Suicide and how to prevent it…
Suicide is depression’s close relative. The more severe depression is, the greater the risk of suicide. Where depression is severe enough to be hospitalized, up to 15% would eventually succeed in a suicide attempt. Women are more likely to be depressed than men, and 4 times more likely to attempt suicide. Males are more than 4 times more likely to die by suicide than females. Subsequently, men who attempt to end their lives are more than 16 times as likely to succeed. Homosexuality is also a factor in many suicide attempts. There are so many questions about suicide looking for an answer. Can you imagine a world without suicide? There is hope, but unfortunately, not every story has a happy ending. We are constantly looking for answers to understanding suicide and how to prevent it.
Additional statistics about suicide:
3144 Australians died by suicide in 2021. It represents a rate of 12.0 per 100,000 people. The number of suicides has increased slightly, with 5 more deaths in 2021 (compared with 3139 deaths in 2020). Suicide is the second most cause of death among Western teenagers. In the US, suicide is responsible for 31,000 deaths per year.
What is suicide?
In short, suicide is the act when a person takes their own life intentionally.
Before someone takes their own life, they usually experience suicidal ideation, suicidal thoughts and suicidal feelings.
Suicidal ideation or suicidal thoughts are thoughts about taking one’s own life and it involves clear thoughts about suicide or plans. Suicidal thoughts can be distressing.
Suicidal thoughts can be passive and active. Passive suicidal thoughts are frequent thoughts about death and dying without actually planning to die or take their own life. It occurs when someone wishes they were dead or that they could die. Active suicidal ideation is not only thoughts about it, but also having the intent to die by suicide, including and making a plan on how to do it. Persistent thoughts about suicide and death can make people hopeless and without support.
These days, we say that someone died by suicide rather than someone committed suicide. The phrase (committed suicide) is no longer used because it comes from a time when suicide was considered as a sin or a crime. It is still full of stigma, but we now use the more appropriate phrase ‘died by suicide’.
Attempts and successful attempts of suicide were previously defined as behaviours associated with mood disorders or other mental disorders. Suicide attempts usually (but not always) occur among people suffering from depression.
There were some steps to include suicidal behaviours in a list of mental disorders. Recognising suicide’s importance as a psychiatric issue, the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision) took a step in suggesting Suicidal Behaviour Disorder (SBD) as a “condition for further study”. That means that Suicidal Behaviour Disorder (SBD) might be included in a later edition, but it is currently pending some further research. The diagnosis of SBD is not applied to suicidal ideation but to acts.
Suicide myths
There are a number of common myths about suicide such as:
- When someone has decided to do it, nothing can change it.
- Suicide comes without warning.
- All people who suicide are mentally ill.
- Most people who suicide do it in winter.
- Suicide is more common at night.
- Parasuicide is just attention-seeking.
- People who talk about it never do it.
- Most people who do suicide, leave notes.
- Talking about suicide increases the risk of doing it.
Suicide methods: Globally
- Hanging: predominant in most countries;
- Firearm: most common in USA, Argentina, Switzerland and Uruguay;
- Pesticides: WHO estimates 20% of global suicides are in rural and poor areas;
- Drugs: Canada, Nordic countries and UK;
- Less frequent: Drowning, gas-fumes, cutting/piercing, other suffocations;
What are the warning signs?
Some of the warning signs are:
- Talking about it – death and suicide, or harming oneself;
- Talking about being a burden to others;
- Substance use;
- Severe withdrawal from social connections and situations;
- Changes in sleep (increase or decrease);
- Showing/expressing feelings of hopelessness and/or self-hate;
- Acting in dangerous and/or self-destructive ways;
- Expressing anger/rage/hostility that is out of character or out of context – drastic change in mood/behaviour;
- Seeking methods/tools: pills, weapons, or other lethal objects;
- Giving away possessions, etc.
Risk factors for suicide
- There are many factors that contribute to increased risk for suicide:
- Impulsivity and anger;
- Crisis in the past;
- The elderly and teenagers are at higher/greater risk;
- Pre-existing mental illness;
- Access to a means, such as pills, drugs, guns, etc.;
- Previous suicide attempts;
- Refusal to seek help;
- Substance use/abuse (Alcohol or drug abuse increases the risk of suicide);
- Females tend to have more attempts;
- Males tend to use more lethal weapons;
- Relationship problems;
- Unmarried, divorced & separated;
- Unemployed;
- Social class (high & low)
- Indigenous population;
- Age (85+, 45-54, under 18)
- Terminally ill or with chronic diseases;
- LGBTIQ+ population;
- Victims of bullying and abuse (including online);
- Military members/veterans;
- Prisoners;
- Family history
- Hopelessness/Depression (The severely depressed are at the highest risk.)
