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Suicide: Facts, Causes, and Prevention

There are certain considerations we all have in regard to protecting ourselves and our families from illness and death. For example, we know as a general rule that it is best to avoid excessive salt as sodium increases the risk of hypertension, a leading cause of death. We avoid excessive alcohol as we know it causes Liver cirrhosis, another leading cause of mortality. We have our houses and offices inspected for the presence of molds and toxic chemicals as we know these can lead to deadly respiratory illnesses.
Suicide kills more people every year than hypertension, liver cirrhosis, or environmental toxins. It has been the tenth leading cause of death since 2011 and has increased every year between 1999 and 2018. Yet for the most part, suicide is missing from the public consciousness when it comes to working on living healthier and longer.
48,344 people died by suicide in 2018 and there were 1.4 million suicide attempts (the last year for which completed statistics are available). While the research thus far is limited and fluctuating, there are indications that during the second half of the COVID 19 pandemic (September 2020 and onwards) suicide rates, particularly in children and adolescents, have increased relative to previous years.
An important thing to note is that suicide was already at crisis levels before the COVID pandemic occurred. Between 1999 and 2018 suicide rates in females increased 50% and in males 21%. The greatest percentage increases were in the 10-14 age group where rates doubled in males and quadrupled in females during this time period. Another major shift has been the 45-64 age group now having the highest suicide rate among males where historically the 75 and older age group had a substantially higher rate.

Major Suicide Factors According to Research:

  • A previous history of suicide attempts.
  • Mental illness, in particular Major Depression, Schizophrenia, Bipolar Disorder, and Borderline Personality Disorder.
  • Substance Use Disorders.
  • Chronic medical problems, especially terminal illness and severe, refractory pain.
  • Major life losses such as bereavement, termination from work, and sudden financial mishap. 
  • Family history of suicide, especially first-degree relatives.
  • Easy access to lethal means, especially firearms
  • Childhood traumas.
  • Sexual assault.
  • Barriers to treatment (stigma, lack of health insurance, financial constraints).
Certain protective factors have also been identified:
  • Strong connections to family and/or friends, coworkers or religious congregation.
  • Easy access to mental health care and strong rapport with providers.
  • Religious beliefs that discourage suicide. 

Seek Help to Prevent Suicide:

Most community measures, as well as medical treatments for suicide prevention, are designed to address acute suicidality. These include suicide hotlines that people experiencing suicidal thoughts can call. The National Suicide Prevention Hotline (accessed by dialing 800-273-8255) is a network of local crisis centers throughout the country available 24/7/365. Staffers and volunteers offer emotional support to individuals experiencing suicidal thoughts and help connect them to support groups, emergency rooms, and psychiatric inpatient facilities.
A list of Crisis Centers throughout Texas is also available on the website of the Texas Department of Health and Human Services.

https://hhs.texas.gov/services/mental-health-substance-use/mental-health-crisis-services

For a meaningful reduction in suicides, however, we will have to do more than intervene in emergencies. Medical science has a basic model of treating diseases: primary, secondary, and tertiary prevention. The first is taking measures to improve health and prevent a disease from occurring. The second is early detection and measures to stop more serious symptoms. The third is intervening when the disease has already manifested and trying to prevent it from doing further damage. When it comes to suicide, we spend the vast majority of time and resources on tertiary prevention because we are yet to develop a functioning model for primary and secondary prevention. The risk factors outlined previously provide us a framework to develop those models.
So, coming now to what practical things friends and family can do towards this end, the very first thing is educating ourselves and others about suicide. Many people lack awareness about the widespread prevalence and contributing factors for suicide. The more we know, the more we can teach others. The more widespread the awareness, the better the odds of someone around a suicidal individual recognizing the signs and making attempts to help or seek help for the individual.
If a loved one shows signs of mental illness, it may not be enough to encourage them to seek treatment. Many mentally ill individuals are resistant to treatment for a number of reasons including fear of stigma, lacking hope of getting better, and misperceptions about psychiatric treatment (e.g., “they’ll lock me up”, “they’ll give me drugs that will turn me into a zombie”). It may require reassuring them that psychiatric treatment is as evidence-based and safe as any other medical discipline, helping them set up appointments, and accompanying them to their treatments.

Things especially important to watch out for include:

  • individuals isolating themselves
  • giving away an inordinate number of personal (especially cherished) belongings
  • talking often about death and dying
  • talking about being a burden to or fantasizing about whether they will “be missed” if they were to pass away. 

The use of alcohol and other recreational drugs in conjunction with mental illness is also a sign that intervention is necessary. Psychoactive drugs exacerbate mental illness and impair judgment, especially when used in excess. Logical reasoning that allows despondent people to talk themselves out of self-harm does not come into play as the effects of intoxication include clouding judgment. 

The most important part of helping individuals prone to suicide is being a good listener. Our own fear of losing a loved one comes into play when we suspect they may be seriously mentally ill or suicidal. At these times we may tend to reflexively start giving advice or making suggestions. Listening empathically will provide us with more information and often provides more reassurance and grounding to a distressed person than any advice or suggestion we make.

And please don’t forget one person in all of this yourself. Drawing from the prevention model, start doing your own primary prevention today: dedicate time to self-care, nurture your connection to friends and family, open up to others about your negative feelings, avoid substance use, exercise regularly, and cultivate hobbies and interests you are passionate about. 

Would you like to have a live question and answer session with Dr. Tariq?

Join us for a Facebook live session on:
THURSDAY, APRIL 15, 2021 AT 12 PM CDT
Topic: Suicide: Facts, Causes, and Prevention

Dr-Khwaja-Tariq-MD

Khwaja Tariq, MD

Dr. Khwaja Tariq, MD is a board certified psychiatrist in Friendswood, Texas. He is affiliated with Texas Behavioral Health.

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