Suicide Warning Signs You Need to Know – Who Attempts Suicide? (1/2)

Some of us in the mental health field have heard the suicide warning signs so often it’s practically tattooed on the back of our skull: suicide note, suicide plan persistent thoughts of suicide, previous suicide attempt and so on.

But if you think you know the warning signs for a suicide attempt you’re probably wrong, at least according to a study out of Florida. For example, fewer than 1-in-10 people leave suicide notes and fewer than one-third of people have persistent thoughts of suicide before their suicide attempt.

Suicide Self-Assessment Scale

A while back I wrote a post called Suicide Self-Assessment Scale – How Suicidal Are You? This was a completely unscientific (or mostly unscientific), personal look at what thoughts suggest suicidal behavior.

Importantly, this was a suicide self-assessment scale relevant to depression. De facto, this means an individual must look at their own thoughts and feelings to rate themselves on the suicide scale. I do think this is a helpful concept for many of us who want to avoid a suicide attempt, for those of us who want to look for suicide warning signs and know we don’t want to die.

Suicide Risk Factors

Unfortunately, this doesn’t help people too depressed / suicidal to care. And this doesn’t help the people outside the depressed / suicidal individual. Luckily, rather than going on my unscientific self-assessment, actual statistics can help us identify significant suicide risk factors.

Statistical Suicide Risk Assessment

Predicting Who Attempts Suicide

Determining accurate suicide risk factors is of great interest of researchers such as in the analysis which provides the statistics for this article: Suicide Risk Assessment: A Review of Risk Factors for Suicide in 100 Patients Who Made Severe Suicide Attempts by Hall RC et al.(1998).

This study is of 100 patients who attempted suicide, required care from an emergency room and then were administered into a medical department of the hospital before admission to an inpatient psychiatric unit. In other words, these were serious, severe suicide attempts. (Demographics of population here.)

Interestingly, these patients often do not show some of the classic suicide risk factors.*

Facts About the Suicide-Attempter Population

Age groups of suicide attempters

  • Age 26-35 – 31%
  • Age 15-25 – 24%
  • Age 36-45 – 22%
  • Age 46-96 – 27% (dramatic decrease in numbers after the age of 45)

That isn’t really a surprise to people in the mental health field.

Help available to suicide attempters:

  • 76% reported they had a family support system available to them they could have called
  • 18% reported there was no one available to help them
  • 6% reported they could have relied on friends
  • Most lived alone and were divorced, separated, single or widowed

Method of Suicide Attempts

In case you’re wondering, more women (58%) attempt suicide than men and women are more likely to choose overdose as the method of suicide. (Men successfully complete suicide more often, but that’s for another post.)

In this case the methods used in the suicide attempts were:

  • Single drug overdose 76% (benzodiazepines the most common drug of choice (47%) but a significant number used over-the-counter drugs (25%))
  • Multiple drug overdose 17%
  • Stabbing or cutting 4%
  • Carbon dioxide poisoning 3%

In Part Two I’ll look at what factors most reliably predicted these suicide attempts.

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Note: These paper refers to those who attempt suicide, the factors for which seem to differ somewhat from those who complete suicide. Also note, this is only an analysis of 100 attempts, so the statistical picture is kind of murky but I think still relevant.

* This paper aims to change how insurance companies decide to allow care for suicidal patients claiming the current model denies care to patients who are suicidal due to outdated understanding of risk factors. That’s beyond the scope of this article but very interesting.

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  1. Pingback: WTF Charlie Brown! I Call Bull Sh!t . . . Again! | The Professionally Depressed Professional

  2. Im warmed w in the feeling of the endind statement of
    Flash ) that is not so ogften hurd or even w in any one
    Ability to agree to such reality to that in ones understand
    To mind. Be cause people I mean just think . Live is that as
    U no it . Iys not always devine , but u roll w it as it cums.
    Yo ur day become a more of a struggle . A lot less ezer to
    Tuck and roll . Not only thus the mind now to the body begains
    To blen w In its feeling merg as one .to now top that you get
    A blanket apone ur core existence . As that of a toothake
    Yet hsd no name words do not define , it has pain is untuch-
    Abl . To that in any reached out hand to it helping. Do u not even
    In the lack of understanding is it not fair to allow in its right
    Of oking ones heart to its right to findly free it pain and begain
    That of life in its ending of being lived?????

  3. I believe you need to recheck your statistics. For example, there has been a huge increase, some are calling it an “epidemic”, of suicides by males over 45 (in the US at least).

  4. Yes, I think hopelessness and helplessness play a great part in suicide thoughts. Often suicidel people are not taken seriously, which adds to their hopelessness. It never is one thing alone, it’s an accumulation of different things going wrong all at the same time, when nothing goes right, then it only takes one more thing, even the slightest to go wrong which tips someone over the edge.
    I found that people who had antidepressants from the doctor are even more likely to feel suicidal, as I sends them into a non-caring, apathetic mood and that is even worse, because feeling nothing at all makes you a zomby and makes you feel your life is not worth anything.

