Suicide: Understand causes, signs and prevention

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Suicide: Understand causes, signs and prevention

Suicide is a complex act. Examine causes, risks and prevention strategies.

If you have a friend or loved one who has talked about suicide, has attempted suicide or has followed through on suicide, learning about this ultimate act of despair can help you understand the thought processes behind this decision. It can also help you recognize the signs of suicidal thought and may help you prevent someone from taking his or her life.

What is suicide?

Suicide is neither an illness nor a condition. Rather, it's a complex set of behaviors that exists on a continuum, from ideas to actions.

For instance, someone you know may wish he or she were dead but never intend to act on those thoughts. They may think about suicide but not have a specific plan. On the other hand, they may have a very specific plan, with a date, location and method. Or they may have a plan as well as the intent and the means to carry it out.

Types of suicidal behavior

Suicidal behavior
Some people engage in acts intended to bring death or acts unlikely to result in death but that indicate self-destructive or suicidal thoughts. These acts include overdosing, reckless driving or excessive drinking. This is called suicidal behavior.

Attempted suicide
Attempted suicide generally refers to an act that was intended to cause death but didn't.

Parasuicide
Not all seemingly self-destructive behavior is suicidal behavior. Acts that may resemble suicidal behavior but aren't intended to lead to death, such as deliberately injuring yourself, are known as parasuicide. Some people engage in this type of behavior as a way of soothing themselves. People who engage in self-injurious behavior, such as cutting, however, are at higher risk of suicide.

In some cases, people who engage in suicidal behavior or parasuicide kill themselves accidentally — they hadn't intended the act to progress to a lethal outcome. For instance, they make take an overdose and expect to be discovered in time to be rescued.

Completed suicide
Completed suicide means taking your own life. It's impossible to know absolutely why someone did this, or even if they intended to. In the case of an attempted suicide, the only way to understand your friend or loved one's intent is to talk about it. That, of course, isn't an option after completed suicide, although conversations before the act and notes left behind may provide clues.

Risk factors for suicide

Regardless of what specifically motivates someone to attempt suicide or complete suicide, a number of medical, biological, psychological and social risk factors are often involved. Those factors can vary based on age, gender and ethnic group, and they can change over time.

Some factors consistently increase a person's risk of suicide and attempted suicide. The factors that put people at higher risk include:

  • A prior suicide attempt
  • Having a psychiatric disorder, such as depression, bipolar disorder, schizophrenia or personality disorders
  • Alcohol or substance abuse
  • A family history of mental disorders or substance abuse
  • A family history of suicide
  • Family violence, including physical or sexual abuse
  • Firearms in the home
  • A significant medical illness, such as cancer or chronic pain

Potential warning signs of suicide

You may notice possible indications that a friend or loved one is thinking about suicide. Here are some typical warning signs:

  • Talking about suicide, including making such statements as "I'm going to kill myself," "I wish I were dead," or "I wish I hadn't been born"
  • Withdrawing from social contact and having an increased desire to be left alone
  • Wide mood swings, such as being emotionally high one day but deeply discouraged the next
  • Preoccupation with death and dying or violence
  • Changes in routine, including eating or sleeping patterns
  • Personality changes, such as becoming very outgoing after being shy
  • Risky or self-destructive behavior, such as drug use or unsafe driving
  • Giving away belongings or getting affairs in order
  • Saying goodbye to people as if they won't be seen again

Some people don't reveal any suicidal feelings or actions. And many who consider or attempt suicide do so when you think they should be feeling better — during what may seem like a recovery from depression, for instance. That's because they may finally be able to muster the emotional energy to take action on their feelings.

Biological and genetic links to suicide

Evidence suggests that genetic factors may increase the risk of suicidal behavior. Major psychiatric illnesses, such as bipolar disorder and schizophrenia, may have a genetic link.

On the other hand, suicidal behavior could be influenced more by a tendency toward impulsive behavior than by a specific psychiatric illness. Identifying people at increased risk could lead to earlier recognition and better treatment of those illnesses or behaviors and, as a result, lessen suicidal behavior.

In addition, suicidal behavior may be linked, at least in part, to a decrease in the brain of the neurotransmitter serotonin. Medications that increase levels of serotonin may help reduce suicidal behavior.

Prevention of suicide

It's impossible to accurately predict which particular individuals will attempt to take their own life.

People who have protective factors — the opposite of risk factors — are less likely to attempt suicide. Those factors include effective and appropriate medical care, easy access to treatment, family or community support, skills in problem solving and conflict resolution, and cultural and religious beliefs against suicide.

Recognizing depression, substance abuse and other disorders associated with suicide could provide you with an opportunity to frankly ask those at risk if they're considering suicide. You could then help steer them to appropriate treatment.

Understanding suicide helps prevent it

Becoming more aware of the factors that may put a family member or friend at risk of suicide can help you keep this person off the path to permanent self-destruction. When problems seem so overwhelming that an individual sees no options other than to end his or her life, distress has distorted this person's thinking. Awareness of this person's vulnerability can help you guide him or her to treatment — and hope. You may be able to step in and help someone who's suicidal.

Last Updated: 04/14/2006
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