions

change in habits, such as eating or personal care habits

silence or withdrawal

verbal statements, such as "I want to die", or "I wonder what they'll do when I am gone"

failing grades or poor work performance

risk-taking behavior

alcohol or drug addiction

Most of the people "thinking of committing suicide" have seen their physician within the past 6 months.

Diagnosis & Tests

How is the condition diagnosed?

The healthcare provider will ask about the person's symptoms. He or she will also want to know about the individual's risk factors.

Prevention & Expectations

What can be done to prevent the condition?

Suicide prevention consists of taking a person's suicide threats seriously. Others should also watch for signs that a person is planning to commit suicide. Steps include:

listening carefully to the person at risk

offering an open, non-judgmental conversation

offering the person a positive solution

discussing options for seeking help

offering support for the person in finding help and treatment

What are the long-term effects of the condition?

Suicidal thoughts may result in the person taking his or her own life.

What are the risks to others?

Suicide is not contagious. If a person shows a risk of committing suicide along with a friend, both people should be evaluated further.

Treatment & Monitoring

What are the treatments for the condition?

Several factors should be taken into account when designing a treatment plan for a person who has attempted or may commit suicide. These include:

the method the person plans to use for committing suicide. It should be determined if the person has access to firearms, medications, or other methods to carry out his or her plan.

whether the person has social support

whether the person has control over his or her actions and judgment

A person should be hospitalized if he or she has:

a suicidal plan

the means of carrying out the plan

poor ability to control his or her actions

poor judgment

lack of social support

In some cases a person who has a plan to commit suicide, but does not have the means, may not need to be hospitalized. If the individual has good mental judgment and good social support, he or she may undergo further evaluation for psychiatric disorders and stressors. The individual must also be willing to sign a contract of "no-harm." This means that he or she will not do harm to him or herself. Medications, such as antidepressants may also be used. Individual therapy as well as family therapy may be recommended.

A person who expresses thoughts of suicide, but does not have a plan to commit suicide should undergo psychiatric evaluation. The stressors in the person's life should be evaluated as well. Antidepressants may be recommended. Individual, group and/or family therapy may also be used.

In some cases of suicidal plans and attempts, the therapist may recommend special programs. These may include programs for treatment of alcoholism or drug abuse. The therapist may also recommend electroconvulsive therapy (ECT). This therapy might be used if antidepressants are not effective. It can also be considered or a quicker form of treatment is needed.

What are the side effects of the treatments?

Side effects to treatment will depend on the treatment used. Side effects to antidepressants may include stomach upset, difficulty sleeping, headache, and irritability. Side effects to ECT may include temporary memory loss, muscle pain and tenderness, and headaches.

What happens after treatment for the condition?

Treatment may continue for some time. It may include antidepressants, therapy, and follow-up appointments.

How is the condition monitored?

A person may be asked to renew the "no-harm" contract. He or she may also need to report any new suicidal thoughts or plans. The family may be asked to monitor the person's mood and behavior. They may also be asked to report their perception of the person's suicidal risk. The person should also be given a 24 hour crisis phone number to call in case suicidal thoughts or plans devleop.