Learn The Symptoms: Suicidal Thoughts and Attempts
Suicidal thoughts are much more common than suicidal attempts. Some persons may have only fleeting thoughts of death, or they may create detailed plans and scenarios for committing suicide. The thoughts can be very distressing, or they can feel normal. In most cases, they are caused by a serious underlying mental health condition.
Suicide attempts are not the result of a carefully thought out decision. Rather, they are driven by strong negative emotions. Often, the person will have felt bad for a long time, but the attempt itself usually occurs in the midst of a short period of unusually intense negative emotions. It is common for persons who attempt suicide to hold especially critical and negative views about themselves. They often consider themselves "failures" for having fallen short of some standard. However, these assessments are often quite inaccurate, and many persons who attempt suicide seem outwardly "successful." What they all have in common is an inability to imagine a positive future; they may have difficulty imagining the future at all.
"Sometimes, even to live is an act of courage.
What causes someone to think about or attempt suicide?
Depression is a major reason people might think about or try to hurt or kill themselves. Intense feelings of depression and despair can make it difficult to find reasons to continue living, and make it difficult to imagine a positive future. Depression interferes with our ability to judge situations accurately, and leads to inaccurate, overly negative thoughts and evaluations. Depression can lead to feelings of reduced self-worth, and increased self-blame for perceived failures. Feelings of anxiety often accompany intense depression, which intensifies feelings of desperation. Suicidal thoughts may linger, and eventually lead to serious attempts at suicide.
Borderline personality disorder is another reason people struggle with suicide attempts or thoughts. A major feature of BPD is deficits in emotion regulation. That is, people with BPD may feel negative emotions more strongly, and have greater difficulty calming down. When they experience intense negative emotions they may react in all sorts of ways in attempts to feel better that actually make things worse. Sometimes, persons with BPD engage in self-harm, or non-suicidal self-injury, by cutting or hurting themselves in some other way. When experiencing especially intense emotions, they may attempt suicide. Sometimes persons with BPD are unfairly described as attention-seeking, and their suicide attempts are dismissed as unserious or even manipulative. In reality, persons with BPD are often in great pain, and they attempt suicide for a variety of reasons.
“...and then, I have nature and art and poetry, and if that is not enough, what is enough?”
Vincent van Gogh
Who Is At Risk? Suicide Statistics
Prevalence: Suicide is a leading cause of death. In 2016, it was the 10th leading cause of death overall for all Americans.
By Gender: Males are about 3.5 times more likely to commit suicide than women.
By Age: The suicide rate increases with age. Men aged 65 and over are the most likely to commit suicide. Women are most likely to commit suicide between the ages of 45-54.
By State: The states with the highest rates of suicide are primarily in the mountain west and southwest regions. The states are: Colorado, Wyoming, Utah, Nevada, New Mexico, Arizona, Montana, Idaho, Oklahoma, and Alaska.
Suicide and Mental Illness
These are some of the most common mental health issues that result can result in suicide.
Depression and Anxiety
Moods disorders, including depression and bipolar disorder, are the most common diagnoses for persons who commit suicide. About half of all persons who commit suicide suffer from depressive episodes. Persons suffering from intense depression may feel hopeless, and begin to have thoughts of suicide. For many persons, depression is highly treatable. Persons with one of the various anxiety disorders are vulnerable to suicide as well. Many such persons also struggle with depression, and anxiety disorders themselves can be highly distressing if untreated.
Substance Abuse and Addiction
Drug and alcohol addiction is also common amongst persons who commit suicide. Long term abuse of substances can lead to mood disturbances similar to depression. In addition, many persons who commit suicide are under the under the influence when they do so. There is also evidence the withdrawal period from certain drugs increases the risk of suicide, especially with stimulants such as cocaine and methamphetamine, and depressants such as alcohol and benzodiazepines.
Borderline Personality Disorder
Persons with borderline personality disorder have difficulty regulating their emotions. Many persons with BPD engage in self-harm, also known as non-suicidal self-injury. Persons with BPD may also make suicide attempt or suicidal gestures. They often struggle with feelings of low self-worth, and depression is common.