    • You nailed it. I can only speak from experience. But I have a question. Well, not so much a question but an observation. In my 50+ years I feel that society is too quick to label depression as an illness. Although it can be, there are times the cause is not illness but circumstance. One after the other leaving the victim barely enough time to catch their breath, come up for air so to speak. In this case there are few choices. One is to change the circumstance which is not always an option. Another is to self adjust my attitude, control my reaction and seek the help of people and friends I can trust and truly have my best interest in mind. Another avenue , if you have faith, is to seek Gods help. Medications? If it’s truly a diagnosed illness and you are under the care of a psychiatrist, absolutely get that help. If for no other reason, to at least be sure. One last thing. We are not alone. Even if all you have is yourself there are people here that feel your pain, live your pain, and are constantly looking for relief. I know first hand. All at once, divorced, found a new love after many tries, flooded out of my home, got laid off, found a job, lost my brother, found a new place to live, got laid off again. My point. To live the life you love, you’ve got to make it happen. Sometimes there seems to be more shit than we think we can handle like right now for me. It’s always something. Enjoy what moments you can. Deal with the rest step by step.

  5. As much as i don’t want to talk about this i worry i am getting worse.
    I have no reasonto.upset.or.anything besides my mom is terminally ill. But.before.that everyday i thought of suicide now.its two or three times a day and have planned it out. I am just tiredat all makes me happy .of life.noth

    nothIng makes me happy even before all this and i feel emotionless besides.sorrow

  6. Most people seem to view suicide as something people do when they are not in their right mind, and that therapy is the way to treat such a situation, as you would with most mental issues.
    But a person could be perfectly rational in their feelings that their life isn’t worth living anymore, so when a person like that shows you how awful and probably irreparable a life they have, don’t you – at some point – have to agree that such a person might indeed be “better off dead”?

    By the way, in the above list, you mentioned “carbon dioxide poisoning”, which I’m sure is bad, but did you mean “carbon MONoxide poisoning”?

  7. Suicidal attempts are made by some people who have already accepted a failed mortality. Bringing the issue
    of suicide to the attentions of all is awareness that may save a life. The real life no one sees beyond the body is what is in need of attention. Only friends and family know this. Who will help a person who is hopelessly resigned to end life where there is no life (within)? There are numerous online chat rooms, as well as live call assistance for the potential suicide. Outreach is there. The chemistry that defeats some is a responsibility of health care professionals who can see the damage within. Trained psychiatric clinicians have the ability to rescue the hopeless once they are exposed. (this personal opinion is not without experience)

  8. Ok so while I didn’t actually make the suicide attempt, I was really close and only backtracked at the last moment because I was too scared it wouldn’t work but leave me somehow disabled. So I guess I almost fit into the study group. I didn’t leave a suicide note – seriously, that was the last concern in my mind. I didn’t make a previous attempt and the serious thoughts (with plans and such) only started maybe 1-2 days earlier. I was already in treatment, but didn’t feel I couldn’t talk about it. I’d only mentioned occational thoughts which are kind of deemed “normal” when seriously depressed. So I guess I didn’t fit the classical case at all. However, in a depression handbook I took a “suicide-test” for myself shortly before, and I scored very high. Questions were mainly concerned with how hopeless I was, if I could imagine my future life etc. Honestly answering these to myself I could see that hopelessness was really the main factor that was driving me, thinking that there was no way life could get better. To me it was not a cry for help, I could have easily had that. It was believing that there could be no help, regardless of all evidence against that. I was completely sure to myself that my depression wasn’t “regular” and treatable, that it was all inherently my fault and couldn’t be changed. And that I simply couldn’t see a way how I could live. And since I am usually a rational person I was also sure I had to be right. Luckily, as i said, there was not a “simple and safe” way, preferably without pain, because if there had been I think I would have taken it. But the inability to do it in the very worst moment finally gave me the strength to accept treatment and stick with it, and not succumb to the strong thoughts again, that still persisted for several weeks. So, in my mind I find it important to talk to someone who is depressed and ask them in clear terms about how hopeless and desperate they feel to assess suicidality. Not just “do you have plans”‘ because they may suddenly manifest quickly. But then, of course this may be very different for others, I don’t know. This is just my story.

    • Hi Leah,

      Actually, you fit the study quite nicely, for whatever that’s worth.

      Feelings of hopelessness score very high as a predictor as do worthlessness and helplessness. In the next article you’ll see the percentages and whatnot.

      “I’d only mentioned occational thoughts which are kind of deemed “normal” when seriously depressed.”

      This is very common too. The suicide attempters report that exact thing. Occasional thoughts that are “normal” for that population.

      “I was completely sure to myself that my depression wasn’t “regular” and treatable, that it was all inherently my fault and couldn’t be changed.”

      That right there is a key, and obviously you see that. You were delusional (to an extent) because you had convinced yourself of the falsehoods above. That kind of thinking _is_ very dangerous.

      I agree, it’s important to sit down and talk with a person, which is basically what these two articles are about. You can’t make a yes/no checklist or ask 4 questions and assume you know the person. Most of these people saw healthcare professionals before their attempt and yet they still attempted and I believe we can do better than that.

      – Natasha Tracy