- At least 90 percent of people who kill themselves have a diagnosable and treatable psychiatric illnesses -- such as major depression, bipolar depression, or some other depressive illness, including:
- Alcohol or drug abuse, particularly when combined with depression
- Posttraumatic Stress Disorder, or some other anxiety disorder
- Bulimia or anorexia nervosa
- Personality disorders especially borderline or antisocial
- Past History of Attempted Suicide
Between 20 and 50 percent of people who kill themselves had previously attempted suicide. Those who have made serious suicide attempts are at a much higher risk for actually taking their lives.
- Genetic Predisposition
Family history of suicide, suicide attempts, depression or other psychiatric illness.
A clear relationship has been demonstrated between low concentrations of the serotonin metabolite 5-hydroxyindoleactic acid (5-HIAA) in cerebrospinal fluid and an increased incidence of attempted and completed suicide in psychiatric patients.
Impulsive individuals are more apt to act on suicidal impulses.
Sex: Males are three to five times more likely to die by suicide than females.
Age: Elderly Caucasian males have the highest suicide rates.
A suicide crisis is a time-limited occurrence signaling immediate danger of suicide. Suicide risk, by contrast, is a broader term that includes the above factors such as age and sex, psychiatric diagnosis, past suicide attempts, and traits like impulsivity. The signs of crisis are:
- Precipitating Event
A recent event that is particularly distressing such as loss of loved one or career failure. Sometimes the individuals own behavior precipitates the event: for example, a man's abusive behavior while drinking causes his wife to leave him.
- Intense Affective State in Addition to Depression
Desperation (anguish plus urgency regarding need for relief), rage, psychic pain or inner tension, anxiety, guilt, hopelessness, acute sense of abandonment.
- Changes in Behavior
Speech suggesting the individual is close to suicide. Such speech may be indirect. Be alert to such statements as, "My family would be better off without me." Sometimes those contemplating suicide talk as if they are saying goodbye or going away.
Actions ranging from buying a gun to suddenly putting one's affairs in order.
Deterioration in functioning at work or socially, increasing use of alcohol, other self-destructive behavior, loss of control, rage explosions.