Introduction
The term Suicide is defined as “intentionally taking one’s own life and comes from the Latin word suicidium. Sui mean e and cidium mean a killing, which literally means “to kill oneself.” It tends to carry different traits depending on the culture and still today in some settings, suicide is considered as a religious taboo, criminal offense and, in some cases, an act of honor (e.g., suicide bombings).
Terminologies:
- Para-suicide: injuries themselves by self-mutilation but do not wish to die.
- Cyber-suicide: suicide pact made between individuals who meet on the internet.
- Copycat suicide: a suicide within a peer group/publicized suicide can serve as a model for next suicide in absence of sufficient protective factors.
- Literally speaking, attempted suicide is an attempt to take one’s life that does not end in death, rather self-injury.
- While in medical field assisted suicide is a controversial topic defined as helping another individual by providing them with the means to carry it out or by providing advice on how to do it.
Historical Perspectives
- In ancient times, a person who committed suicide without the approval of the state was denied the honor of a normal burial.
- In ancient Greece & Rome, Suicide was thought to be an acceptable method to deal with military defeat.
- In Islam, suicide is prohibited.
- In Christianity, suicide is considered as a sin.
- In 19th century in Europe the act of suicide shifted from being viewed as caused by sin to being caused by insanity.
- In Hinduism the Bhagavad Gita condemns Suicide.
Global Scenario:
- More than 8, 00000 people die by suicide every year.
- Around one person every 40 seconds.
- 75% suicides occur in low- and middle-income countries.
- 10th leading cause of death worldwide.
- It is the second leading cause of death in 15-29 year olds globally.
Etiology:
Social Factors
Feeling lonely, experiencing family conflicts and low levels of community integration are social factors revealed by western psychological theorists to be involved in the etiology of suicide.
Durkheim’s Theory;
Emile Durkheim a French Sociologist explain suicide in three stages;
- Egoistic: this type of Suicide occurs when the degree of social integration is low.
- Altruistic: degree of social integration too high.
- Anomic: integration into society is disturbed.
Psychological Factors
Freud’s Theory: Mourning and Melancholia.
Menninger’s Theory: suicide as inverted homicide.
Biological Factors
Researchers believe that suicidal behavior can be linked to decreased serotonin in the brain. Low levels of a serotonin metabolite, 5-HIAA, have been detected in cerebral spinal fluid in persons who have attempted suicide, as well as by postmortem studies examining certain brain regions of suicide victims.
- Serotonergic system: low concentration of 5-HIAA (metabolite of serotonin)
- Nonadrenergic system: stress-Diathesis model
- HPA axis: Dexamethasone suppression test- non-suppressor.
- (Suicide is more common in groups with low cholesterol level.
Genetic Factors
Genetics is thought to play a role in risk of suicide—such that a family history of suicide tends to indicate an increased risk of suicide among other family members—accounting for up to 55% of suicidal behaviors. Family history of mental disorders and substance abuse is also a risk factor for suicide. In a similar respect, exposure to suicide (e.g., watching a family member commit suicide or finding their body) is also indicative of an increased risk of suicidal behavior.
Risk Factors:
Risk factors are characteristics of a person or his or her environment that increase the possibility that he or she will die by suicide (i.e., suicide risk). While Major risk factors for suicide include:
- Prior suicide attempt(s)
- Misuse and abuse of alcohol or other drugs
- Access to lethal means
- Knowing someone who died by suicide, particularly a family member
- Social isolation
- Chronic disease and disability
- Lack of access to behavioral health care
- Psychiatric disorders, particularly depression and other mood disorders
- Genetics,
- Oftentimes, psychiatric factors and substance abuse co-exist.
- Financial problems
- Impulsive or aggressive tendencies
Protective Factors:
Protective factors are personal or environmental characteristics that help protect people from suicide.
Major protective factors for suicide include:
- Effective behavioral health care
- Connectedness to individuals, family, community, and social institutions
- Life skills (including problem solving skills and coping skills, ability to adapt to change)
- Self-esteem and a sense of purpose or meaning in life
- Cultural, religious, or personal beliefs that discourage suicide
- Coping and problem-solving skills
- Cultural and religious beliefs that discourage suicide
- Connections to friends, family, and community support
- Supportive relationships with care providers
- Availability of physical and mental health care
- Limited access to lethal means among people at risk
Precipitating Factors:
Precipitating Factors are stressful events that can cause suicidal crisis in a weak person.
Precipitating factors include:
- End of a relationship or marriage
- Death of a loved one
- An arrest
- Serious financial problems
Common Methods of Suicide:
- Pesticide poisoning 30%
- Hanging
- Firearms
- Drug overdose
- Fatal injuries
- Exsanguinations
- Suffocation
- Drowning
Stages of Suicide:
- Ideation
- Threatening
- Attempting
Causes:
- Mental illness
- School difficulties
- Broken romance
- Separation
- Rejection
- Physical/sexual abuse
- Bullying
Warning Signs:
- Trouble coping with recent losses, death, divorce, moving, break-ups etc.
- Feeling hopelessness and despair
- Making final arrangement, writing a will or acclamation, or taking care of details (i.e. closing a bank account).
- Gathering of lethal weapons
- Sudden change in personality or attitude, appearance, chemical use or school behavior
Gender Differences
- Males are four times more likely than females to commit suicide
- Females are more likely to have thoughts of suicide
- Females are four times more likely than men to attempt suicide
- Males are most likely to use firearms to commit suicide
- Females are most likely to use poisoning to commit suicide
Age Differences
- 1 in 100,000 children ages 10 to 14 die by suicide each year
- 7 in 100,000 adolescents ages 15 to 19 die by suicide each year
- 12.7 in 100,000 young adults ages 20 to 24 die by suicide each year
Suicide Prevention
Suicide prevention methods and treatment are based on patient risk factors. Treatments are prescribed in light of underlying conditions in addition to prevention of suicidal thoughts and acts.
If you are suffering from a mental disorder, a treatment plan to treat this condition is implemented first. One of the most common suicide prevention techniques is psychotherapy— also known as talk therapy —in the form of Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT).
Cognitive Behavioral Therapy is a common treatment option for individuals suffering from a variety of mental disorders. In this method of psychotherapy, you are taught new ways of dealing with stress and stressful life experiences. In this manner, when thoughts of suicide arise, you can redirect those thoughts and cope with them in a different way than attempting to take your own life.
Dialectical Behavior Therapy is used to help an individual recognize disruptive or unhealthy feelings or actions. In relation, this therapy method then introduces techniques on how to deal with difficult or troubling situations. More research is needed on psychotherapy related to suicide prevention though, as DBT, in particular, has been shown to decrease the prevalence of attempted suicide but has shown no effect on completed suicides.
Medications can also be prescribed as a prevention method to suicide; however, controversy exists in this method, as many medications used in the treatment of mental disorders include increased risk of suicide as a side effect.
Antidepressants especially carry a risk of a potential increase in suicidal thoughts and behavior—but this risk might be dependent on age. Clinical research has shown that young adults increase their risk of suicide and suicidal thoughts when taking antidepressants, but in older individuals, this side effect diminishes.
Increased awareness among doctors is also a prevention technique. Research indicates that many individuals who have completed suicide or attempted suicide did seek medical attention in the year prior; however, warning signs may have been missed. Increased education and awareness among medical professionals might decrease suicide rates in the future.
In an additional effort to bring awareness to suicide and risk factors associated with suicide, September 10 has been observed as World Suicide Prevention Day in partnership with the International Association for Suicide Prevention and the World Health Organization.
daily health issues 