Month: March 2021

I heard someone say today that suicide was a selfish act. What do you think? Do you really think that someone would intentionally take his or her own life out of being selfish? If you do, I’m so sorry you feel that way. If you do, I hope I can change your mind.

Suicide certainly leaves a wake of devastation for those who are impacted. Survivors of suicide loss are at increased risk for depression, addiction, and the emergence of suicidal ideation themselves. Even though suicide causes massive collateral damage, can it really be considered selfish? The answer is a resounding “No”.

According to https://www.psychologytoday.com/us/contributors/shauna-h-springer-phd,:

The suicidal mode is an altered state of consciousness. When a person is battling with their demons and feeling hopeless, their thinking is often significantly distorted. They do not see reality the way they would if they were not in suicidal crisis. Their thoughts loop on the theme of how they are a burden to those they love. Their brains actively make a case for how others will not really miss them or that in the long run, those they love would be better off without them somehow. (Of course, their loved ones don’t agree with this).

An analogy might be helpful here. Take the case of a person who is in the grips of anorexia. (I, myself, had anorexia before anyone ever knew it existed.) I was dangerously underweight. However, I didn’t see myself that way at all. I could still see that overweight little girl who was so tired of being overweight. I had a distorted perception of reality. In a similar way, those who are in a very dangerous crisis of suicidal despair often have distorted perceptions of reality. They see themselves as a burden, the same way that an individual struggling with anorexia sees him or herself as being overweight.  

Further, those who are in the grips of the suicidal mode (or suicidal trance) often become mentally detached from those they love. With that being said, each suicide attempt is different. Regardless of each one’s personal story, it’s clear that interpersonal detachment is a core part of the suicidal mode. People’s demons become like the domestic abuser whose first move is to isolate his or her partner from the influence of those who love them. Demons will ambush those who suffer in silence, but those who break this dangerous code of silence before the suicidal crisis begins, often can regain their hope and will to live.

Finally, those who survive suicide attempts often look back on their crisis from a different perspective. They often understand how suicide would devastate their loved ones, where they did not see this in the throws of their earlier suicidal mode (trance). Those who come through a dark time and regain a sense of hope and purpose have stories that can save lives. Those who are suffering need to hear stories of hope and recovery. Attempt survivors can use their experience of being in the grips of suicide to argue that hope awaits us, even in the midst of some of our darkest days. Their stories can break the power of shame and stigma.

(I would like to share what an individual who survived a suicide attempt had to say to a blog author from”Psychology Today”.)

     I am a suicide survivor who attempted to take my own young life, at age 23, with an overdose of antidepressant and anti-anxiety medications. Fortunately, my sister found me unconscious and was able to call an ambulance in time. After 2 years of therapy with a great psychiatrist, I recovered and, now, 30 years later, am still eternally grateful to my sister.What I remember most about deciding to end my life is that it was an unpredictable, lightning-fast decision, preceded by an upsetting event, during a time in my life when I was both depressed and anxious. I remember feeling pure relief when I made the decision to end all the pain. You mentioned the word “tunneling,” and that is a perfect word to describe my thought process. I blocked out all thoughts of how my actions would affect my loving parents, family, and friends. This wasn’t purposeful—it was simply what occurred. It was, as you said, an altered state of consciousness, and the lens through which I saw my life at that moment was so different from how I had previously, or would see it in the future. I didn’t intend to hurt anyone; I wanted to unburden my family and finally escape the pain. I felt hopeless in the truest sense of the word. And, no one saw it coming, including me just a few hours earlier. That is how unpredictable and instantly gripping I believe [suicidal thoughts can be].

This article is discussing the duration of suicidal crises of those who may or may not suffer from a mental health condition. We are a long way in finding answers in how to help and respond to these types of tragedies.

While some suicides are deliberative and involve careful planning, many appear to have been hastily decided-upon and to involve little or no planning. Chronic, underlying risk factors such as substance abuse and depression are also often present, but the acute period of heightened risk for suicidal behavior is often only minutes or hours long (Hawton 2007).

The following studies are interviews from those people hospitalized after a suicide attempt.

The Houston study interviewed 153 survivors of nearly-lethal suicide attempts, the the 13-34 age range. Survivors of these attempts were thought to be more like suicide completers due to the medical severity of their injuries or the lethality of the methods used. They were asked: “How much time passed between the time you decided to complete suicide and when you actually attempted suicide?” One in four deliberated for less than 5 minutes!  (Simon 2005).

Duration of Suicidal Deliberation:

24% said less than 5 minutes

24% said 5-19 minutes

23% said 20 minutes to 1 hour

16% said 2-8 hours

13% said 1 or more days

A study from Deisenhammer asked people who were seen in a hospital following a suicide attempt how long before their suicidal act they first started thinking about attempting it. 48% said within 10 minutes of making the attempt. An Australian study of emergency department visits found 40% of attempters took action within 5 minutes of deciding to attempt (Williams 1980). The authors summarized seven earlier studies that found one-third to four-fifths of attempts were impulsive.

In an Australian study of survivors of self-inflicted gunshot wounds, 21 of 33 subjects (64%) stated that their attempt was due to an interpersonal conflict with a partner or family member (deMoore 1994). Most survivors were young men who did not suffer from major depression or psychosis, and the act was almost always described as impulsive. A similar study in Texas with 30 firearm attempters found 60% had experienced an interpersonal conflict during the 24 hours preceding their attempt (Peterson 1985).

