Preventing suicide

“Where there is life, there is hope.” — Marcus Cicero

Talking about suicide — whether it is an issue with which we ourselves struggle or see the struggle in a loved one — is fraught with difficult emotions. Feeling hopeless, trapped, thoughts of giving up or about actively taking one’s own life are often the most private, painful and distressing things that can occupy our mind. Similarly, seeing those who we care about struggle with these thoughts and the specter of depression can leave us unsure of how to act, unclear about reaching out, despite our deepest of concerns.

In either case, feelings of loneliness, fear and disconnection are difficult to overcome. It is most likely these uncomfortable emotions that deter people on either side from having these life-saving conversations.

Sadly, it is estimated that most individuals with depression either do not seek treatment or are not adequately treated.

It is important to be clear about two things: Suicide is a serious health issue, and it is preventable.

Suicidal thoughts are most closely associated with depression, and about 15 percent of those who are diagnosed with depression result in suicide. More than half of suicides are completed with a firearm, and it is estimated that almost 75 percent of suicides are associated with substance use. While rates of completed suicides are four times more common in men, suicide attempts are three times more common in women. Middle-age adults have the highest rates of suicide, though it is one of the top three leading causes of death in adolescents and young adults.

Some of the important risk factors for suicide include suffering a serious, significant life event (such as a death or job loss), substance abuse, a personal or family history of depression or suicides, and having a serious medical condition or pain. There are also notable warning signs of depression and suicidality, which include:

  • Sad, depressed, negative mood or significant changes in mood.
  • Sleep disturbances, either a significant increase or decrease.
  • Withdrawing from usual activities and people.
  • Loss of pleasure in usually pleasurable activities.
  • Low energy, low motivation.
  • Substance abuse or change in substance use patterns.
  • Increase in risky behaviors such as reckless driving or initiating conflicts.
  • Preoccupation with death, dying, or violence.
  • Talking about suicide.
  • Feeling trapped, overwhelmed, hopeless.
  • Giving prized possessions away; getting one’s “affairs in order.”
  • Saying goodbye to people.

Serious suicidal thoughts and actions typically are the result of depression. Sadly, it is estimated that most individuals with depression — about two-thirds — either do not seek treatment or are not adequately treated.

There is substantial evidence that depression in its various clinical manifestations can be successfully treated with psychotherapy and medication. And there are factors that serve as preventive for suicidality, including being involved in mental health care, having strong, positive personal connections with people and having the capacity for adaptive coping and problem-solving.

If you are concerned about a family member or friend, it is important to reach out to them, ask questions about how they are feeling and provide support. Despite the cultural myth, this will not induce someone to act on their self-destructive impulses.

To reduce access to dangerous means, remove guns from the home or at least make them less accessible by locking them away. Similarly, securing medications that may be lethal in larger doses is an important safety measure.

If you become imminently concerned about a loved one or friend, call 911 or go to the nearest emergency room. The National Suicide Prevention Lifeline 1-800-273-TALK (8255) can also provide information and guidance.