Suicide and Suicidal Behavior

Suicidal behavior is a successful or unsuccessful attempt to kill oneself. It is an unmistakable proclamation of a person's feelings of desperation and hopelessness.

Suicidal behavior includes attempted suicide, suicide gestures, and completed suicide. An attempted suicide does not result in the person's death. A suicide gesture is a suicide attempt that has almost no potential of being fatal (for example, ingesting six acetaminophen tablets). A person taking such an action is usually making a plea for help without intending to actually end his life. A completed suicide results in death.

Married people of either sex have a much lower suicide rate than single people. People who live alone because of separation, divorce, or a spouse's death have higher rates of attempted and completed suicides. Men over age 70 (especially white men) have the highest rate of completed suicide, compared with younger men and with women of any age.

Suicidal behaviors usually result from the interaction of several factors, the most common of which is depression. In fact, depression is involved in over half of attempted suicides. Marital problems or the recent loss of a loved one may precipitate the depression. Depression associated with a physical disorder is frequently a factor in suicide attempts among older people. People whose depression includes anxiety or psychosis may be at higher risk of suicide than people whose depression does not include these features.

Depression may be intensified by the use of alcohol, which in turn makes suicidal behavior more likely. Because persistent and excessive drinking often leaves a person with deep feelings of remorse during dry periods, suicidal behavior is common even when heavy drinkers are sober.

Although suicide threats or suicide attempts often come as a shock, clear warnings are given in many cases. Any suicide threat or suicide attempt is a plea for help and must be taken seriously. If the threat or attempt is ignored, a life may be lost. If a person is threatening or has already attempted suicide, the police should be contacted immediately so that emergency services can arrive as soon as possible. Until help arrives, the person should be spoken to in a calm, supportive manner.

After a completed suicide, family, friends, and health care practitioners may feel guilt, shame, and remorse at not having prevented it. They may even feel angry toward the person. Eventually, many of them realize that they could not have prevented the suicide. Sometimes a grief counselor or a self-help group, such as Survivors of Suicide, can help family and friends deal with their feelings of guilt and sorrow. The primary care doctor or local mental health services (for example, at the county or state level) can often help locate these resources. In addition, national organizations, such as the American Foundation for Suicide Prevention, often maintain directories of local support groups.