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Suicide

Suicide can occur with a variety of mental disorders. The most obvious is severe depression, when the person feels hopeless and helpless and wants to escape from the misery he feels. Ironically, the risk of suicide can increase as someone's depression begins to improve (because he still feels bad but has more energy to act on suicidal thoughts).

Another common cause of suicide is schizophrenia. This severe, usually chronic, mental illness can provoke feelings of despair. In addition, suicide can occur secondary to mental disorganization or when delusional beliefs promote suicide, such as when the person believes he has to die to save the world.

Other things that can precipitate a suicide attempt include severe anxiety, significant losses, humiliation, victimization (e.g., rape), and the presence of a severe, chronic medical illness.

Another group of people attempt suicide or make suicidal threats/gestures because they have personality types that are chaotic, volatile, unpredictable, impulsive, excessively emotional, and easily overwhelmed. These people can attempt suicide because they want to escape distress, seek attention, express anger, or cry for help. The issue is even more complicated by the tendency of some of these people to engage in self-injurious behavior (e.g., superficial cutting, burning) where the intent is to cause minor harm but not to die. Regardless of the reason for the attempt, however, it is prudent to take these attempts seriously. Sometimes people intend to make a suicide gesture and end up completing suicide.

Alcohol and other drugs often are contributing factors to suicide in that they impair judgment and increase the risk of impulsive behavior.

If you are seriously thinking about killing yourself or planning how to end your own life, you should seek help immediately through a professional caregiver or the Emergency Department of your local hospital. In addition, avoid the use of alcohol or other unprescribed drugs because these can increase the risk of impulsive self-harm.

We encourage you to read more in the following topics:


Warning Signs

Here are some possible warning signs for suicide:

  • Feeling severely depressed, despondent, or hopeless.
  • Losing interest or pleasure in life.
  • Repeatedly thinking about suicide, talking about suicide, or wishing you were dead.
  • Giving up on the future, having no plans for the future, having only negative expectations for the future.
  • Feeling severe anxiety, agitation, anguish, or emotional distress that is difficult to manage or tolerate.
  • Being preoccupied with feelings of shame, guilt, or worthlessness.
  • Experiencing a recent, significant loss or humiliation (e.g., a relationship ending, job loss, financial losses).
  • Experiencing a significant victimization, personal violation, or trauma (e.g., rape, sexual abuse).
  • Having psychotic symptoms that promote suicide (e.g., a delusional belief that you must die, voices telling you to kill yourself, or disorganized thoughts and behavior).
  • Thinking of ways to commit suicide; developing plans for how, when, and where to commit suicide.
  • Collecting the means for suicide (e.g., hoarding pills, getting a gun).
  • Engaging in termination behaviors (giving away prized possessions, tying up loose ends, saying goodbye to people).
  • Detaching from others; lacking a significant involvement with other people or an avocation.

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Other Risk Factors

Here are some additional risk factors for suicide. They may not be relevant to an individual's risk, but reflect groups that, overall, have higher rates of suicide.

  • Having a chronic or life-threatening medical illness that has a significant impact on your day-to-day life.
  • Having a history of suicide attempts.
  • Having a family history of suicide.
  • Being a white male.
  • Being divorced, separated, widowed, or single if you are an adult; being married if you are an adolescent.
  • Using alcohol or other drugs excessively.

Note: Women attempt suicide three times more often than men, but men complete suicide three times more than women. This is because men choose more lethal methods.

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What Do I Do If I Think Someone is Suicidal?

If you have any concern at all that someone might be suicidal, it is a good idea to talk to them about it. It's okay to say, "I'm worried about you. You seem to be having such a hard time, and I am wondering if you are thinking about killing yourself."  

People sometimes are afraid they will plant the idea of suicide in the person's head. This is not the case. If someone is going to consider suicide, it won't be because you ask them about it. Indeed, asking about it might actually reduce the risk because they see that someone cares about them.

Encourage the person to seek help. If they are in therapy already, you might want to contact the provider to be sure they are aware of your concerns. You might contact their physician if they are not seeing a mental health professional.

Try to have someone stay with the person, so (1) they are not alone and (2) to reduce opportunities to make a suicide attempt. Remove access to guns, pills, and other means of self-harm.

If you think there is an imminent risk of suicide, or if they have already started to attempt suicide, call 911 or get them immediately to the Emergency Department of your local hospital.

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Is Suicide Ever Justifiable?

This is a philosophical/ethical issue about which people have very strong feelings. What is true is that suicide most often occurs in response to problems that can be treated or resolved. It is a long-term solution to a short-term problem. We believe it is essential that someone who is preoccupied with suicide or planning an attempt should be evaluated and treated by a psychologist or physician.

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The Role of the Psychologist

Diagnosis:

The psychologist can assess suicide risk factors and the underlying causes, and can recommend appropriate treatment. However, psychologists in outpatient practices usually can manage suicidal crises only for established clients. Other people who are in an acute suicidal crisis are advised to go to the Emergency Department of their local hospital. The reality is, if a stranger comes in and expresses suicidal ideation, the psychologist is likely to direct the person to the hospital anyway, where there is a more secure environment.

Treatment:

Psychologists help their clients survive and work through suicidal crises by treating the underlying disorder and offering support during the crisis. If the risk seems high, the psychologist is likely to refer the client for inpatient treatment in order to provide a safe environment where the client can weather the crisis.

Psychologists also can help people who have survived a loved one's suicide. These people have strong feelings and reactions to the suicide, including anger, guilt, shame, and embarrassment. If they discovered the suicide, symptoms of Posttraumatic Stress Disorder may be present.

Survivors can be helped to work through their reactions. Because psychologists understand the effects of suicide and are experts in dealing with strong feelings, they can help the survivor come to terms with the suicide and move on in a constructive way.

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Disclaimer:  You know, we see a disclaimer like this in every ad that lawyers put out, and it probably is a good idea for us to use one, too:  "No representation is made that the quality of the psychological services to be performed is greater than the quality of psychological services performed by other psychologists.  The outcome of assessments or psychotherapy, or individual client satisfaction, cannot be guaranteed and is dependent on many factors.  Material on this site regarding symptoms, disorders, and treatment is informational only.  Diagnosis and treatment of mental disorders requires the expertise of a trained professional."

The information on this site regarding psychological disorders and treatment comes from many sources that cannot be credited, simply because they have been integrated over the years into our general knowledge base. However, one important source is the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (1994) published by the American Psychiatric Association.