What if it is attention-seeking?
Some people say that many of those who talk about it are just attention seekers. Of course, they are seeking attention! They are desperately trying to reach out for help because they don’t know what to do, especially the young ones.
Over time, the public perception of mental health is changing. Hopefully, the perception of suicide is changing too.
How to deal with suicidal ideation / suicidal thoughts?
First of all:
- Take it seriously.
- Don’t spend a night alone if you are suicidal – call out for family or friends.
- Cut off all ties with toxic people! You don’t need them!
- Think about your accomplishments and make a list of them! You might be surprised!
- Practice positive affirmations/mantras! For example, “I can do it!” and “I will get through this!”
- Find out what is hurting you! Don’t succumb to helplessness!
- If it’s urgent, call 000 (in Australia);
- Find a therapist! (A good therapist – psychologist, clinical social worker, counsellor, clinical nurse, medical doctor/psychiatrist are some of those who can be helpful.)
- Do not lose hope! Hope is possible! You deserve much more!
- Humour and laughter can help reduce suicidality!
We can prevent suicide and save lives!
How?
Firstly, by not sweeping the problem under the carpet. Talk about it! Educate ourselves and others. The long-term effects of stress on mental functioning can be very serious. Loss of job, situations at home, relationships, substance abuse – with some or all of that we can seem hopelessly trapped and without light at the end of the tunnel, but all can be shifted to give you enough survival space, but action has to be taken in the proper direction. If we have taken all possible steps to reduce our stress to a minimum, we can ensure that the impact of the rest of the burden is reduced as much as possible. Wisdom is to recognize what essentials are needed to be provided to preserve our physical, mental and moral integrity. We need to learn to be more assertive in dealing with ourselves and others. That does not mean being rude and/or aggressive. In fact, it means making clear to others how we feel about something. Evidence shows that providing support services, talking about suicide, reducing access to means of self-harm, and following up with loved ones are some of the actions we can all take. Also, by providing peer support – mutual interaction between people who share the same life experiences, offer acceptance, understanding and validation, promote connection and inspire hope.
Finally, remember, maybe what you need is external professional support. Simply talking with a therapist about your worries, thoughts and feelings can often make you feel better. You don’t have to be diagnosed with a mental health problem to benefit from therapy. In fact, it can be very healing for everyone. We all have problems in our lives and have to learn how to solve the problems and/or go through them. Medication has its place and may help ease certain symptoms, but very often it comes with side effects, and a new medication is needed for those side effects to be addressed. In my humble opinion, medication as a way of therapy can create a foundation for a real problem solution through psychotherapy and counselling.
Can you imagine a world without suicide? Yes, you can!
Resources:
- American Foundation for Suicide Prevention – https://afsp.org
- Australian Bureau of Statistics – https://abs.gov.au
- Australian Institute for Suicide Research and Prevention – https://www.griffith.edu.au/griffith-health/australian-institute-suicide-research-prevention
- DSM-5-TR, Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision.
- Gelabert, R. C. (2007) Depression – Scientific and Natural Treatments, Ediciones Vidasana.
- Mental Health Research Matters – https://mentalhealthresearchmatters.org.uk
- Nedley, N (2005) Depression – The Way Out, Nedley Publishing.
- Suicide Prevention Australia – https://www.suicidepreventionaust.org
- US Department of Health and Human Services: Mental Health: A Report to the Surgeon General, Rockville, Maryland, 1999, p. 244.
Author: Nenad Bakaj, MHumServ (RehabCouns), BSocWk, DipAppSci (Comm&HumServ), AMHSW, MAAC, MAASW, JP (Qld)
Nenad Bakaj is a Brisbane based Clinical Counsellor, Accredited Mental Health Social Worker, Life Coach and Bigger Bite Out Of Life Trainer with a keen interest in positive psychology, mental health and well-being, and is continually developing his professional skills and knowledge. Nenad enjoys working with adolescents and young adults, as well as older clients, and feels it is a privilege to be able to support them. In the counselling room, Nenad aims to build rapport with his clients to assist them to reach their health, relationship, personal and life goals, and a happy and fruitful life.
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