These days, people talk about suicide and depression as if both are just common things. In a way, they are. Newspapers and television reports are replete with stories on suicide. Some youngsters regularly post in their social media that they are depressed.
Depression, especially associated with psychosis or anxiety, is one of the high-risk factors for suicide, according to “The Merck Manual of Medical Information.”
“Depression is involved in over 50% of attempted suicides,” it explains. “Marital problems, unhappy or ended love affairs, disputes with parents (among adolescents), or the recent loss of a loved one (particularly among older people) may precipitate the depression. Often, one factor, such as a disruption of an important relationship, is the last straw.”
Other high-risk factors for suicide include painful or disabling illness, living alone, debt or poverty, bereavement, humiliation or disgrace, history of drug or alcohol abuse, and persistence of sadness even when other symptoms of depression are getting better.
Still other high-risk factors: history of prior suicide attempts, family history of suicide, family violence (including physical or sexual abuse), suicidal preoccupation and talk, and well-defined plans for suicide.
Suicide causes almost half of all violent deaths and results in almost one million fatalities every year, according to the Geneva-based World Health Organization (WHO). Estimates suggest fatalities could rise to 1.5 million by 2020 – that’s two years from now!
“For every suicide death, there are scores of family and friends whose lives are devastated emotionally, socially and economically,” the United Nations health agency said in a statement.
“Suicide is a tragic global public health problem,” it added. “Worldwide, more people die from suicide than from all homicides and wars combined.”
There are estimated to be 10-20 times the number of deaths in failed suicide attempts, resulting in injury, hospitalization, emotional and mental trauma, according to the WHO.
Suicidal behavior occurs in people of all ages and of both sexes, although more men than women commit suicide. Rates tend to increase with age. However, in recent years, “there has been an alarming increase in suicidal behaviors amongst young people aged 15 to 25 years,” the WHO claimed.
According to the Merck manual, suicide notes are left by about one of four people who complete suicide. “The notes often refer to personal relationships and events that will follow the person’s death,” it explains.
“Notes left by older people often express concern for those left behind, whereas those of younger people may express anger or vindictiveness,” the manual states. “The content of the note may indicate that the person may had a mental health disorder that led to the suicidal act.”
More often than not, the choice of method of suicide is influenced by cultural factors and availability and may or may not reflect the seriousness of intent. “Some methods (for example, jumping from a tall building) make survival virtually impossible, whereas other methods (for example, overdosing on drugs) make rescue possible,” the Merck manual notes.
“However, even if a person uses a method that proves not to be fatal, the intent may have been just as serious as that of a person whose method was fatal,” the manual reminds.
Although some attempted or completed suicides come as a shock even to family and friends, clear warnings are given in most cases. Any suicide threat or suicide attempt is a plea for help and must be taken seriously, the manual urges. If the threat or attempt is ignored, a life may be lost.
“It’s important to realize that suicide is preventable,” the WHO says. “And that having access to the means of suicide is both an important risk factor and determinant of suicide.”
The WHO talked about some protective factors which include high self-esteem and social “connectedness,” especially with family and friends, having social support, being in a stable relationship, and religious or spiritual commitment.
“Early identification and appropriate treatment of mental disorders is an important preventive strategy,” the WHO says.
There is also evidence that educating primary health care personnel in the identification and treatment of people with mood disorders may result in a reduction of suicides amongst those at risk.
Media – print, television, radio and social – have a significant role to play, too. “Evidence also suggests that media reporting can encourage imitation suicides and we would urge that the media show sensitivity in its reporting on these tragic and frequently avoidable deaths,” the WHO pleads.
“The media can also play a major role in reducing stigma and discrimination associated with suicidal behaviors and mental disorders,” the UN agency concludes.