Suicide

Some people with recurrent depression tragically end up taking their own lives. The risk of suicide is 15-20 times higher among those with recurrent depression than among those who never suffer from depression at all. But there is a lot you can do to prevent recurrent depression.

More than 2500 Australians commit suicide each year.  About half of these suicides are committed by people suffering from a mental illness, most often depression. This is far too many. Many people don't understand what depression is. By reading about depression on DepNet and by getting help you can break out of this risk group - knowing about depression will improve your chances of quickly returning to good health.

Sex
Far more people attempt suicide than actually succeed. Generally speaking, women are two to three times more likely than men to attempt suicide, but men are four times more likely than women to succeed, mainly due to the more violent methods that they choose.

Previous attempts
People who have previously attempted to take their own lives are at a significantly higher risk of suicide. However, it's never too late to get out of your depression and be free from thoughts of suicide.

Suicide in the family
Unfortunately the risk of suicide is higher if one or more members of your family have committed suicide. Another suicide in the family will feed this circle and so we would urge you to break the circle.   
                  
Alcohol or drug abuse
People who are suffering from depression and also abuse alcohol or drugs are at a greater risk of suicide. However, both substance abuse and depression can be treated.

Physical illness
People who are suffering from depression and a serious physical illness run an increased risk of suicide. However, this risk can be reduced significantly through preventive techniques and treatment for depression as well as the physical illness.

Lack of social support
People who are alone without family, friends or other form of social support also seem to be more likely to commit suicide. There are many places you can go if you feel alone.

Unemployment
Suicide is more prevalent among the unemployed than among the working population. There are many people you can turn to who can help improve your quality of life.

Rural Suicide
Suicide is more common among males in rural and remote areas than in urban areas of Australia.

Indigenous Australians
Aboriginals suicide rates are possible two to three times that of non-aboriginal Australians. More than 80% of indigenous suicides are by males.

When is the risk of suicide greatest?

The risk of suicide is greatest during the early stages of the illness. Most suicides are committed during one of the first few depressive episodes. It's important that you are examined by your GP, even if you have only fleeting thoughts about suicide.
It is estimated that 60% to 90% of young people who attempt suicide are considered to have depression.

After discharge
The risk of suicide is particularly high during the first few weeks after you are discharged from psychiatric care. So stick close to your family and friends and avoid being alone. You can find out how to make contact with other people here at DepNet.

Sudden discontinuation of medication
If you suddenly stop taking antidepressants or mood-stabilizers (such as lithium), the risk of developing another depression will increase. The risk of suicide is particularly high in the period immediately after you discontinue your medication.

Genetic predisposition
It seems that some people are genetically predisposed to suicide. Suicide is more common in some families, and the results from studies of twins and adopted children suggest that people can inherit a predisposition not only for depression but also for suicide.
This means that it is incredibly important for you to take depression seriously and obtain the right treatment.

SUICIDAL THOUGHTS
A Personal Experience - Dr Simon Bridge (Australian GP)

I am a general practitioner and have trained in Family Therapy, Narrative Therapy and Solution Focused Therapy. For many years I worked in psychiatry and in private counseling. During this time I spoke to many people, who were struggling with suicidal thoughts. Some felt that they had good control over these thoughts as they had good reasons to keep living. For others, it was a real struggle as they were overwhelmed by the depression and saw suicide as a way out. For nearly all, admitting the presence of such thoughts was a matter of shame.
 
I then developed leukemia and finished up on high dose steroids. This unleashed my existing tendency for manic depression. I had several courses of electroconvulsive therapy at different times and plenty of my own experiences with suicidal thoughts. In particular I became aware that when the thoughts are most dangerous they try to trick you into thinking that the rest of the family would be better off without you.
 
These are particularly dangerous thoughts because they make it sound like suicide would be doing the family a favour, a noble act. This is never the case. Surviving family and friends never really get over the loss and spend years struggling to come to terms with the impact of your action.
 
I developed a pamphlet which gives the patient an idea of how the suicidal thoughts work and I wanted to share its message here. If you can understand suicidal thoughts, you can outsmart them. Putting the thoughts out there exposes them. It allows you to take a stand against them.

It suggests that you have a choice of whether you put yourself in a setting where they are more or less susceptible to the suicidal thoughts. Clearly, very few people commit suicide in company.
 
Remember, depression will pass – a point often hard to accept by someone in the grip of depression. You will get stronger with time, if only you will give it time.
 
Often, as a general practitioner, after one has established that the patient has suicidal thoughts but ruled out that they are not in the category where admission to hospital is warranted, you make the decision to treat the patient in the community i.e. at home. Frequently, medication has been started but there is often a ‘gap’ period before it takes effect. Therefore, the patient leaves the room with the doctor not having given any practical strategies to control the suicidal thoughts. The doctor is left hoping that nothing silly will happen.

I would like to share some key points from a pamphlet I developed called:
“Toughin’ it Out” Survival skills for Dealing with suicidal thoughts

• Suicidal thoughts come in waves – they peak and pass, usually lasting a few hours and often at night
• The thoughts try to discourage you from sharing them with others
• They isolate you
• They try and trick you into the idea that there is no future
• They try and trick you into the idea that others would be better off without you. This is never the case
 What to do?
• People rarely commit suicide in company – if you are at risk, be with someone.
• If you are alone use the phone.
• Alcohol and illegal drugs feed the thoughts
• Remove anything in the house that could make suicide easy  

Remember:
The depression will pass and you will wonder how the depression got such a grip on you.
Over time you will get your old strength back where it will be impossible for suicidal thoughts to make a comeback. But this takes time and so you need to hang around to get to this point in recovery. This is where the strategies and skills come in.
Help is available, call a friend, a doctor, the emergency department or Lifeline 13 11 14
Your life is worthwhile!

For further information about the pamphlet see www.kirinaran.com