Suicide is now one of the top 10 causes of death in the United States. And its incidence is growing.
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Celebrity deaths only call attention to a problem that cuts a wide swath across America, where suicide rates jumped 25 percent from 1999 through 2016.
Psychiatrist Tatiana Falcone, MD, says the uptick can be attributed, in part, to a under recognized, undertreated mental illness which, in turns, increases incidence of hopelessness, as well as other negative emotions.
“Hopelessness is a strong predictor of suicidal ideation, while sadness, anxiety, guilt, worthlessness, anger and irritability may also play a role,” she says.
Despite the upward trend, Dr. Falcone says that suicide is preventable — we all need to understand and notice the warning signs.
Groups at risk
Middle-aged adults, especially over age 60, are at greatest risk.
“Older adults with cognitive impairments may struggle to modulate negative emotions, which, in turn, can translate into increased anxiety and risk of suicide.” Dr. Falcone says.
On the other end of the spectrum, adolescents 15 to 24 are also at high risk. This includes another troubling trend: a sharp rise in suicide risk for young girls.
“This might be associated with the earlier onset of menstruation, increasing the susceptibility of mood disorders, as reported by the Centers for Disease Control. Bullying and social media might also play a role,” she says.
Men are three to five times more likely to die by suicide, although the incidence of suicide is rising faster in women.
Other groups at risk include:
- American Indian and Alaskan Indians.
- Veterans, whose suicide risk is 10 percent higher than the general population.
- Those undergoing a health crisis.
- Those with access to firearms at home.
- Those being jailed.
Overall, a lack of positive emotions, including apathy and the inability to feel pleasure, put people at risk, Dr. Falcone says.
The role of mental illness
Certain mental illnesses increase the risk of suicide, including:
- Depression (major depression and bipolar depression).
- Substance abuse disorder.
- Anxiety disorder.
- Borderline personality disorder.
- Psychosis (e.g., schizophrenia.)
But half the Americans who die by their own hand have no such diagnosis on record. Relationship struggles; money, legal or housing issues; and lack of access to care and social services may be factors.
What happens in the family also matters: A family history of mental illness, substance abuse, suicide, suicidal behavior, or physical or sexual abuse increase the risk of suicide.
Words to watch for
Not everyone who is at risk of suicide will attempt it. Social, life or financial stresses are sometimes the tipping point.
Which warning signs should you look for? Pay attention when someone says they:
- Want to die (or often talk about death).
- Feel empty or hopeless.
- Feel overwhelming guilt or shame.
- Feel trapped, with no way out.
- Are in unbearable physical or emotional pain.
- Feel like a burden to loved ones.
- Want to take revenge.
Behaviors to watch for
Sometimes, a person’s actions show that they’re serious about suicide. Consider it a red flag when someone:
- Makes a plan to kill themselves (search online, collect pills, buy guns or rope).
- Uses alcohol or drugs more often.
- Acts anxious or agitated.
- Withdraws from family and friends.
- Changes eating/sleeping habits.
- Becomes enraged.
- Takes physical risks, like reckless driving.
- Swings between mood extremes (e.g., from very sad to very calm to happy).
- Gives away prized possessions.
- Says goodbye to friends and family.
- Puts their affairs in order (e.g., making a will).
What you can do
If you notice these warning signs in a friend or loved one, don’t wait. Contact the 988 Suicide & Crisis Lifeline through chat, text or a phone call without delay.
“Take your loved one to the Emergency Department if you think they are not safe. Also, don’t leave them alone — make sure there are no guns in the house, and be sure to secure any medications,” Dr. Falcone says.
This national network of local crisis centers offers free and confidential help to those who are contemplating suicide and their loved ones.