At least one-third of suicide decedents under age 18 experienced a crisis within 24 hours of taking their life, according to NVISS data drawn from police and coroner/medical examiner reports. The proportion with a crisis declined with age. In some cases the crises were not just same-day but virtually same-moment (such as shooting themselves in the midst of an argument).

Interviews with 268 patients hospitalized for a poisoning suicide attempts in Sri Lanka found that just over half took the poison after less than 30 minutes of thought, often directly following an argument (Eddelston 2006). While most of these patients survived their attempts, 13 died. Like the nonfatal attempters, over half of those who died deliberated less than 30 minutes.

Duration of Suicidal Crises

In a recent BBC film, Roman Kemp explored how mental health problems can be related to ideas about masculinity.  He understands that the causes of suicide are always complex and never related to one single issue.

However, he states, “No matter what, there is still an idea that the man is the breadwinner of the family. The man is the person that has to have a family, has to find the ‘perfect person’ and be happy with them, have kids and help them financially …  And sometimes that pressure for guys is too much.”

Add to that, the pandemic – and the financial toll that comes with it.  Roman states that Covid has an impact as well.

“The pandemic has just accelerated everything,” he says. “It’s accelerated people’s depression, anxiety, fears. We’re living in a world now where it’s literally like ‘fear porn’ – how can the world be scared next?”

“And for someone who is already going through something mentally, when you start hearing about job losses, people not even being able to put food on the plate for their family, that’s a serious thing that – especially for guys – is a tough, tough thing to take.”

Roman stated that guys suffer hugely with thinking they’re not where they should be in their life.  They feel they can’t take a pause for themselves.

Roman visited organizations across the UK that are trying to help young men struggling with mental illnesses, like an emergency street triage team in Nottingham who dispatch mental health workers to people in crisis and a charity called Lighthouse, in Belfast, that helps boys and young men who’ve been affected by suicide.

“You’ve got light at the end of the tunnel in terms of groups and charities starting to make this movement happen,” he says.

But Roman also believes the government needs to take mental health issues more seriously.

“Not enough is being done,” he says. “To not have the support in place for kids, in my opinion, is disgraceful. There’s not enough budget there. There’s not enough onus put on it.”

https://www.bbc.co.uk/bbcthree/article/13c2fd0b-2a24-4afa-aff5-48f4249df784

It is often very challenging for men to talk about their experiences and seek support. Asking for help is not a sign of weakness. 

Governments everywhere, need to pause, listen, and put our hard-earned money toward helping those who suffer from mental health issues.

According to the AFSP for 2019, Global  

• An estimated 703,000 people die by suicide worldwide each year.
• Over half (58%) of all deaths by suicide occur before the age of 50 years old.
• The suicide rate is over twice as high among men than women.
• An individual suffering with depression is twenty times more likely to die by suicide than someone without the disorder.

According to the AFSP for 2019, in the US:

• The age-adjusted suicide rate in 2019 was 13.93 per 100,000 individuals.
• In 2019, men died by suicide 3.63x as often as women.
• White males accounted for 69.38% of suicide deaths in 2019.
• On average, there are 130 suicides per day.

https://afsp.org/suicide-statistics/

I’ve mentioned in previous blogs that many mental disorders have a genetic link.  There are many people who suffer from mental illnesses.  In fact, at least a quarter of our population in the US has some type of mental health condition.  Mental illness puts a person at a higher risk of suicidal ideation, and it’s been reported that a large percentage of those suffering from suicidal ideation also have some type of mental disorder.  However, it has also come to the attention of researchers that most of those who have mental health disorders do not have suicidal ideation or attempt suicide.

Confusing?  In other words, many people suffer from mental health disorders, but most of these people don’t suffer from suicidal ideation.  On the flip side, many of the people who attempt or complete suicide do have a mental health disorder. 

Suicide is extremely complex, and there are many factors involved.  Suicidal thoughts have many causes. Most often, suicidal thoughts are the result of feeling like you can’t cope when you’re faced with what seems to be an overwhelming life situation. If you don’t have hope for the future, you may mistakenly think suicide is a solution. You may experience a sort of tunnel vision, where in the middle of a crisis you believe suicide is the only way out.  Some refer to this as a suicidal trance.

Scientists are also theorizing that there is a genetic link to suicide. Suicidal ideation is now being studied as a disorder in and of itself.  People who complete suicide or who have suicidal thoughts or behavior are more likely to have a family history of suicide.  However, it’s important to understand that a family history is only one possible contributor; not a projection.  Environmental causes, societal challenges, brain inflammation, genetics, and possible biomarkers are all being studied, and thought to play a part.

Discoveries have now shown that neuroinflammation is a potential link, and that certain biomarkers can predict the onset of suicidal behaviors.  The research for biomarkers is still in the early stages, but it’s there. 

Biomarkers would suggest a biological indicator (predisposition)  for suicide.  If there are biomarkers for suicide, this would suggest that there may be a treatment in the future to help those suffering from suicidal ideation and suicide.  Again, much more funding is necessary to continue with this research.

https://www.mayoclinic.org/diseases-conditions/suicide/symptoms-causes/syc-20378048

What Neurobiology Can Tell Us About Suicide