About Suicide
More than 30,000 people in the United States die by suicide every year. It is this country's 11th leading cause of death, and is often characterized as a response to a single event or set of circumstances. However, unlike these popular conceptions, suicide is a much more involved phenomenon. The factors that contribute to any particular suicide are diverse and complex, so our efforts to understand it must incorporate many approaches. The clinical, neurobiological, legal, and psychosocial aspects of suicide are some of the major lines of inquiry into suicide.
NM Rates
New Mexico consistently ranks among the top 5 states in the United States for its suicide rate, which is 1.5 to 2 times the national average. The suicide rates among all ethnicities and age groups are 4 times higher among males (31.6 per 100,000) than females (6.9 per 100,000). Suicide is the 9th leading cause of death for New Mexicans.
Factors that contribute to suicide
Substance abuse and mental health disorders are the two most common psychiatric illnesses associated to suicide, yet those afflicted are often undiagnosed, untreated, or both. Alcohol is the 2nd leading cause of death for New Mexicans and is 2 times the national average. A study in patients with major depression found "men were more likely to have psychoactive substance abuse and women were more likely than men to have a history of hospitalization" ("A Review of Suicide," 1994). The risk of suicide is much greater when both substance abuse and mental health disorders are present. According to another study, the risk of suicide attempts or completions following a psychiatric admission is highest in the first 1-2 years after discharge ("Adequacy of Antidepressant," 2002).
American Journal Psychiatry April 1994, vol.151, p. 530. Review of suicide in patients with major depression. Retrieved 10/01/05 from www.findarticles.com/p/articles/mi_m3225/is_n5_v501/ai_15870971
Oquendo, M., Kamali, M., Ellis, S.,Grunebaum, M., Malone, K., Brodsky, B., et al (2002). Adequacy of Antidepressant Treatment After Discharge and the Occurrence of Suicidal Acts in Major Depression: A Prospective Study. 159:1746-1751. Retrieved 09-24-05 from www.ajp.psychiatryonline.org/cqi/content/full/159/10/1746
New Mexico Department of Health Office Spring 2005. New Mexico State Epidemiology Profile Strategic Prevention Framework – State Incentive Grant (SPF-SIG). www.health.state.nm.us
Suicide can be prevented.
While some suicides occur without any outward warning, most do not. Prevent suicide among loved ones by learning to recognize the signs of someone at risk, taking those signs seriously and knowing how to respond to them. The emotional crises that usually precede suicide are most often both recognizable and treatable. Prevent suicide through early recognition and treatment of depression and other psychiatric illnesses.
Warning Signs of Suicide
All of the warning signs of suicide are magnified in importance if the patient is depressed. Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it expressed instead as a loss of pleasure or withdrawal from activities that had been enjoyable.
Depression is present if at least five or more of the following symptoms are present during a two-week period; at least one of the symptoms must be either depressed mood or loss of interest or pleasure in usual activities.
- Depressed mood
- Loss of interest or pleasure in usual activities
- Change in appetite or weight
- Change in sleeping patterns
- Speaking and/or moving with unusual speed or slowness
- Loss of interest or pleasure in usual activities
- Decrease in sexual drive
- Fatigue or loss of energy
- Feelings of worthlessness, self-reproach or guilt
- Diminished ability to think or concentrate, slowed thinking or indecisiveness
- Thoughts of death, suicide, or wishes to be dead
Risk Factors for Suicide
- Psychiatric Disorders
At least 90 percent of people who kill themselves have a diagnosable and treatable psychiatric illnesses -- such as major depression, bipolar depression, or some other depressive illness, including:- Schizophrenia
- Alcohol or drug abuse, particularly when combined with depression
- Posttraumatic Stress Disorder, or some other anxiety disorder
- Bulimia or anorexia nervosa
- Personality disorders especially borderline or antisocial
- Past History of Attempted Suicide
Between 20 and 50 percent of people who die by suicide had previously attempted suicide. Those who have made serious suicide attempts are at a much higher risk for actually taking their lives. - Genetic Predisposition
Family history of suicide, suicide attempts, depression or other psychiatric illness increases the risk of suicide. - Neurotransmitters
A clear relationship has been demonstrated between low concentrations of the serotonin metabolite 5-hydroxyindoleactic acid (5-HIAA) in cerebrospinal fluid and an increased incidence of attempted and completed suicide in psychiatric patients. - Impulsivity
Impulsive individuals are more apt to act on suicidal impulses. - Demographics
- Sex: Males are three to five times more likely to commit suicide than females.
- Age: Elderly Caucasian males have the highest suicide rates.
Suicide Crisis
A suicide crisis is a time-limited occurrence signaling immediate danger of suicide. Suicide risk, by contrast, is a broader term that includes the above factors such as age and sex, psychiatric diagnosis, past suicide attempts, and traits like impulsivity. The signs of crisis are:
- Precipitating Event
A recent event that is particularly distressing such as loss of loved one or career failure. Sometimes the individuals own behavior precipitates the event: for example, a man's abusive behavior while drinking causes his wife to leave him. - Intense Affective State in Addition to Depression
Desperation (anguish plus urgency regarding need for relief), rage, psychic pain or inner tension, anxiety, guilt, hopelessness, acute sense of abandonment. - Changes in Behavior
Speech suggesting the individual is close to suicide. Such speech may be indirect. Be alert to such statements as, "My family would be better off without me." Sometimes those contemplating suicide talk as if they are saying goodbye or going away. Actions ranging from buying a gun to suddenly putting one's affairs in order. Deterioration in functioning at work or socially, increasing use of alcohol, other self-destructive behavior, loss of control, rage explosions.
