Suicide and suicidal behavior

Definition

Suicide is the act of deliberately taking one’s own life. Suicidal behavior is any deliberate action with potentially life-threatening consequences, such as taking a drug overdose or deliberately crashing a car.

Causes, incidence, and risk factors

Suicidal behaviors can accompany many emotional disturbances, including Depression, Bipolar disorder, and schizophrenia. More than 90% of all suicides are related to a mood disorder or other psychiatric illness.

Suicidal behaviors often occur as a response to a situation that the person views as overwhelming, such as social isolation, death of a loved one, emotional trauma, serious physical illness, growing old, unemployment or financial problems, guilt feelings, and alcohol or other drug dependence.

In the U.S., suicide accounts for about 1% of all deaths each year. The highest rate is among the elderly, but there has been a steady increase in the rate among adolescents. Suicide is now the third leading cause of death for those 15 to 19 years old, after accidents and homicide.

Suicide attempts that do not result in death far outnumber completed suicides. Many unsuccessful suicide attempts are carried out in a manner that makes rescue possible. They often represent a desperate cry for help

The method of suicide varies from relatively nonviolent methods (such as poisoning or overdose) to violent methods (such as shooting oneself). Males are more likely to choose violent methods, which probably accounts for the fact that suicide attempts by males are more likely to be completed.

Suicide attempts should always be taken seriously and mental health care should be sought immediately. Dismissing them as “attention seeking” can have devastating consequences.

Relatives of people who seriously attempt or complete suicide often blame themselves or become extremely angry, seeing the attempt or act as selfish. However, when people are suicidal, they often mistakenly believe that they are doing their friends and relatives a favor by taking themselves out of the world and these irrational beliefs often drive their behavior.

Symptoms

Early signs:

     
  • Depression  
  • statements or expressions of guilt feelings  
  • tension or anxiety  
  • nervousness  
  • impulsiveness

Critical signs:

     
  • sudden change in behavior (especially calmness after a period of anxiety)  
  • giving away belongings, attempts to “get one’s affairs in order”  
  • direct or indirect threats to commit suicide  
  • direct attempts to commit suicide

Treatment

Emergency measures may be necessary after a person has attempted suicide. First aid, CPR or mouth-to-mouth resuscitation may be required.

Hospitalization is often needed, both to treat the recent actions and to prevent future attempts. Psychiatric intervention is one of the most important aspects of treatment.

Expectations (prognosis)

All suicide threats and attempts should be taken seriously. About one-third of people who attempt suicide will repeat the attempt within one year, and about 10% of those who threaten or attempt suicide eventually do kill themselves.

Complications
Complications vary depending on the type of suicide attempt.

Calling your health care provider

A person who threatens or attempts suicide MUST be evaluated by a mental health professional promptly. NEVER IGNORE A SUICIDE THREAT OR ATTEMPT!

Prevention

Many people who attempt suicide talk about it before making the attempt. Often, the ability to talk to a sympathetic, nonjudgmental listener is enough to prevent the person from attempting suicide. For this reason suicide prevention centers have telephone “hotline” services. Again, do not ignore a suicide threat or attempted suicide.

As with any other type of emergency, it is best to immediately call the local emergency number (such as 911). Do not leave the person alone even after phone contact with an appropriate professional has been made.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.