Let’s Talk About Suicide

According to the National Institute of Mental Health (NIMH), suicide is the tenth leading cause of death in the United States, claiming the lives of over 47,500 people in 2019. It is the second leading cause of death for those between the ages of 10 and 34, and the fourth leading cause of death among people between the ages of 35 and 44.

Suicide is when people harm themselves intending to end their life, and they die as a result. (NIMH)
A suicide attempt is when people harm themselves intending to end their life, but they do not die. (NIMH)

It is never easy to understand why someone attempts suicide, and the reasons are varied and complex. Often suicide involves emotional or physical pain that someone finds to be unbearable and leaves them feeling as if there is no escape.

The Centers for Disease Control and Prevention (CDC) reports that women are more likely to attempt suicide, but men are more likely to die by suicide. Additionally, men often attempt suicide using more lethal methods such as firearms or suffocation, where women are more likely to use poison or prescribed or unprescribed drugs. The rates of suicide vary by race, ethnicity, age, and gender.

As we grapple to understand more about suicide, it is important to know some of the key warning signs and some of the most noted reasons that lead to someone attempting to take their life.

What are the warning signs of suicide?

According to NIMH, below are some of the warning signs of someone who may be at risk for attempting suicide:

• Talking about wanting to die or wanting to kill themselves
• Talking about feeling empty or hopeless or having no reason to live
• Talking about feeling trapped or feeling that there are no solutions
• Feeling unbearable emotional or physical pain
• Talking about being a burden to others
• Withdrawing from family and friends
• Giving away important possessions
• Saying goodbye to friends and family
• Putting affairs in order, such as making a will
• Taking great risks that could lead to death, such as driving extremely fast
• Talking or thinking about death often
• Increased drug or alcohol use
• Display extreme mood swings
• Feeling guilt or shame
• Change in eating or sleeping habits

Why do people attempt to commit suicide?

While there is not one reason for suicide, there are several key factors that may be influencers.

Mental Health Conditions. A mental illness can be a significant risk factor, as roughly 90% of those who die by suicide have a mental disorder. Some of mental health conditions that contribute to suicidal thoughts or intent include depression, borderline personality disorder, bipolar disorder, anxiety, and psychosis. The most common risk factor is depression, as it is present in almost half of all suicides.

Hopelessness. People sometimes reach a point where they feel there is no hope and no way to change that feeling. When they are hopeless, they may realize the good things in their life, making suicide a viable option to escape.
Traumatic Stress. Traumatic experiences such as sexual abuse, physical abuse, assault, or war trauma can put someone at greater risk for suicide, even a great time after the event takes place. One survey found (Very Well Mind), that of 6,000 U.S. adults, nearly 22% of people who have been raped and 23% who had experienced physical assault had attempted suicide at some point. Those diagnosed with Post Traumatic Stress Disorder (PTSD) are at a greater risk due to depression that can often be present.

Substance Use. Drug and alcohol use can also influence suicidal ideation. Additionally, the risk become higher for those who have a substance use disorder combined with depression or other mental illness.

Chronic Pain or Illness. When someone feels there is no hope of cure or end to suffering, suicide may feel like the only option. According to a study in the American Journal of Preventative Medicine, the following health conditions are associated with a higher risk of suicide:

• Asthma
• Back pain
• Brain injury
• Cancer
• Congestive heart failure
• Diabetes
• Epilepsy
• HIV/AIDS
• Heart disease
• High blood pressure
• Migraine
• Parkinson’s disease

Social Isolation. As we know from recent events, isolation can have a devastating effect on overall health. People can become isolated due to many reasons such as a life event like a divorce or a death, physical illness, depression, anxiety, mental health issues, or loneliness. This isolation can lead someone to experience depression or substance use, exacerbating their suicidal thoughts.

How do I help?

If you know someone who is at risk, you can help them by taking these steps:

• Validate their distress while not agreeing to hopelessness
• Affirm their meaning and value to you and how loss would affect you and others
• Voice your commitment to support them though their despair
• Support finding a trustworthy and trained professional
• Call 911 if there are communications of active imminent intent and/or the individual is alarmingly unresponsive to supportive efforts

Many reasons that may lead someone to attempt to end their life. While the reason is not always clear to us, they may see no alternative. They may not truly want to die, but could be crying for help. You can take the first step in helping by having the conversation.