Suicide is a real issue, one that generally gets ignored even though it’s the 10th leading cause of death. More than 40,000 people in the U.S. die from completed suicide every year. More than 800,000 people end up in the ER from suicide attempts or self-inflicted injury. The rate of suicide is more than twice the amount of people that die by homicide, but we seem to only hear about homicides. Suicide is a silent and personal death. There are numerous reasons why people commit suicide whether financial problems or stressful life events, but up to 90% of suicides are committed by people with mental illness. The highest group of people that are vulnerable to suicide are the ones with bipolar disorder.
We don’t like to talk about suicide. You hear about it in whispered tones like if saying out loud makes it contagious. We don’t talk about it, and it’s killing us.
Suicide has been a taboo since ancient times. Aristotle considered it not only morally offensive, but an economic issue for the state. Catholicism views suicide as a mortal sin. Not only do you forfeit burial rights, but heaven is no longer an option. There are exceptions to this, thankfully, and having a mental illness is one of them.
The moral premise against suicide is that it’s basically murder, only it’s committed against the self. Some people consider it selfish. After all, you’re leaving behind loved ones and anyone who may be dependent on you. We are obligated in this sense to consider their pain over our own, neither of which we can control.
Suicide is not necessarily a wish to die. Sometimes it certainly is, but it’s more complicated than that. When you live with depression, it literally hurts. It is chronic pain for which there may be treatment, but no cure.
You just want the pain to stop and the illness in our minds tell us that suicide is the only way to make that happen.
About 34% people with bipolar disorder only have suicidal ideation. They think about it, but never formulate an actual plan or carry it out. I’m familiar with this feeling. You just get tired. It’s not that you want to die, it’s that living with this huge ordeal day in and day out is exhausting. When simply breathing is hard, death can seem like the better option.
Major depressive disorder and schizophrenia share similar suicidal mortality. Around 2%-15% of patients with these illnesses commit suicide. For bipolar disorder, that number increases to up to 25%. People with bipolar disorder are 20 times more likely to commit suicide than the general population.
Some overall risks for suicide are:
- Male gender (though women have more attempts)
- Mental illness
- Substance abuse
- Financial hardship
- Separation or loss
- Family history of suicide/mental illness
- Feelings of hopelessness
- Emotional or physical abuse
- The stigma of asking for help
So what is it about bipolar disorder that’s different? The above factors absolutely come into play, but there are additional factors that need to be watched for when it comes to bipolar disorder:
- Younger age at onset of symptoms
- Recent inpatient care
- Psychotic symptoms
- Bipolar II disorder
- Mixed states
- Childhood physical abuse
- Higher number of depressive episodes vs. manic
- Additional disorders like substance abuse, eating or anxiety disorders
- Lack of treatment
Let’s chew on that last one a bit. Impulsivity is a huge issue in bipolar disorder. It’s the thing that makes you quit your job without a game plan or without considering the consequences. It makes you think that “Eh, we don’t need a condom!” when you don’t know your partner’s sexual history or STI status. It worsens compulsive eating disorders and tells you it’s okay to buy something you can’t afford.
If impulsivity can aid in all of these things, it can absolutely lead to the quick decision of suicide without thinking about the depressive episode ending on its own or that having a doctor adjust your medication can help. Impulsivity is all about the right now, and it doesn’t just occur during mania. It’s there in a lesser extent for depression and even between episodes.
If you are considering suicide there are steps you can take to help.
- Call a crisis hotline. They are there 24/7 for support.
- Go to the ER. Most are equipped to handle psychological emergencies.
- Call your doctor. They can give more personal direction and adjust your meds if necessary.
- Tell someone. If you are unable to get help for yourself, ask someone to do it for you, even if you think they don’t care.
In the meantime, may you find peace in existence.
You can find me on Twitter @LaRaeRLaBouff
Photo credit: Anil kumar