Suicide is the act of deliberately killing oneself. People willingly take part in many activities that carry a risk of death. But to be considered suicide, death must be self-inflicted—that is, it must result from self-injury or from purposefully exposing oneself to immediate fatal harm.
According to the World Health Organization, suicide ranks as one of the leading causes of death worldwide. Hundreds of thousands of people throughout the world commit suicide each year, including children, adolescents, adults, and elderly people of all cultural backgrounds. Rates of suicide can vary widely among different cultures and age groups. The worldwide rates of suicide among teenagers and young adults have risen faster than those in any other age group. In general, females attempt suicide more often than males, but males are more likely to die in a suicide attempt.
Psychologists recognize that the individuals most likely to commit suicide are those who have thought about it, threatened to commit it, or attempted it. Suicide-related behaviors can take different forms. People may engage in suicidal ideation, in which they think about committing suicide but do not act on their thoughts. They may perform suicidal gestures, harming themselves in ways that are unlikely to prove fatal. People engage in such suicidal behaviors to escape from a situation that seems impossible to deal with or to get relief from troubling thoughts and feelings.
Causes.
Many factors contribute to suicide. People who have attempted suicide in the past, have a family history of suicide, or are exposed to the suicide of other people are more likely than other people to commit suicide. People with certain mental disorders—especially depression—are vulnerable to suicide, as are people suffering a hopeless physical illness. Some people commit suicide in reaction to a stressful experience or situation, such as the loss of a loved one, child abuse, family conflict, or relationship problems. Other factors that may lead people to end their lives include overwhelming feelings of hopelessness or helplessness, low self-esteem, social isolation, and lack of involvement in school or work. Among children and adolescents, bullying can lead to feelings of fear and hopelessness severe enough to cause suicide. The use of alcohol or drugs may intensify depression and other factors, making suicidal behavior more likely.
Psychologists have documented that suggestion can play a role in bringing on suicides. For example, suicides often increase after a famous person commits suicide. This effect is known as suicide contagion or copycat suicide. Suicide contagion is especially common among teenagers. For this reason, mental health professionals often take measures to prevent additional teenage suicides in a community after one such suicide occurs there.
Prevention.
Health professionals can work with people who are suicidal to reduce their risk factors and strengthen factors that may protect them. Such protective factors include: healthy coping and problem-solving skills and impulse control; close and supportive family relationships and other social support; effective and appropriate mental health care; and cultural and religious beliefs that discourage suicide. Many interventions and treatments enable people to feel better about themselves and to better cope with their lives, reducing the risk of suicide. However, suicidal people may not seek appropriate help because of the stigma (disgrace or shame) often associated with suicide and suicidal thoughts, feelings, and actions. People can help prevent suicide in others by learning to recognize its warning signs and to intervene effectively.
Common warning signs of suicide include changes in eating and sleeping patterns, mood shifts, and personality changes. People considering suicide may express feelings of hopelessness and talk about death; withdraw from family, friends, and social contact; reduce involvement in activities; and show a decline in school or work performance. They may neglect their personal appearance or put various affairs in order—for example, giving away personal possessions—as if preparing for death.
Once the warning signs of suicide are recognized, it is important to seek professional help. Community suicide prevention centers and telephone hotlines enable people considering suicide to discuss their problems and get support and guidance. Counseling and support can help many people overcome the wish to die. Limiting access to firearms and other means of killing oneself may help prevent some suicides. Medical treatment is often necessary for people who attempt suicide or have risk factors for suicide. People with a high risk of suicide may require hospitalization.
Many suicidal people suffer from depression or other mental illness. Physicians may prescribe antidepressant drugs to help them feel less depressed and lower their risk of suicide. However, certain antidepressant drugs may increase the risk of suicide in some individuals, especially younger people. For this reason, physicians must closely monitor patients who are prescribed antidepressants. They must be especially vigilant when a patient begins taking such medication, when the dosage is increased, or if the depression worsens.
Professional counseling may help people deal with their feelings, cope more effectively, and interact better with others. Counseling can be conducted on an individual basis or in group or family settings. Family counseling can help increase communication, support, closeness, and understanding among family members. This can help create an environment that reduces the risk of suicide for an individual.
Types.
Suicide generally refers to an individual taking his or her own life, but other people may be involved. In a suicide pact, a small group of people plans to die together or at the same time for personal reasons. Suicide pacts between strangers communicating over the Internet have become more common. Group suicide occurs when many people kill themselves together, often in pursuit of shared religious or spiritual beliefs, as a form of political protest, or to avoid military capture.
Some suicides accompany or follow a violent act. Murder-suicide occurs when a person kills others before or while committing suicide. Suicide bombers, for example, use explosives to kill as many people as possible and themselves. Bombers often target a group of victims for religious, moral, political, or cultural reasons, seeing their own deaths as an act of self-sacrifice.
Some people believe that hopelessly ill patients are entitled to physician-assisted suicide, in which a physician provides or prescribes medication to help a patient commit suicide. The physician does not participate, however, in the actual act of suicide. Supporters of physician-assisted suicide believe that people have a “right to die“ and that a physician’s help can be a compassionate act allowing for death with dignity. Opponents, however, feel that people do not have a right to suicide and that assisting in suicide violates a physician’s duty as a healer. Many countries have laws against physician-assisted suicide. In the United States, it is legal only in California, Colorado, the District of Columbia, Hawaii, Montana, Oregon, Vermont, and Washington. In 2015, a New Mexico court ruling legalizing assisted suicide was struck down by a higher court. Other states are considering legalizing physician-assisted suicide. In 2015, the Supreme Court of Canada overturned a ban on physician-assisted suicide. In 2016, Canada passed a law allowing physicians to assist in suicide upon request if a person’s natural death is reasonably foreseeable.
