Suicide is a growing problem in our nation and not just among our veterans. Always more common among older folks, suicide is now a serious risk for adolescents, young veterans, and active military.
What drives people to commit suicide?
The simple answer is “pain”, either physical or emotional. But what causes that pain is anything but simple. In the USA, men commit suicide almost 4 times as often as women (19 deaths for every 100,000 men per year). Women try suicide more often but are less successful (5 deaths for every 100,000 women). In other countries the percentages may be equal or reversed.
The rate of suicide in our veterans is roughly twice that in the general population (38 deaths for every 100,000 veterans), and veterans commit 20% of all suicides in the US. (Veterans are 7% of the population). In 2012, more active duty military died from suicide than from combat. Surprisingly, our youngest veterans (17-24 years old) are most at risk.
Factors that increase the risk of suicide include:
1) Depression, bipolar disorder, substance abuse, and PTSD.
2) Lack of support–no family, no friends, no work, no money
3) Serious medical illness or injury
4) History of childhood abuse, sexual assault, or physical assault
5) History of suicide attempt or suicide in family
6) Access to lethal means
7) Lack of effective medical/ psychological care
8) No hope than things will improve
The link between PTSD and suicide is well established in a number of studies that have carefully ruled out alternative explanations.
In people suffering with PTSD, the symptoms of depression, frequent vivid flashbacks, severe irritability, jitteriness, and agitation, and a tendency to suppress rather than confront current stressors have been found to increase the person’s suicide risk.
In addition to those symptoms, PTSD can also lead folks to being alcoholic, jobless, homeless, and alienated from family and friends, all of which further increase their suicide risk.
Suicide is also linked to trauma, even without PTSD. Physical assault, sexual trauma, and childhood abuse all significantly increase the risk of suicide. It’s interesting that battlefield trauma only increases the risk if you actually were wounded.
How can we prevent it?
Current therapeutic approaches are very effective in preventing suicide, so the need is to get the suicidal person to accept professional care. But people planning suicide don’t usually announce it . . . Or do they?
Actually half the people who complete suicides have sought medical care in the previous 6 months.
There are a number of other behaviors that can warn you:
1) Making statements like, “I can’t go on like this.”
2) Talking about death/dying.
3) Saying goodbye to friends
4) Giving away belongings and pets
5) Buying a gun or lethal drugs
6) Withdrawing from people and activities
7) Engaging in dangerous behaviors
8) Sudden calm in someone who has been severely depressed.
What should you do if you suspect a friend is suicidal?
1) Talk to them about suicide. It won’t make things any worse, and it gives them a chance to tell someone how they feel.
2) Listen to what they say and take it seriously. Don’t judge or joke around or try to make a quick fix. Show them with your words and actions that you really care.
3) Find professional help and take your friend to the appointment.
4) Remove the means for committing suicide (guns, pills, etc.)
5) Follow up and encourage them to go back for treatment. Engage them in outside walks, exercise, and other fun activities.
Assessing a person’s risk of suicide.
Five questions to ask:
1) Are you thinking about suicide?
2) Do you have a plan?
3) Do you have what you need to carry out your plan?
4) Have you decided on a time and place?
5) Will you do it?
Low risk: Some suicidal thoughts, no plan, say they won’t commit suicide.
Moderate risk: Suicidal thoughts, vague plan that’s not very lethal, say they won’t commit suicide.
High risk: Suicidal thoughts. Specific plan that is highly lethal, still say they won’t commit suicide.
Severe risk: Suicidal thoughts. Specific plan that is highly lethal, and say they will commit suicide.
If a suicide attempt appears imminent, you need to get that person help and do not leave them alone.
Suicide is a serious risk–especially for military veterans, folks with depression, and those who have a history of trauma. But if you can help them through the crisis and get them into treatment, you’ve given them a good chance for recovery.
I received a comment on this blog about spiritual/moral injury as an important factor in suicidal behavior. I strongly agree! In fact it’s such an important issue that I’ll try to write a separate blog about it. Thanks, Mark Dallner