Suicide is often associated with mood disorders but can occur in their absence or in the presence of other disorders. Many depressed persons and persons with Bipolar disorder have suicidal thoughts and sometimes make genius attempts to take their own lives. It is believed that more than half of those who try to kill themselves are depressed and despondent at the time of the act, and it is estimated that as many as is percent of people who have been diagnosed with major depression ultimately commit suicide. A significant no. of people who are not depressed, however make suicidal attempts, some with success - most notably people diagnosed with Borderline Personality Disorder. The suicide rate for Male alcoholic is greater than that for the general population of men, and it becomes extremely high in alcoholic men who are also depressed. In understanding suicidal behavior, three indices are important:
- Suicidal Ideation: Serious thoughts about committing suicide.
- Suicidal Plans: A detailed Method for killing one self.
- Suicidal Attempts: Not successful
FACTS ABOUT SUICIDE
- About half of those who commit suicide have made at least one previous attempt but most attempters never make another attempt.
- Men are four to five times more likely than women to kill themselves, although the ratio may be diminishing as women are becoming a higher-risk group.
- Three times as many women as men attempt to kill themselves but do not die.
- Being divorced as widowed increases suicide risk by four or five times and may be a risk factor that becomes more influential with age.
- Suicide is found at all Social and economic levels but is especially common among psychiatrists, Physicians, lawyers and psychologists, even more so if they are women.
- The rates of suicide for adolescents and children are increasing dramatically.
- Rape Survivors are at increased risk for suicide, and they are especially more likely to consider it seriously.
- Physical illness, for example, AIDS or multiple sclerosis, is a contributing factor in suicide cases.
- Suicide rates rise during depression years, remain stable during war years of prosperity, and decreases during war years.
- No other kind of death leaves friends and relatives with such long-lasting feelings of distress, shame, guilt, puzzlement and general disturbance.
PERSPECTIVE ON SUICIDE
Ideas about the nature and causes of suicide can be found in many places. Letters and diaries can provide insights into the phenomenology of people who commit suicide.
Many Motives for Suicide have been suggested:
- Aggression turned inward.
- Retaliation achieved by inducing guilt in others.
- Efforts to force love from others.
- Efforts to make amends for perceived past wrongs.
- Efforts to rid oneself of unacceptable feelings: sexual attraction to members of one's own sex.
- The desire for reincarnaton .
- The desire in region a dead loved one.
- The or need to escape from stress, deformity, pain or emotional vacuum.
Past Conception: The great sociologist Emile Durkheim (1951) defined a number of suicide types, based on the social or cultural conditions in which they occurred---
- Altruistic Suicide formalized: Suicides that were approved of, in which an individual brought dishonor to himself on his family was expected to impale himself on a sword.
- Egoistic Suicide: Older adults who kill themselves after losing touch with their friends or family, its loss of social support.
- Anomic Suicide: Feeling of lost and confused, such as sudden loss of a high prestige job.
- Fatalistic Suicide: Loss of control over one's own destiny.
The Psychological Profile of the person who committed suicide is reconstructed through extensive interviews with friends and family members who are likely to know what the individual was thinking and doing in the period before death. This and other methods have allowed researchers to identify a number of risk factors for suicide.
FAMILY HISTORY: If a family member committed suicide, there is an increased risk that someone else in the family will also. In fact recent research found that among depressed patients, the strongest predictor of suicidal behavior was having a family history of suicide. It was noted that offspring of family members who had attempted suicide had 6 times the risk of suicide attempts compared with offspring of non attempters. If a Sibling was also a suicide attempter, the risk Increase even more. This may not be Surprising, because so many people, who kill own self are depressed or have some related mental disorder, and these disorders run in families.
Neurobiology: A variety of evidence suggests that low levels of Serotonin may be associated with suicide and with violent suicide attempts. As we have noted, extremely low levels of Serotonin are associated with impulsivity, instability and the tendency to overreact to situations. It is possible then that low level of Serotonin may contribute to creating a vulnerability to act impulsively.
Existing Psychological Disorders and other Psychological Risk Factors: More than 80% 0f people who kill themselves suffer from a psychological disorder, usually mood disorder, substance use disorder, or impulse control disorders. Suicide is often associated with mood disorders, and for good reason. As many as 60% of suicide is associated with an existing mood disorder. But many people with mood disorders do not attempt suicide, and, conversely, many people who attempt suicide do not have mood disorders.
A recent important theoretical account of suicide termed the Inter Personal Theory of Suicide cites a perception of oneself as a burden on others and a diminished sense of belonging as powerful predictors of hopelessness and subsequently suicide. Alcohol use and abuse are associated with approximately 25% to 50% of suicides and are particularly evident in Suicide among college students and adolescents.
Stressful life Events: Perhaps the most important risk factor for suicide is a severe, stressful event experienced as shameful or humiliating, such as a failure (real or imagined) in school or at work, an unexpected arrest, or rejection by a loved one. Physical or sexual abuse is also important sources of stress.
Most large communities have Suicide Prevention Centers, and most therapists at one time or another have to deal with patients in suicidal crisis. Suicidal person need to have their fears and concerns understood but not judged; clinicians must gradually and patiently point out to them that there are alternatives to self-destruction to be explored.
David H. Barlow, BOSTON UNIVERSITY
V. Mark Durand, UNIVERSITY OF SOUTH FLORIDA- ST. PETERSBERG
2. ABNORMAL PSYCHOLOGY: 9TH EDITION
Davision G.C., Neale, J.M. and Kring, A.M.
3. ABNORMAL PSYCHOLOGY
Allov. L.B.: Riskind, J.H. and Manos, M.J.
4. ABNORMAL PSYCHOLOGY AND MODERN LIFE. NY: Harper and Collins. 2000
Carson. R.C. and Butcher. N.J.