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Suicide, or intentionally causing one's own death, is a serious and all too common problem in the United States. More than a tenth of all deaths nationwide are attributable to suicide and the rate of death by suicide has increased significantly during the last decade. Suicide has recently become the leading cause of death by injury, surpassing even deaths by car accidents.

Self-inflicted death has reached what some have called epidemic proportions among the military. There were more deaths by suicide during 2012 than there were combat deaths in Afghanistan. Suicide prevention involves providing more far-reaching education about its risk factors and warning signs and making more mental health care resources available to those at risk.

Types of Suicide

There are various methods by which individuals take their own lives. Among the most common are gunshot, poisoning or overdosing with medication. Means of committing suicide are extremely varied, but fall into three basic categories:

Physical

A physical suicide takes place when the individual incapacitates respiration or the functioning of the central nervous system. Physical suicide includes smothering or the use of firearms.

Chemical

Chemical means of suicide include all types of poisoning or overdosing.

Indirect

Indirect suicides result from premeditation but are indirectly inflicted. An example is the deliberate commission of a dangerous illegal act in order to provoke death by law enforcement officials.

The specific ways human beings destroy themselves are numerous and may include:

  • Bleeding, most commonly through wrist-cutting
  • Firearms
  • Jumping from a height
  • Drowning
  • Hanging
  • Poisoning or overdosing
  • Deliberate vehicular death
  • Suffocation
  • Dehydration or starvation
  • Hypothermia
  • Electrocution
  • Self-immolation
  • Suicide attack

Risk Factors for Suicide

Suicide is usually the result of a serious mental disorder, but individuals are presumed to be at greater risk if they have:

  • Family history of mental disorder or substance abuse
  • Family history of suicide
  • History of separation or divorce
  • History of previous suicide attempts
  • Weapons, poisons or medications available to them
  • Chronic debilitating illness or pain
  • History of incarceration or wartime trauma
  • Experienced suicidal behavior of admired figures

Demographics of Suicide

There are certain groups of individuals more prone to commit suicide. These groups include:

Men

Men are not only more likely to commit suicide than women, but are much more likely to use overtly violent means, such as firearms, to commit the act. Men and the elderly are also more likely to succeed in suicide attempts than other portions of the population.

Gay, Lesbian, Bisexual and Transgender Individuals

Individuals with less typical gender identities or those who question their gender roles, are three times more likely to commit suicide than their heterosexual counterparts. This is believed to result from societal stigma, victimization, and a sense of isolation.

Individuals Who Are Bullied

People who are bullied for any reason, including physical, mental or psychological attributes or disabilities, gender issues, or minority economic, racial or religious status are more likely to be victims of suicide.

Those in Severe Financial Distress

Many studies have shown that individuals who suffer extreme financial distress, or financial ruin, are at much greater risk for suicidal behavior. During times to severe economic downturn, there are noticeably more suicides recorded.

Age

The peak age for suicide in the United States is early adulthood, with another smaller peak appearing among the elderly. Suicide rates are also elevated for teens. Adult males are most at risk.

Ethnicity

In the United States, Native Americans and Caucasians have the highest suicide rates. African-Americans have intermediate rates and Hispanics have the lowest rates.

Marital Status

Unmarried men and divorced or widowed women are at increased risk of suicide. Of this population, single, white, older males have the highest risk.

Warning Signs of Suicide

Warning signs of suicide should always be taken seriously. They may include one or more of the following:

  • Frequent discussion of death
  • Clinical depression
  • Feelings of worthlessness or hopelessness
  • inability to experience pleasure
  • Risk-taking behavior
  • Putting affairs in order, giving away beloved objects
  • Sudden calm or contentment after a period of desperation
  • Thinking about suicide (suicidal ideation)
  • Talking about suicide
  • Saying goodbye to intimates

Suicide Prevention

Suicide is often preventable. In a person who is suffering mental anguish, those around the individual need to be alert. It is important that a person who is feeling suicidal not be left alone. Human contact and receptive listening can make a tremendous difference to someone who is feeling alienated, helpless and alone. When dealing with a potentially suicidal patient, it is also necessary to make sure that any potential weapons, medications, poisons or dangerous objects are removed from the vicinity.

Psychotherapy

Patients with suicidal ideation should be under regular, ongoing psychotherapeutic care. Talking to a skilled psychiatrist, psychologist, social worker or nurse practitioner may be of help. There are several types of therapy available, including cognitive and dialectical. Group therapy, in combination with individual counseling, may also be of assistance, particularly to patients who have recently experienced a traumatic event or have an ongoing problem with substance abuse.

Medication

Fortunately, there are now a variety of psychotropic medications available to help patients suffering from misery and despair. Anti-psychotic medications may be of great help in preventing schizophrenic suicides and antidepressants, tranquilizers and mood stabilizers may be helpful to other patients. It is important that patients continue taking their medications even after the immediate danger of suicide seems to have passed.

Emergency Intervention

Although many more people experience suicidal ideation than attempt or complete the act, it is best to err on the side of caution. If there appears to be a credible threat of suicide, particularly in a high-risk individual, or if one or more warning signs of suicide is present, the individual should be evaluated by a mental health care professional as soon as possible. If the perceived threat is imminent, the person should be given treatment at an emergency room or 911 should be called.

Assisted Suicide

There has been much controversy surrounding the concept of assisted suicide in the United States over past decades. Those who favor the proposal believe that patients suffering with diseases or conditions causing absence or deterioration of physical or mental function should be allowed to die if they so wish. Different states and different countries have varying laws about suicide. In jurisdictions where suicide is illegal, if a person who desires to die, presumably when in a rational state of mind, commits suicide, there is no one to legally prosecute. Though a person may, in some states, be prosecuted for attempting suicide, this is rarely done.

Assisted suicide, however, highly publicized in the acts of Dr. Jack Kevorkian in the 1990s, may be considered manslaughter or murder in some places. Assisted suicide occurs when one person helps another to die because the patient is unable to commit suicide alone and has requested assistance. If the person assisting the suicide is a doctor, the act is referred to as physician-assisted suicide. The difference between assisted suicide and euthanasia is that the person committing euthanasia, while believing the deed to be morally justified, is making the decision for a person apparently incapable of doing so.

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