Suicidal behavior: what it is. causes, symptoms, treatment, prevention

What is suicidal behavior?

Suicidal behavior (thoughts) includes committed suicide and attempted suicide. Thoughts and plans to commit suicide are called suicidal thinking.

Suicide is usually the result of the interaction of many factors, usually including depression.

Some methods, such as the use of weapons, are more likely to result in death, but choosing a less lethal method does not necessarily mean that the intent was less serious.

Any threat of suicide or attempted suicide must be taken seriously and the person needs help and support. A hotline is available for people who are considering suicide.

Hotline phone: 8 495 989-50-50 (anonymously, around the clock, free of charge).

Helplines: 8 495 988-44-34 (free within Moscow), 8 800 333-44-34 (free within Russia).

Suicidal behavior includes the following:

• Completed suicide: Intentional act of self-harm that results in death.
• Suicide attempt: An act of self-harm that is fatal but does not result in death. A suicide attempt can also lead to injury.

Non-suicidal self-harm Is an act of self-harm, the purpose of which is not death. Such acts include hand scratching, cigarette burns, and vitamin overdose. Self-harm without suicidal tendencies can be a stress reliever or a call for help from people who still want to live. These acts should be taken seriously.

Information on suicide rates is obtained primarily from death certificates and inquiry reports, and the actual suicide rate is likely to be higher. However, suicidal behavior is already an all too common health problem. Suicidal behavior occurs in men and women of all ages, races, religions, income levels, educational levels and sexual orientation. There is no typical pattern of suicide.

Statistics of committed suicides around the world

Globally, about 800,000 people die by suicide every year.

Suicide has become the second most common cause of death among people aged 15 to 29 years.

Available evidence suggests that for every person who dies as a result of suicide, there are many who have attempted suicide. This ratio varies greatly by country, region, gender, age and method.

Do you know that…

Suicide is the leading cause of death among young people, but the number of suicides committed is highest in people aged 45 to 54, followed by people aged 85 and older. Men are more likely to commit suicide than women. For every person who commits suicide, there are many others who have tried to commit it.

People who try to commit suicide have significantly reduced life expectancy. Much of the decline in life expectancy appears to be due to physical impairment rather than later suicide.

Causes and risk factors

Among people who kill themselves, about 1 in 6 people leave a suicide note, which sometimes contains clues as to why they did this.

Suicidal behavior is usually the result of the interaction of several factors.

The most common contributing factors to suicidal behavior are:

• Depression.

Depression, including depression, which is a component of bipolar disorder, takes place with more than 50% of suicide attempts and an even higher proportion of committed suicides. Depression can come on suddenly due to a recent loss or other sad event, or as a result of a combination of factors. People with depression have family problems, recent arrest or legal problems, unhappy or ended love relationships, disputes with parenting or bullying (among teens), or the recent loss of a loved one (especially among the elderly) can lead to trying suicide. The risk of suicide is higher if people with depression also have significant anxiety.

People with some diseases may become depressed and attempt suicide or commit suicide. Most diseases associated with an increase in the number of suicides, either directly affect the nervous system and the brain (as happens with AIDS, multiple sclerosis, temporal epilepsy or head injuries), or provide treatments that can cause depression (for example, some drugs used to treat high blood pressure).

In older adults, approximately 20% of suicides may be due in part to severe, chronic and painful physical disorders.

Traumatic childhood experiences, including physical and sexual abuse, increase the risk of attempted suicide, possibly because depression is common among people who have had such experiences.

Use alcohol can worsen depression, which in turn increases the likelihood of suicidal behavior. Alcohol also reduces self-control. About 30% of people who are trying to commit suicide drink alcohol before attempting, and about half of them are drunk during this time. Due to the fact that alcoholism, especially drunkenness, often causes deep feelings of remorse in alcoholics in periods when they do not drink alcohol, they are prone to committing suicide even when sober condition.

Almost everyone else mental disorders also increase the risk of suicide.

People with schizophrenia or other psychotic disorders may be delusional states (established false beliefs), with which they cannot control, or they may hear voices (auditory hallucinations) ordering them to kill myself. In addition, people with schizophrenia are prone to depression.

People suffering borderline personality disorder or antisocial personality disorder, especially people with a history of violent behavior are also at higher risk of suicide. People with these disorders do not tolerate frustration well and react violently to stress, sometimes resulting in self-harm or aggressive behavior.

Lonely lifestyle increases the risk of suicidal behavior. People who are separated from their spouses, are divorced or widowed are more likely to commit suicide. Suicide is less common among people in strong relationships than among single people.

- Risk factors for suicidal behavior:

• Men;
• An illness that causes pain or disability;
• Living alone;
• Economic downturns or debts;
• Unemployment;
• Bereavement or loss;
• Humiliation or shame;
• Hopelessness;
• Aggressive or impulsive behavior;
• Depression, especially if it is accompanied by anxiety or is a component of bipolar disorder;
• Recent hospitalization for depression;
• Most other mental disorders, such as personality disorders;
• Long-term sadness, even when other symptoms of depression decrease
• Past drug or alcohol abuse;
• Past attempts to commit suicide;
• A history of suicide or mental illness among family members;
• Childhood traumatic experiences, including physical or sexual abuse;
• Suicide concern and talk about it;
• A well-defined plan for committing suicide.

- Antidepressants and the risk of suicide.

The risk of attempting suicide is highest in the month before starting treatment antidepressants, and the risk of dying from suicide after starting antidepressants is not increases. However, antidepressants do not significantly increase the incidence of suicidal ideation and attempted suicide (but not the incidence of suicide committed) in children, adolescents, and young adults. Therefore, parents of children and adolescents should be warned about this, and children and adolescents should be carefully monitored for side effects. effects such as increased anxiety, agitation, restlessness, irritability, anger, or going into hypomania (when people feel energized and alert, but often easily irritated, distracted, and aroused), especially in the first few weeks after starting drug.

