By: Ulliance, Inc.
Suicide is one of the most complex and difficult human behaviors to process and understand. The extent to which we can understand a person’s decision to end his or her own life is arguably limited. In part, this is because relatively little research has been done about suicide. Clinical interviews have been conducted with individuals who survived their suicide attempts, and this has helped cast some light on underlying causes, and the course and progression of suicidal impulses. But in many ways, suicide is and will remain a mystery, especially for those of us who have lost loved ones to such a devastating event.
Why We Say “Completed” and Not “Committed”
You’ve likely heard the expression “They committed suicide.” Mental health advocates would prefer that we use the term “completed suicide” rather than “committed suicide”. The reason for this is because the word “committed” implies wrongdoing (one “commits a crime”), whereas today we understand suicide as a tragic (though not inevitable) outcome of a complex set of health and life circumstances.
History and Impact
One of the leading causes of death across a wide spectrum of demographic groups, suicides have been on the rise over the past 20 years, approximately. However, the suicide rate today is roughly the same as it was 100 years ago. Despair, depression, and the compulsion to end one’s life have unfortunately been a part of the human experience for centuries. Today, we are perhaps better at identifying risk factors, contributing stressors, and we have a clearer, more scientific understanding of how brain disorders work. But nevertheless, suicide has been and remains to be an epidemic.
Men are four times more likely to die by suicide than women, however, women are at greater risk for suicidal ideation, plans, and attempts.
Men are more likely to die by suicide while women are more likely to attempt suicide.
Depression and Risk for Suicide
Any clinical disorder can increase the risk for suicide. Such disorders include depression and bipolar disorder, anxiety disorders, impulse control disorders, and substance use disorders. Clinical depression is especially associated with a risk for suicide.
We use the term “clinical depression” to distinguish from what counselors call adjustment disorders and what others may refer to as “situational depression,” or a short-term period in one’s life when a temporary change or life event causes us to feel differently than we normally do. Examples of adjustment disorders include coping with job loss, health problems, or the death of a loved one.
Clinical depression, on the other hand, involves a set of symptoms experienced most of the day, nearly every day, including:
- Feelings of hopelessness
- Loss of interest in things you once enjoyed
- Changes in appetite and energy levels
- Fatigue or loss of energy
- Inappropriate or excessive guilt
- More than just sad feelings
Often when we think of someone who is depressed, we imagine someone who is sad, melancholy, perhaps tearful. But there is more to depression than sad feelings.
According to Dr. Kay Redfield Jamison, a clinical psychologist who has published several books about suicide and other mental health disorders, depression is a more nuanced disease than some people might think.
Dr. Jamison has pointed out that apathy and irritability are often more symptomatic of depression than sadness. She has also mentioned that it is important to remember that there can be periods of high energy and activity between depressive episodes – individuals suffering from depression aren’t always in bed, unable to face the world.
Where Does Depression Come From?
If you’ve read any literature online or watched any documentaries about mental health and depression, you’ve likely encountered terms like “brain disorder,” “mood disorder,” “chemical imbalances,” “serotonin deficiency,” and the like. While it may be easy to describe clinical depression as “a chemical imbalance,” there is evidence to suggest that the contributing factors that give rise to depression as a mood disorder are multifaceted and complex, and extend well beyond anything that might be happening neurologically with a person.
Besides neurological conditions, here are some additional factors that are thought to play a role in the development of clinical depression:
- Financial problems
- Lack of social support
- Negative self-perception
- Difficult life circumstances
It’s also important to remember that depression is not new. “Major Depressive Disorder” is the way we medically characterize the symptoms of depression today, but those symptoms – apathy, irritability, despair, and hopelessness – have been with us, affecting certain individuals in the population, since ancient times.
Does Depression Always Lead to Suicide?
Suicide is one possible – though not inevitable – outcome of depression. Treatment for depression, including medication and psychotherapy, is effective and can be successful for many individuals. Not everyone who suffers from depression will complete suicide. Some who suffer from depression will not even attempt suicide, though they may have suicidal thoughts and thoughts of self-harm. With appropriate and timely intervention, recovery is possible.
What Do I Do When I Think Someone Might Be Suicidal?
This is one of the scariest situations we can find ourselves in. The good news is that the best approach is simple (though certainly not easy). If you suspect someone in your life is having thoughts of suicide, you need to do three things:
- Don’t leave the person alone.
- Ask the person directly, “Are you thinking about suicide?”
- If the answer is yes, contact the police or emergency services.
Recommendations for Managers
If an employee tells you they are suicidal or having thoughts of self-harm, don’t leave them alone and contact emergency services. We do not recommend transporting them to a hospital ER yourself.
If you are made aware that an employee may be actively suicidal and he or she is not currently at work, contact the police and ask that they do a welfare check on the employee.
If an employee denies having suicidal thoughts but you still have concerns about their well-being, escort the employee to a private space and assist them in calling your Employee Assistance Program.
You Are Not Alone
If you are having thoughts of harming yourself, please know that you don’t have to live with these thoughts by yourself. There are people out there willing, able, and ready to help. You can contact the National Suicide Hotline 24/7/365 at 1-800-273-8255. The National Suicide Hotline website also has a chat option – visit suicidepreventionlifeline.org/chat.