What Is It?
Of all the complications of untreated depression, suicide is the most tragic. It has often been called "a permanent solution to a temporary problem". In the midst of depression it can begin to look like the only option left.
Why Do People Do It?
Depressed people who take their own lives do so because they are enduring unbearable psychological pain and perceive that there are no more options available to them. Physical pain can also trigger suicidal feelings, but pain of psychological origin can be just as, if not more, intense.
Who Commits Suicide
Some distinction has been made between "suicide attempters" and "suicide completers". Suicide attempters are likely to be female and generally attempt suicide by taking an overdose of medication. Suicide completers, by contrast, are more often male and tend to use more lethal means. Both genders, however, may fall within either of these groups. Suicide threats should always been taken very seriously. They are a cry for help.
The primary risk factors that have been identified for completed suicides are major depression, substance abuse, severe personality disorders, male gender, older age, living alone, physical illness, and previous suicide attempts. Chronic pain and illness have also been associated with suicide.
Suicide is most prevalent among the young and the elderly. It is the leading cause of death among those aged 15-24. Among those young people who attempt suicide, eventually anywhere between 0.1 and 10% of these will complete the act.
For more information about the epidemiology of suicide, the Task Force on Life and the Law has provided an excellent resource called When Death is Sought. Although this online book deals primarily with euthanasia, it gives some valuable information about suicide in general.
The Suicide Awareness/Voices of Education (SA/VE) Website lists the following danger signs:
- Talking or joking about suicide. Statements about being reunited with a deceased loved one.
- Statements about hopelessness, helplessness, or worthlessness. Example: "Life is useless." "Everyone would be better off without me." "It doesn't matter. I won't be around much longer anyway." "I wish I could just disappear."
- Preoccupation with death. Example: recurrent death themes in music, literature, or drawings. Writing letters or leaving notes referring to death or "the end".
- Suddenly happier or calmer.
- Loss of interest in things one cares about.
- Unusual visiting or calling people one cares about - saying their good-byes.
- Giving possessions away, making arrangements, setting one's affairs in order.
- Self-destructive behavior (alcohol/drug abuse, self-injury or mutilation, promiscuity).
- Risk-taking behavior (reckless driving/excessive speeding, carelessness around bridges, cliffs or balconies, or walking in front of traffic).
- Having several accidents resulting in injury. Close calls or brushes with death.
- Obsession with guns or knives.
The person who is depressed enough to be thinking of suicide needs immediate professional help. Do not feel afraid to bring up the topic with your teen. Ask questions about their plans. Those who are passively suicidal or have only vague ideas of wanting to die should still be taken very seriously and arrangements made for them to see a psychiatrist. If your teen seems in immediate danger of a suicide attempt, call 911 or your local emergency room and ask for assistance. Because medication and therapy take some time to become effective, it may be necessary for your child to be hospitalized for their own protection.
During a crisis situation, do not leave them alone. Do not minimize their feelings. It is not important that the problem seems trivial or easily solved to you. What counts is how severe the problem seems to them. Do not treat your teen as if they are simply seeking attention. Suicidal behavior is an indication of deep psychological pain. They are asking for your help. Reassure your child that they are not a burden to you and they are not weak. Praise them for having the courage to ask for help.
As alert as you may be for the signs of suicidality in your teen, it may be that they hide their feelings from you or feel afraid to approach you. The Yellow Ribbon Suicide Prevention Program is dedicated to helping bridge this communication gap. Giving your child one of their Yellow Ribbon Cards if a great way to open up a dialogue with them. It lets them know you are there for them if they need you and gives them a simple way to communicate with you when words are difficult to find.