Suicide

Suicide is the intentional taking of a person's own life.

As shocking as it may seem, in the United States every year there are more suicides than murders and twice as many suicides as deaths from acquired immunodeficiency syndrome (AIDS). Yet suicide gets far less press than murder or AIDS. Why? It may be because talking about suicide makes people very uncomfortable, because there are religious prohibitions against suicide, because suicide is thought of as a shameful act, or because many people simply cannot believe that someone they know and love could intentionally take his or her own life.

Who Commits Suicide?

Suicide is a complex act that results from many factors, not all of which are understood. It is not clear or predictable why the setbacks, losses, or difficulties that would lead one person to feel very unhappy may lead another person to be suicidal.

It is estimated that about 30,000 Americans die as the result of suicide each year, while about 20,000 people are murdered. Some experts, however, believe that the number of suicides is even higher. Many "accidents," such as self-inflicted gunshot wounds or single-car crashes, actually may be unrecognized or unreported suicides. Although no official record is kept of suicide attempts, it is estimated that there are between 8 and 25 attempts for each completed suicide. Overall, suicide is the eighth leading cause of death in the United States.

Suicides are not spread equally throughout the population. Although more women than men attempt suicide, about four times more men die, because they use more lethal means. Men of European ancestry committed 72 percent of all suicides in 1997, while women of European ancestry accounted for about 18 percent of these deaths. The rate of suicide among people of Native American ancestry, especially young men ages 15 to 24, is particularly high. The suicide rate among men of African ancestry ages 15 to 19 doubled between 1980 and 1996. Age is another factor in suicide. After age 65, the rate of suicide among men of European heritage increases steadily as they get older. Men of European heritage who are older than 85 have a suicide rate that is six times the national average. The reasons for the different rates of suicide among people of different ethnic backgrounds, gender, and ages vary. Some factors include increased rates of alcoholism, poverty, loneliness, and violence for particular groups at a particular time of life.

Young people also have higher than average rates of suicide. Suicide is the third leading cause of death among people 15 to 24 years old. A 1997 survey found that 1 in 13 high school students said that they had attempted suicide. Meanwhile, the number of children ages 10 to 14 committing suicide has increased sharply during the past decade. The most common methods of committing suicide are by intentionally taking a drug overdose (prescription or over-the-counter medicines), inhaling carbon monoxide from car exhausts, or using guns.

What Factors Make People More Likely to
Commit Suicide?

About 90 percent of people who commit suicide have a diagnosed psychiatric disorder. Depression and substance abuse (either alone or in combination) are the two most common disorders that play a part in suicide. This does not mean that everyone who has depression or an alcohol or drug problem will commit suicide. The majority of people with these problems are not suicidal.

People who are more likely to kill themselves also may:

• have previously attempted suicide
• live alone and have no social support network
• have chronic (long-lasting or recurring) physical pain or a terminal (life-ending) illness
• have a family history of suicide
• be unemployed
• be impulsive
• keep a gun in the home
• have spent time in jail
• have experienced family violence, child abuse, or sexual abuse.

What Are the Signs That a Person Is Thinking of
Committing Suicide?

It is a myth that people who talk about killing themselves do not do it. Four of five people who attempt suicide have given clues about their intentions before they acted on them. It is important to take seriously any talk about suicide or any indication that suicide is a possibility.

Some common warning signs that a person is thinking about suicide include:

• talking about death or making suicide threats
• making such statements as "You would be better off without me" or "I'm no good to anybody" (even if these are said jokingly)
• having any of the symptoms or signs of depression
• exhibiting major personality changes or unexplainable odd behavior
• making a will or giving away cherished possessions
• seeking isolation and becoming uncommunicative
• being fascinated with death
• taking a sudden interest in religion if previously not religious, or rejecting religion if previously devout.

Why Do People Commit Suicide?

No one can explain why some people commit suicide and others do not. One theory is that suicide is an act of rage or anger. Another theory is that people may commit suicide because they feel they have no other choice. Hopelessness and distorted thinking may prevent a person from seeing solutions to their problems.

For a mentally healthy person, the idea that a person would have no choice except to seek death sounds absurd. But depression, substance abuse, and other mental illnesses, such as schizophrenia, alter the healthy mind. People with these problems may feel that they are in a deep, dark hole from which there is no escape and that life is so painful that there are no alternatives except death.

Researchers are finding that there may be inherited tendencies for depression, schizophrenia, alcoholism, substance abuse, and certain personality disorders. All of these problems can increase a person's vulnerability to suicidal thoughts when things go wrong. Some studies suggest that the brain chemistry of people who commit suicide is abnormal. Research is under way to examine the effects of certain medications that alter brain chemistry in a way that could decrease suicidal behavior.

If You Suspect Someone Is Suicidal

People who are thinking about committing suicide need professional help. They have usually sunk so deeply into their mental and emotional black holes that they may be unable to recognize that they are in trouble

or to seek help on their own. It is important to pay attention when people talk about wanting to die and to take their words seriously. Having another person approach the subject directly is often a relief to them. It is sometimes thought that speaking to people about their possible wish to commit suicide will "put thoughts in their heads." But people who talk about suicide often are already thinking about suicide.

Professional help is available through suicide prevention and crisis intervention centers, mental health clinics, hospitals and emergency rooms, family doctors, health maintenance organizations, mental health practitioners, and members of the clergy. When a person is possibly suicidal, it is a good idea to talk to another mature, responsible person and ask that person to join in helping to deal with the crisis. Many telephone books have community service sections that list suicide and mental health crisis hotlines. Immediate help can be obtained by calling emergency services (911 in most communities).

Other ways of possibly minimizing the risk of suicide include:

• removing guns and ammunition from the house
• locking up medications and alcohol
• staying with the person, since suicide is an act most often performed alone
• talking calmly, without lecturing, being judgmental, or pointing out all the reasons a person has to continue living.

Suicide places a heavy emotional burden on the survivors. People who have been close to someone who has attempted or completed suicide might consider mental health counseling to help them deal with their own emotions.