Understanding the risk factors, prevention, and what we can do to help
Suicide is defined as intentionally taking one’s own life and comes from the Latin suicidium, which literally means “to kill oneself.” It tends to carry different traits depending on culture. Historically, and still today in some locations, suicide is considered a criminal offense, a religious taboo, and, in some cases, an act of honor (e.g., kamikaze and suicide bombings).
Literally speaking, suicide, or completed suicide is the successful act of intentionally causing one’s own death. Attempted suicide is an attempt to take one’s life that does not end in death, rather self-injury. Assisted suicide, a controversial topic in the medical field, is defined as an individual helping another individual in bringing about their own death by providing them with the means to carry it out or by providing advice on how to do it.
Suicide is the 10th leading cause of death worldwide and rates of completed suicide are higher in men than women – with men up to four times more likely to kill themselves than women. According to the CDC, male deaths represent 79% of all US suicides. However, the rates for non-fatal, attempted suicide are four times more likely in women than men and are more common in young adults/adolescents. Suicide is the second leading cause of death for individuals aged 15 to 34. On average, 38,000 deaths a year are attributed to suicide in America.
The most cited risk factors for suicide include psychiatric disorders, genetics, substance abuse, and family and social situations. Oftentimes, psychiatric factors and substance abuse co-exist. Access to weapons and other methods of suicide also increase risk. For example, rates of suicide in homes with guns are greater than in homes without them.
Mental disorders play an overwhelming role in the increased risk of suicide – with estimates suggesting up to 90% of individuals who take their own life suffer from some type of psychiatric disorder. Risk of suicide for individuals suffering from mental disorders drastically decreases once admitted to treatment. The mental disorders with the greatest prevalence of suicide risk associated with them include major depressive disorder, bipolar disorder, schizophrenia, personality disorders, post traumatic stress disorder, and eating disorders. Individuals suffering from major depressive disorder and bipolar disorder are at the highest risk of suicide – with risk of suicide increasing 20-fold.
Behind major depressive disorder and bipolar disorder, substance abuse ranks as the second highest risk factor for suicide. Statistics indicate that alcoholism is present at the time of death in up to 61% of completed suicide cases. Heroin and cocaine use is also a common risk factor for suicide, with heroin users having a 14-fold greater risk of suicide and cocaine users having a higher risk of suicide during withdrawal drug use. Cannabis use has not been found to increase suicide risk among users.
Genetics is thought to play a role in risk of suicide – such that a family history of suicide tends to indicate an increased risk of suicide among other family members – accounting for up to 55% of suicidal behaviors. Family history of mental disorders and substance abuse is also a risk factor for suicide. In a similar respect, exposure to suicide (e.g., watching a family member commit suicide or finding their body) is also indicative of an increased risk of suicidal behavior.
Family and socio-economic problems are also contributing factors to suicide risk. Unemployment, homelessness, poverty, childhood sexual abuse, social isolation, loss of a loved one, and other life stresses can all increase the likelihood of suicide. Sexual abuse alone is thought to contribute to 20% of the overall risk of suicide.
According to the CDC, general statistics on suicide include the following:
Every day, approximately 105 Americans die due to suicide
Over the past 10 years, suicide rates have increased 12.1 per 100,000
One person dies by suicide every 12.3 minutes in the United States
There is one completed suicide for every 25 attempted suicide attempts
In the elderly, there is one suicide for every 4 attempted suicide attempts
Suicide is the 10th leading cause of death in the United States across all ages
In the United States, rates of suicide are highest among Whites, American Indians, and Alaska Natives
Males are four times more likely than females to commit suicide
Females are more likely to have thoughts of suicide
Females are four times more likely than men to attempt suicide
Males are most likely to use firearms to commit suicide
Females are most likely to use poisoning to commit suicide
1 in 100,000 children ages 10 to 14 die by suicide each year
7 in 100,000 adolescents ages 15 to 19 die by suicide each year
12.7 in 100,000 young adults ages 20 to 24 die by suicide each year
Suicide prevention methods and treatment are based on patient risk factors. Treatments are prescribed in light of underlying conditions in addition to prevention of suicidal thoughts and acts. If you are suffering from a mental disorder, a treatment plan to treat this condition is implemented first. One of the most common suicide prevention techniques is psychotherapy – also known as talk therapy – in the form of Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT).
Cognitive Behavioral Therapy is a common treatment option for individuals suffering from a variety of mental disorders. In this method of psychotherapy, you are taught new ways of dealing with stress and stressful life experiences. In this manner, when thoughts of suicide arise, you can redirect those thoughts and cope with them in a different way than attempting to take your own life.
Dialectical Behavior Therapy is used to help an individual recognize disruptive or unhealthy feelings or actions. In relation, this therapy method then introduces techniques on how to deal with difficult or troubling situations. More research is needed on psychotherapy related to suicide prevention though, as DBT, in particular, has been shown to decrease the prevalence of attempted suicide but has shown no effect on completed suicides.
Medications can also be prescribed as a prevention method to suicide; however, controversy exists in this method, as many medications used in the treatment of mental disorders include increased risk of suicide as a side effect. Antidepressants especially carry a risk of potential increase in suicidal thoughts and behavior – but this risk might be dependent on age. Clinical research has shown that young adults increase their risk of suicide and suicidal thoughts when taking antidepressants, but in older individuals, this side effect diminishes.
Increased awareness among doctors is also a prevention technique. Research indicates that many individuals who have completed suicide or attempted suicide did seek medical attention in the year prior; however, warning signs may have been missed. Increased education and awareness among medical professionals might decrease suicide rates in the future.
Popular “crisis hotlines” have not received solid data indications in the research that suggest their use is effective or not. Though, one positive side effect of these hotlines is that they are generally well-known and common – increasing the general population’s awareness of suicide. In an additional effort to bring awareness to suicide and risk factors associated with suicide, September 10 has been observed as World Suicide Prevention Day in partnership with the International Association for Suicide Prevention and the World Health Organization.
Christina Gregory, PhD
Besma (Bess) Benali, Clinical Social Work/Therapist, MSW, RSW, Counselling Ottawa Nepean. I am trained in Cognitive Behavioural Therapy (CBT), Brief Psychodynamic Therapy, ACT, and mindfulness. Clients come to me because they are struggling and feel like they are trapped in a darkness that no matter what they have tried (and many have tried therapy before) they can’t pull themselves out. I help my clients understand themselves in ways no one has ever taught them before allowing them to see positive changes.