Suicide

Suicide

Definition

Suicide is the act of taking one's own life on purpose. Suicidal behavior can range from thoughts of killing oneself to actually going through with the act.

What is going on in the body?

An individual who thinks or talks about suicide is considering ending his or her life. In some cases, thoughts of suicide are never acted upon. In other cases, suicidal thoughts lead to an attempt at ending one's life.
People who are more prone to commit suicide are:
  • white men
  • those in their forties or over 65 years old
  • those living alone or who have no children living in the home
  • those suffering from major life stress such as the death of a loved one, the loss of a job or a divorce
Eighty percent of completed suicides are men. However, most people who try to commit suicide but don't actually die are women between the ages of 25 and 44 years old. Although the suicide rate is lower than in adults, suicide is one of the leading causes of death among young persons 10 to 19 years old because death overall is uncommon in this age group.

Risks

What are the causes and risks of the condition?

Risks for suicide vary greatly. A mental disorder such as severe depression or alcoholism is a common risk factor. Other risk factors include:
  • previous suicide attempts or a family history of suicides or suicide attempts
  • history of psychiatric disorders. This can include including major depression, alcohol or drug abuse, schizophrenia, panic disorders, and borderline personality disorder.
  • antisocial, aggressive or impulsive behavior in teenagers
  • serious medical illness, such as cancer, accompanied by psychiatric illness
A combination of biological, emotional, intellectual and social factors play a part in suicide risk. Factors that may contribute to teenage suicide risk include:
  • sadness
  • stress
  • poor school performance
  • peer pressure
  • grief
  • learning disabilities
  • illness or physical disabilities
  • desire to be perfect
  • lack of friends
  • questions about sexual identity
  • feelings of being disliked

Prevention

What can be done to prevent the condition?

Suicide prevention consists of taking a person's suicide threats seriously. Others should also watch for signs that a person is planning to commit suicide. Steps include:
  • ask the person if he or she has had any thoughts of dying or ending their life
  • listening carefully to the person at risk
  • offering an open, non-judgmental conversation
  • offering the person a positive solution
  • discussing options for seeking help
  • offering support for the person in finding help and treatment

Diagnosed

How is the condition diagnosed?

The healthcare professional will ask about the person's symptoms. He or she will also want to know about the individual's risk factors. The person must be asked if he or she has had thoughts of dying or hurting him- or herself.

Long Term Effects

What are the long-term effects of the condition?

Suicidal thoughts may result in the person taking his or her own life.

Other Risks

What are the risks to others?

Suicide is not contagious in the usual sense, although "copycat" suicide attempts have been seen following a highly publicized instance of suicide. If a person shows a risk of committing suicide along with a friend, both people should be evaluated further.

Treatments

What are the treatments for the condition?

First and foremost, the safety of the person must be ensured. This may require hospitalization and/or continuous observation.
Several other factors should be taken into account when designing a treatment plan for a person who has attempted or may commit suicide. These include:
  • the method the person plans to use for committing suicide. It should be determined if the person has access to firearms, medications, or other methods to carry out his or her plan, and then arranging to have these removed from their access.
  • whether the person has social support
  • whether the person has control over his or her actions and judgment
A person should be hospitalized if he or she has:
  • a suicidal plan with the means to carry it out
  • poor ability to control his or her actions
  • poor judgment
  • lack of social support
In some cases a person who has a plan to commit suicide, but does not have the means, may not need to be hospitalized. If the individual has good mental judgment and good social support, he or she may undergo further evaluation for psychiatric disorders and stressors. The individual must also be willing to sign a contract of "no-harm." This means that he or she will not do harm to him or herself.
Medications, such as antidepressants may also be used. Individual therapy as well as family therapy may be recommended. A person who expresses thoughts of suicide, but does not have a plan to commit suicide should undergo psychiatric evaluation. The stressors in the person's life should be evaluated as well. Antidepressants may be recommended. Individual, group and/or family therapy may also be used.
In some cases of suicidal plans and attempts, the therapist may recommend special programs. These may include programs for treatment of alcoholism or drug abuse. The therapist may also recommend electroconvulsive therapy (ECT). This therapy might be used if antidepressants are not effective. It can also be considered if a quicker form of treatment is needed.

Side Effects

What are the side effects of the treatments?

Side effects to treatment will depend on the treatment used. Side effects of antidepressants may include stomach upset, difficulty sleeping, headache, and irritability. Side effects to ECT may include temporary memory loss, muscle pain and tenderness, and headaches.

After Treatment

What happens after treatment for the condition?

Treatment may continue for some time. It may include hospitalization, antidepressants, therapy, and follow-up appointments.

Monitor

How is the condition monitored?

A person may be asked to renew the "no-harm" contract, although this is not a fail-safe method of suicide prevention. He or she may also need to report any new suicidal thoughts or plans. The family may be asked to monitor the person's mood and behavior. They may also be asked to report their perception of the person's suicidal risk.
The family should be urged to seek emergency medical assistance if they sense any urgent concern over the person's safety. The person should also be given a 24-hour crisis phone number to call in case suicidal thoughts or plans develop.

Sources

http://aafp.org/afp/990315ap/1500.html/ http://www.aacap.org/web/aacap/publications/factsfam/suicide.htm

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