Public health officials warn of a possible link between antidepressant use and increased risk of suicide, so doctors began to prescribe antidepressants to children about 30% less often and young people. However, after such warnings appeared, the youth suicide rate temporarily increased by 14%. Thus, it is possible that recommendations not to use medication for depression led to more, rather than fewer, deaths due to suicide.

When people with depression take antidepressants, doctors take certain precautions to reduce the risk of suicidal behavior:

• Prescribing antidepressants in an amount that will not lead to death;
• Scheduling more frequent visits when treatment is just beginning;
• A clear warning to people, their families and loved ones to watch for worsening symptoms or suicidal thoughts;
• Tips for people, their families, and loved ones to call the doctor prescribing the antidepressant immediately or seek other help if symptoms worsen or suicidal thoughts arise.

What methods do suicides use?

The choice of method of suicide is often influenced by cultural factors and the availability of the method. It may or may not reflect the seriousness of the intention to commit suicide. In the case of some methods of suicide (for example, jumping from a high building), survival is almost impossible, in while in the case of other methods (for example, an overdose of drugs) a person can still to rescue. However, even if the person uses a method that is not fatal, their intent may have been as serious as that of the person whose method was fatal.

Attempted suicide most often associated with drug overdose and self-poisoning. Violent methods such as suicide by gun and hanging are rarely used in suicide attempts because they are usually fatal.

Most committed suicides weapon involved. In the United States, weapons are used in about 50% of suicide cases. Men use this method more often than women. Other methods include hanging, poisoning, jumping from a height, and self-inflicting injury. Some methods, such as falling off a cliff in a car, may endanger others.

Globally, pesticide poisoning accounts for about 30% of suicides committed.

Prophylaxis

While some suicide attempts or completed suicides are a shock, even to family members and friends, many people give clear warnings. Any threat or attempted suicide must be taken seriously. If you ignore it, you can lose a person.

If a person threatens to commit suicide or has already attempted suicide, you should immediately contact the police so that emergency services can arrive at the scene as soon as possible. Before help arrives, you need to speak calmly and supportively with the person.

A doctor may hospitalize people who have threatened or attempted suicide. In most states, a doctor is allowed to hospitalize people against their will if the doctor believes there is a high risk of harm to themselves or others.

Suicide Prevention: Helplines and Psychological Hotlines.

People who threaten to commit suicide are in a state of crisis. Helplines and psychological hotlines (see. below) provides crisis intervention for such people throughout Russia.

Hotline phone: 8 495 989-50-50 (anonymously, around the clock, free of charge).

Helplines: 8 495 988-44-34 (free within Moscow), 8 800 333-44-34 (free within Russia).

When people with potential suicidal tendencies call the hotline, the specialist does the following:

• Seeks to establish a connection with them, reminding them of their identity (for example, repeatedly using their name);
• Can offer constructive help in solving the problem that led to the crisis and urge the person to take clear measures to solve it;
• Can remind the person that they have family members and friends who care about them and want to help;
• May try to arrange a personal meeting with a specialist who can provide emergency professional assistance to the person.

Sometimes people call the hotline to say they have already committed a suicidal act. (for example, took a high dose of a drug or turned on gas) or are doing so in a given moment. In such cases, the specialist tries to find out their address. If this is not possible, he contacts the police to trace the call and try to save the person. If possible, the specialist continues to talk to the person on the phone until the police arrive.

Situation management

Doctors take any suicidal act seriously, regardless of whether the person actually intended to commit suicide or not.

If a person is seriously injuring themselves, doctors assess and treat the injury, and usually the person is hospitalized. If people overdose on a potentially deadly drug, doctors take immediate steps to prevent the drug from being absorbed and speed up its elimination from the body. People are also provided with any antidote and supportive treatment available, such as a breathing tube.

After an initial assessment, people who have attempted suicide are referred to a psychiatrist who tries to identify the problems that led to the attempt and plans for appropriate treatment.

To identify problems, psychiatrists do the following:

• Listen to what the person wants to say.
• They are trying to understand what caused the person to commit suicide, what led to this attempt, where and how it happened.
• Asks questions about the symptoms of mental disorders that increase the risk of suicidal behavior.
• Asking if the person is receiving treatment for a mental disorder, including whether the person is taking any medication to treat it
• The mental state of a person is assessed, signs of depression, anxiety, agitation are identified, anxiety attacks, severe insomnia, other mental disorders, and alcohol or drugs.
• Asking questions about personal and family relationships.
• They talk to close relatives and friends, ask them questions about a person's use of alcohol, marijuana, pain relievers and drugs.
• Help the person identify things that trigger suicidal thoughts and plan ways to deal with the provoking factors.

Because depression increases the risk of suicidal behavior, doctors closely monitor people with depression for suicidal behavior and thoughts.

Some evidence suggests that the use of lithium, antidepressants, and antipsychotics to treat mood disorders in people at risk of suicide can reduce the number of people committed suicide. Treatment of schizophrenia with clozapine reduces the risk of suicide.

Suicide effect

Death by suicide has a profound emotional impact on all the people involved. Family, friends, and doctors can feel guilt, shame, and remorse for not preventing suicide. They may also feel anger towards the deceased. Eventually they may realize that they could not have prevented suicide.

Sometimes a therapist helping to cope with the loss of a loved one or a self-help group can help the family and friends of the bereaved person deal with their feelings of guilt and grief.

The effect of attempting suicide is similar. However, family members and friends of a person have the opportunity to calm their feelings by responding appropriately to the call for help.