In Part 3 of the Stress Connection we will move into the heavy part that addresses Suicide Risk. If you haven’t read the two parts preceding this blog please do so. It will provide more clarity surrounding the continuum I am addressing when it comes to stress, anxiety, depression, and suicide risk.
Stress and depression exist before a suicide attempt. When we know the relationship of stress and depression to suicide, we can see how coping skills can help prevent suicide.
Teenagers need to be aware of some facts about suicide and the warning signs that help determine whether someone is a suicide risk. Adults need this information as well.
- Stress and depression are important to understand because they are related to suicide.
- Stress and depression exist to varying extents before a suicide attempt.
- There are many misconceptions about the causes of suicide and about the warning signs suggesting suicide risk.
- The warning signs of suicide are unique to individuals. Not everyone who is suicidal will display all the signs.
- Looking for warning signs is only one part of determining suicide risk.
Warning Signs of a Suicide Risk:
- Threats of suicide or statements indicating a desire for death.
- A previous suicide attempt after which no counseling was received.
- A personality or behavioral change, such as apathy, moodiness, a sudden change from depression to happiness or euphoria.
- Depression, including crying, insomnia, hypersomnia, increase or decrease in appetite, irritability, lack of energy.
- Giving away of personal belongings.
- Excessive use of alcohol or other drugs.
- Excessive risk taking, accident proneness or other life-threatening behaviors.
- Disruptive or rebellious behaviors, which may be a disguised cry for help.
- Truancy or running away from home.
- Preoccupation with aspects of death or the impact of death on others.
- Poor grades; underachievement.
- Overachievement; difficulty in handling failure, disappointment, rejection.
- Self-deprecating statements; putting oneself down.
- Self destructive or self-punishing behaviors; self-mutilation (cutting).
- Neglect of personal appearance.
- Leaving notes, diaries, letters where they can be found and read by others. The contents of such writings usually suggest suicidal thoughts or feelings of despair and hopelessness.
- Social isolation; lack of close friends; withdrawal from friends or usual social activities; loss of interest in hobbies, sports, job or school.
Reminder: One sign does not mean someone is suicidal. Consider the signs, the person’s environment, the existence of traumatic events or recent changes in the person’s life.
Determining Suicide Risk:
Suicide is not an isolated event but a process. The identifiable event that occurs before a suicide attempt is usually only “the last straw.” Identifying signs early in the process is a key to suicide prevention.
- Suicide is preventable.
- Suicide is a process.
- Sometimes the process of suicide is caused by a single event. The single event people refer to is usually only the last straw, the identifiable event that appears just before the suicide attempt.
- Many factors can be identified as symptoms, signals or variables before a suicide attempt.
Just How Do We Determine a Suicide Risk?
Symptoms + Signals + Variables = Suicide Risk
Symptoms (Warning Signs)= Insomnia, hypersomnia, crying spells, loss of appetite, weight gain or loss, apathy, despondency, moodiness, hostility, anxiety, agitation, indecisiveness or impulsiveness, inability to concentrate, physical or psychological exhaustion, noticeable personality change.
Signals (Behaviors)= Threats or hints about self-destruction, preoccupation with aspects of death or impact on others, truancy or running away, disruptive or rebellious behaviors, abuse of alcohol or other drugs, reckless driving, excessive risk taking, accident proneness, sexual promiscuity, social isolation, neglect of personal appearance, putting affairs in order, giving away personal belongings or prized possessions, revising wills or insurance policies.
Variables (Personal and Family Factors, Traumatic Events and Life Changes)=
Personal factors can include: family relationships and the quality of these relationships, existence of lack of close friends, alcohol or other drug abuse, a previous suicide attempt, impulsive or dangerous behaviors, perfectionism, difficulty handling failures, extreme mood swings, signs of depression.
Family factors can include: a family history of suicide or a suicide attempt, a family history of a severe mental disorder, alcohol or other drug abuse in the family, poor family communication, child abuse, conditions that reduce the family’s stability, including financial difficulties, too much control by family over the teenager’s life (no independent decision making allowed), not enough intervention by the family (parents too permissive, not involved with teenager, teen makes all or most of her decisions, teen given adult responsibilities).
Traumatic events and life change might include: recent loss of a family member through death or divorce, recent loss of a romantic involvement, pregnancy, child abuse, sexual assault, a family move, earthquakes, hurricane, or other natural disasters, any event, situation or change in which loss is involved; in which change and readjustment are involved; in which the dominant theme is loss accompanied by feelings of helplessness, hopelessness and powerlessness.
These factors all have one thing in common. They all represent loss of one kind or another. The loss may build and result in feelings of helplessness, hopelessness and powerlessness. These feelings may lead to further depression. As depression sets in more heavily, the person may give up or may become angry at her or himself rather than at others who may be the sources of pain or discomfort. The person is then a risk for suicide. If no intervention (help) takes place, the process toward possible suicide continues.
When suicide is viewed as a process you can see that intervention anywhere during that process reduces suicide risk.
Know your resources in your community and in your personal life.
The best time for intervention is before a crisis.
If someone you knows appears at risk tell someone, intervene, involve a reliable and mature adult.
This information for Part One, Part Two, and Part Three are part of a book on Preventing Suicide by Nanette Burton Mongelluzzo, PhD.