Suicide is a rare event — most depressed people do NOT commit suicide. The rarity of suicide, however, makes it impossible to predict which people are most likely to follow through. Even though suicide is rare, all depressed people are at some risk of suicide. Active treatment of depression makes suicide less likely. Thus, mental-health providers pay attention to thoughts of suicide, aiming to relieve suffering and reduce suicide risk.
- Risk Factors
- Related Resources
Having risk factors does not mean you will commit suicide. In fact, 99 percent of those who have risk factors for suicide do not kill themselves. A risk factor is a marker for increased risk, not a cause of suicide. The point of identifying risk factors, therefore, is to take action, when possible, to reduce risk. For example, if people are more likely to commit suicide when depressed, then treating depression will reduce that risk.
Certain characteristics are found more frequently among those who commit suicide:
- Having made previous suicide attempts
- Having a family member who has attempted suicide
- Having a mood disorder, such as major depression or bipolar disorder
- Having psychotic symptoms, such as false beliefs (delusions) or false perceptions (hallucinations)
- Experiencing sudden or severe anxiety or hopelessness
- Being male
- Being single, especially widowed, divorced or separated
- Being unemployed
- Being socially isolated
- Experiencing sudden loss (such as the death of a loved one) or a life crisis (such as bankruptcy)
- Having a chronic medical illness or chronic pain
- Being a victim of violence
- Having a marked downturn in social or economic status
- Having been in jail or prison
- Having access to firearms
Identifying risk factors helps with making a plan to reduce suicide risk.
Suicide Help Resources
The risk of suicide will never be completely eliminated, but it can be reduced. The first step is to make a list of risk factors, separating the factors you can do something about (for example, a mood disorder) from the ones you can’t do anything about (for example, your age and gender). Work with your health-care provider to address those risk factors that can be treated or modified in a helpful way. For example, if you have depression, anxiety or distorted thinking, drug treatment or psychotherapy may have a very positive effect. Or if you have a problem with alcohol or drugs, counseling or a 12-step program may help you get it under control.
Here are other factors that can help lower the risk of suicide:
- Treating mental, physical and substance-use problems
- Improving family and/or community support
- Getting help with problem solving
- Getting re-engaged with a meaningful cultural or religious community
- Removing access to deadly means of suicide, such as firearms
The success of treatment depends on many things. First, a suicidal person will make more progress if he or she is open to getting help.
This issue is key, because it is easy for suicidal people to hide thoughts and feelings. Even though they contemplate suicide as a way out, most suicidal people hope to get help and are likely to be open to treatment.
Nonetheless, treatment can be demanding. For example, abstinence can be tough if you are an alcoholic. Psychiatric drug treatment is taxing if you dislike taking medication. Psychotherapy requires attention and work. Yet these efforts cannot only save your life, but may also make your life worth living.
Suicide Prevention – the Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/prevention/suicide.aspx
The Stigma of Depression
Many people wrongly view depression as a personal weakness or a character flaw. And they often believe the person can just “snap out of it” if they want to. But depression is a real disease, similar to any physical condition. Similar to most diseases, it has a combination of biological and environmental causes.
This misguided view of depression is slowly going away. But depression and mental illness too often lead to stigma (meaning a mark of shame or discredit). The result can be delay in diagnosis and treatment.
Your personality, moods and thoughts are made possible by biological activity in your brain. This biological activity is shaped or altered by interactions with the environment. The environment is the sum of your past and present life experiences, including the ups and downs of important relationships. Similar to the symptoms of many physical diseases, the symptoms of depression are strongly influenced by this biology/environment interaction.
Depression is a common illness. Any of us can develop depression. It does not need to have an identifiable cause. Being rich and having a loving family does not prevent you from developing depression, just as it does not prevent you from getting cancer.
Stigma about depression causes all of us to lose out. There is no shame in getting appropriate help. The shame would be to not seek help and thereby not allow yourself and your loved ones to feel better.
Depression And Alcohol And Drug Problems
A person’s genetic make-up influences the risk of developing problems with drinking, drug use and depression. These problems can overlap; the link between depression and substance abuse and dependence is strong:
- Depression makes substance use worse.
- Depression lasts longer in people who drink, and it is more likely to happen again.
- Depressed people who drink alcohol attempt suicide more frequently than depressed people who do not drink alcohol.
Abusing alcohol or drugs is linked to brain damage, stroke, liver disease, heart disease, digestive problems and cancer. People who use alcohol and drugs are more at risk of car accidents, drowning and falling. They may engage in unsafe sex, which exposes them to illnesses such as HIV/AIDS and herpes. Any alcohol- or drug-related problems can contribute to depression.
Substance abuse also can wreak havoc on your personal life. Relationships become tense. The risk of divorce and domestic violence increases. School or work performance may be poor. Initially, people may turn to alcohol or drugs as an escape from painful emotions. The substances, though, tend to amplify rather than reduce problems.
Depression and substance use/abuse feed each other. No matter which problem comes first, it is important to treat both the depression and the substance problem. (Sometimes substance abuse is a hidden reason why depression treatment fails.)
Treatment often involves a combination of psychotherapy, group support (such as Alcoholics Anonymous) and drug treatment. Your doctor can help to determine whether you have any associated medical problems that need to be treated.