Suicide and suicide prevention

Suicide can be a heavy and frightening subject. Knowing someone who has attempted or died by suicide can be shocking and extremely sad. Far more people die by suicide each year than are murdered. The latest data available from the Centers for Disease Control and Prevention indicates that almost 40 thousand suicide deaths were reported in the U.S. in 2010. This latest rise places suicide again as America’s 10th leading cause of death. In the U.S., the annual suicide rate is approximately 12 suicides per 100,000 people. Alarmingly, it is also estimated that more than 1 million suicide attempts occur in the U.S. each year. According to The National Public Health Institute of Quebec, the Quebec rate is declining but is still higher than in other provinces of Canada, and in the U.S.: in 2009 1,091 Quebecers took their own lives, a rate of 14 deaths per 100,000 residents.

Risk Factors

The main factors that increase risk of suicide are: (1) having depression or another mental disorder (2) having a prior suicide attempt (3) having a family history of a mental disorder or suicide (4) a family violence, including physical or sexual abuse (5) having firearms in the home (6) having been imprisoned, and (7) having been exposed to others’ suicidal behavior, such as that of family members, peers, or media figures.

Among those who attempt suicide, men are more four times likely to die by suicide than women, but women are three times more likely to attempt suicide than men. Men seem likely to use deadlier methods, such as firearms or suffocation. Women are more likely than men to attempt suicide by poisoning. Children and young people are also at risk for suicide. Suicide remains one of the top three leading causes of death for young people ages 15 to 24. Older adults are at risk for suicide, too. In fact, white males age 85 and older consistently have the highest suicide rate than any other age and ethnic group. Among ethnicities, First Nations peoples tend to have the highest rate of suicides, followed by Whites. Hispanics and African-Americans tend to have lower suicide rates.

In addition to factors in the environment, the risk for suicidal behavior also seems to be associated with changes in brain chemicals called neurotransmitters, including serotonin, which is also associated with depression and impulsive behaviours. Lower levels of serotonin have been found in the brains of people with a history of suicide attempts. Genes that regulate serotonin activity in the brain seem to be associated with impulsive forms of suicide as well.

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Warning signs

The following are some of the signs you might notice someone that may be reason for concern: (1) Talking about wanting to die or to kill oneself (2) Looking for a way to kill oneself, such as searching online or obtaining the tools necessary to attempt (3) Talking about feeling hopeless or having no reason to live (4) Talking about feeling trapped or in unbearable pain (5) Talking about being a burden to others (6) Increasing the use of alcohol or drugs (7) Acting increasingly anxious or agitated; behaving more recklessly (8) Sleeping too little or too much (9) Withdrawing or feeling isolated (10) Showing rage or talking about seeking revenge (11) Displaying extreme mood swings (especially anger or sadness).

Prevention of suicide

Like many areas in psychology and mental health, effective suicide prevention is based on sound research data. Programs that work tend to take into account people’s risk factors and promote interventions that are appropriate to specific groups of people. For example, research has shown that mental disorders such as depression and substance abuse are risk factors for suicide. Therefore, many programs focus on treating these disorders in addition to addressing suicide risk specifically.

Psychotherapy can effectively reduce suicide risk. One effective therapy is called cognitive behavioral therapy (CBT). CBT can help people learn new ways of dealing with stressful experiences by helping them to learn healthier actions when thoughts and feelings of suicide arise. Another type of psychotherapy called Dialectical Behavior Therapy (DBT) has been shown to substantially reduce the rate of suicide among people with Borderline Personality Disorder, a serious condition characterized by unstable moods, relationships, self-image, and impulsive behavior. A therapist trained in DBT helps a person recognize when his or her feelings or actions are disruptive or unhealthy, and helps the patient to develop the skills needed to deal better with upsetting situations. Some medications may also help reduce suicide risk. For example, the antipsychotic medication clozapine is approved by the U.S. Food and Drug Administration for suicide prevention in people with schizophrenia.

If you are concerned that you or someone you know is at risk for suicide, immediate action is very important. Suicide can be prevented and most people who feel suicidal demonstrate some of the warning signs. Recognizing some of these warning signs is the first step in helping yourself or someone you care about. If you or the person you are concerned about is in imminent danger, a call to 911 or a suicide hotline is the best answer. For people feeling depressed or sad (but who are not suicidal at the moment), making an appointment with a doctor or mental health professional is the best option.

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For more information on our services, or for help on deciding which of our team psychologists to choose, don’t hesitate to contact our clinic coordinator at 514-337-2473, ext. 0, and it is with great pleasure that we will discuss with you the psychological services we can offer you.