Psychosis (related to Schizophrenia, Mania, or Intoxication)
Persons with psychosis commit suicide for a variety of reasons. They may do so because of a loss of connection to reality, or they may be struggling with mood issues related an ongoing condition.
Adolescent Suicide Prevention
Child and Teen Suicide Statistics
Suicide is the second leading cause of death for persons aged 10-34. Boys are more likely to commit suicide, accounting for 81% of completed suicides. Girls are more likely to report attempting suicide. Suicidal thoughts and gestures are much more common, and are very serious symptoms.
Is Suicide Contagious?
Suicide can, in some cases, occur in clusters. One such suicide cluster occurred in Colorado Springs, CO from 2013-2017. Young people seem to be especially vulnerable to the effect. Teens aged 15-19 are four times more likely to respond in this way than any other age group.
When a young person commits suicide, it can lead to copycat suicides amongst others from their school, or in the surrounding areas. With social media, the effect can spread further and faster than ever. For example, the positive and well intentioned messages left for a teen who commits suicide can unintentionally inspire others, who see the outpouring of love and support they receive.
Cluster suicides appear to account for only a small percentage of teen suicides, but parents, teachers, and mental health professionals should be aware that the effect is real. An adolescent suicide in the community should be treated as a major risk factor.
Adolescent Suicide: Risk Factors
These are some of the major risk factors for adolescent suicide. Each of this factors increases the risk of suicide occurring.
Psychological Risk Factors
Depression, anxiety, other mental illnesses
Previous suicide attempts, suicidal thoughts, or a history of self-injury
Abuse of drugs and/or alcohol
Low academic achievement
Feelings of loneliness or isolation
Social Risk Factors
Lack of peer support
Lack of social support from caring adults in the community
Exposure to suicide or violence on social media
Family and Community Related Risk Factors
A history of trauma or abuse (physical, sexual, emotional, or verbal)
A history of witnessing violence
Neglectful or absent caregivers
Lack of access to mental health and medical care
A previous suicide amongst family or friends
Adolescent Suicide: Protective Factors
These are some of the factors that protect against adolescent suicide. Each of this factors decreases the risk of suicide occurring.
Psychological Protective Factors
Well developed problem solving skills
High achievement (in academics, sports, and/or hobbies)
Social Protective Factors
A strong peer support network
Involvement in multiple groups/activities
Positive relationships with non-familial adults (such as teachers, coaches, and religious leaders)
Family and Community Related Protective Factors
Attentive and supportive caregivers
Regular medical checkups and access to mental health care if needed
Suicide Prevention Treatments
If you or someone you know is struggling with thoughts of suicide, or has a history of suicide attempts, help is available. They are many treatments shown by research to be effective for many people. At Front Range Treatment Center, our clinicians are trained in the difficult task of working with suicidal patients. Here are some of the ways that we treat issues of suicidal thoughts or attempts. If you or a loved one needs help, contact us today.
Dialectical Behavior Therapy
Dialectical Behavior Therapy (DBT) was designed for persons with borderline personality disorder (BPD). A major feature of BPS is difficulty with emotion regulation, and DBT helps persons develop those skills. Today, DBT is used for a variety of different issues beyond BPD, including depression and substance abuse. Persons at risk from suicide because of a difficulty in managing one's emotions may benefit from DBT.
Collaborative Assessment and Management of Suicidality (CAMS)
Collaborative Assessment and Management of Suicidality, or CAMS, is a system for assessing for suicide risk, and then addressing that risk. The therapist and client work together to develop a treatment plan, and revise the plan over time to keep the client safe. CAMs can be used with any client, who comes to therapy for any issue. For example, a client suffering from depression may be treated with cognitive behavioral therapy for their depressive symptoms, while also participating in CAMs.
Workshops & Presentations For Your School or Organization
At FRTC, our clinicians have a special interest in suicide prevention efforts. We can offer informational presentations and workshops to interested organizations, free of charge. Request a phone call with us to discuss the needs of your organization.
We can offer presentation to the following groups:
School faculty and staff, at the middle school, high school, and college level
Middle-school and high school students (for example, as part of a health class)
Mental health professionals wanting to learn more about suicidality and suicide prevention from a DBT perspective
Other organizations interested in establishing or improving a suicide prevention program