Suicide is the 10th leading cause of death with over 44,000 completed suicides in 2014 (the most recent available data). That’s more than breast cancer or colon cancer. In addition to those who died, there were 800,000 people who were hospitalized for suicide attempts or self-injury. When it comes to bipolar disorder, somewhere between 25-50% of people with the disorder attempt suicide at some point, and even more people have plans for suicide or have suicidal thoughts. New research has followed bipolar disorder patients to see if their suicidal ideation changes over time.
There are many factors and trends that contribute to whether or not a person engages in suicidal thoughts. For example:
- Male gender
- Substance abuse
- Family history of suicide
- Emotional or physical abuse
- Recent inpatient care
- Psychotic symptoms
- Higher number of depressive episodes
- Lack of treatment
This does not mean that you have to fit into one of these categories in order to consider suicide or have thoughts of death or dying. It can and does happen frequently to a diverse group of people. New research, led by Ole Köhler-Forsberg of Aarhus University Hospital, Risskov, Denmark, sought to find if the course and persistence of suicidal thoughts changes over time.
The team surveyed 482 outpatients with bipolar I or II disorder over a period of six months, with surveys around every 2-4 weeks. Each patient was prescribed either lithium or quetiapine (brand name Seroquel) to see if the type of medication prescribed might influence the pattern or intensity of suicidal ideation.
Over the course of 24 weeks, participants were asked to rate the statement “I have
been having thoughts of killing myself” on a scale of 0-4 with 0 as Strongly disagree;
1 Disagree; 2 Neither agree nor disagree; 3 Agree; and 4 Strongly agree.
When the data were analyzed, four major groups emerged. There were those whose suicidal ideation was moderate and remained fairly stable; those whose suicidal ideation was moderate but fluctuated over time (unstable); those with persistent but low ideation; and those with persistent but very low on the scale of 0-4.
Most patients fell into the Persistent-very-low group representing 65.1% of the sample. Persistent-low was next at 20.8%. Moderate-stable represented 11.1% of the sample. Moderate-unstable represented 2.9% of the sample.
Here is what they found at the conclusion of the study:
- Suicidal thoughts generally decreased over time for the entire patient sample.
- Just over 4% attempted suicide during the course of the study.
- Those experiencing more depressive symptoms at the beginning of the study were most likely to be in the Moderate-stable group.
- 14% of the participants experienced suicidal thoughts over the entirety of the six months.
- 39% had previous suicide attempts.
- Those who had previous suicide attempts were associated with higher levels of suicidal ideation.
- Results did not differ depending on which medication was assigned.
This study shows that having thoughts of suicide is persistent among those with bipolar disorder and that those with previous attempts and those with higher levels of depression need more resources available to them in order to prevent future suicide attempts and to decrease suicidal thoughts.
If you are considering suicide there are steps you can take to get help.
- Call a crisis hotline. They are there 24/7 for support
- For the U.S., call or chat online with the National Suicide Prevention Lifeline: 1-800-273-8255
- For LGBTQ youth, call The Trevor Project: 1-800-4-U-TREVOR
- For veterans, call or chat online with the Veterans Crisis Line: 1-800-273-8255 option 1 or text 838255
- Text the Crisis Text Line
- Text HOME to 741741
- Go to the ER.
- 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.
Image credit: VANDENBERG AIR FORCE BASE