Suicide Prevention Basics

Suicide is complex, and there is no single cause for it. Suicide most often occurs when multiple stressors are all happening at once to a person who's coping capabilities are not enough to deal with these problems at the same time. This can result in them experiencing despair, helplessness, and hopelessness. 

Most people who die by suicide have an associated mental health condition, but it is often undiagnosed or untreated. For example, only two thirds (2/3) of people with Major Depressive Disorder (MDD) go on to pursue treatment. People who actively participate in treatment for a mental illness see a significant reduction of symptoms in 70-90% of cases. 

Very few people make a suicide attempt "Out of the blue." People at risk will often display warning signs, either through conversation or in their actions. These signs are associated with feelings of depression, anxiety, guilt, shame, loss of interest, anger, or dramatic mood swings. We can recognize these signs when we pay attention.

Things people talk about:

• Killing themselves (Often sarcastically or as an exaggeration)

• Feeling hopeless or helpless

• Feeling trapped or feeling the need to escape

• Having no reason to live or that they are living a meaningless life

• Feeling like a burden to friends and family

• Being in unbearable pain 

Things people do:

• Increased substance use

• Withdrawing from things they usually enjoy

• Isolating from friends and family

• Performing poorly at school or work

• Sleeping too much or too little

• Giving away prized possessions 

• Increased aggression or agitation

• Visiting or calling people to say goodbye

Factors that contribute to suicide can be individual, relationships, community, and societal norms. These are all associated with suicide, but that does not mean they are direct causes.

RISK FACTORS

Individual Health Factors: 

• Mental Health Condition- Depression, Anxiety, Substance Misuse/abuse, Schizophrenia, Mood Disorders

• Serious or chronic physical illness

• Chronic pain

• Traumatic brain injury

Relational and Environmental Factors:

Recent losses or transitions: 

• Relationships- breakups/divorce

• Social situations- rejection/loss of friendship

• Work- loss of job/change of job/recent retirement

• Financial- unexpected expenses

• Death of a loved one/exposure to another person's suicide

Prolonged Stressors:

• Harassment

• Bullying

• Relationship problems

• Domestic Violence

• Unemployment

• Loneliness/Isolation from others

Historical Factors:

• Previous suicide attempts

• Family history of suicide attempts or deaths

• History of abuse or maltreatment

Access to Lethal Means, specifically firearms and drugs, is a major risk factor for suicide. Visit the Means Safety Subcommittee page to learn more. 

PROTECTIVE FACTORS

These factors act as a buffer from suicidal thoughts and behavior. Effectiveness of these factors depends on the individual. Identifying and understanding protective factors are equally important to understand as risk factors. 

• Self-esteem and a sense of purpose or meaning in life

• Connectedness to individuals, family, community, and social institutions

• Cultural, religious, or personal beliefs that discourage suicide and support self-preservation

• Life skills such as problem-solving skills, positive coping mechanisms, and adaptability to change

• Effective care for mental, physical, and substance use disorders

• Support from healthcare providers

Suicide is a difficult subject to talk about, but we must not shy away from having these conversations.  Talking about suicide saves lives by breaking down the stigma that keeps people silent about it. However, it is important to use appropriate, compassionate language when we do so. 

The right words make all the difference. Certain ways of talking about mental illness can contribute to the stigma, leading to discrimination, alienating members of the community, and sensationalizing the issue. 

Several terms that are used to talk about suicide have been found to be insensitive:

Using "Committed" suicide carries the implication of a crime or a sin. Simply saying "died by suicide" or "ended their life" conveys the same information in a healthier way. 

Using "Successful" to describe a suicide attempt skews the meaning. The word "Success" is generally a positive outcome, which is clearly not what we want to use to describe a death by suicide. 

Using "Failed" to describe a suicide attempt is wrong in a similar way. "Failed" describes a negative outcome, but the person is still alive, which is what we want! Also, if someone is feeling bad enough to have made an attempt on their life, then hearing that they "failed" will only make them feel worse. 

Possibly the most damaging myth is the idea that asking someone who is struggling if they are feeling suicidal will put the idea of suicide in their head, increasing the risk of a suicide attempt. Unfortunately, the ideas of suicide and self-harm is quite prevalent in all forms of media, so it is very unlikely that anyone has never thought of these. Many studies have found that talking about their suicidal thoughts with a trusted person is helpful to people having thoughts of suicide and is an important first step in getting treated. 

Some believe that if someone wants to kill themselves, there is no stopping them. The very fact that they are still alive is proof that there is something keeping them from making an attempt. A common element of suicidality is intense apathy and a sense of exhaustion. It actually takes a lot of effort to make an attempt on one's life, and this dissuades people from making an attempt. This is also why some anti-depressants have a warning on their label saying users may be at higher risk of suicide - their mood and energy improves just enough to feel able to take on the effort required to make an attempt. 

There is also an idea out there that there are "Talkers" and "Doers" when it comes to suicide. That people who really want to do it will just do it, and people who talk about suicide or threaten suicide are only doing it for attention. However, the only way to get help for suicidal thoughts is to actually talk about them. So, in a way, yes, these people are looking for attention . . . MEDICAL attention! 

*An important caveat to this is that some people lack the skills to properly communicate their needs when they are not met and they will use a threat of suicide to gain attention.*

No matter what, ALL TALK OF SUICIDE should be taken seriously and be addressed. 

People who do this should be taught how to better communicate their needs in a respectful way, not be reprimanded for misusing terminology.