Life events & circumstances

These are the things that are most likely to push someone over the edge from considering suicide, to actually trying it. The table below is from a study¹ in Oxford (UK), where suicide survivors were asked what factor was causing them current distress and/or contributed to them making their attempt. It is interesting to note the variations between men and women:

In a different study², of 4,391 self harmers in Oxford, 80.6% reported multiple life problems, the most common being the relationship with spouse or partner. Females, but not males, with high suicidal intent, had more problems than those with low intent. Patients with high intent more frequently experienced psychiatric and social isolation problems than those with low intent. Females with high intent more frequently reported bereavement or loss and eating problems.

The study in Oxford is by no means a definitive list though. The American Association of Suicidology (AAS) published a factsheet³ on the risk factors for suicide, and had the items below as things that can increase the short term risk of suicide:

• Recently divorced or separated with feelings of victimization or rage

• Current self-harm behaviour

• Recent suicide attempt

• Excessive or increased use of substances (alcohol or drugs)

• Psychological pain (acute distress in response to loss, defeat, rejection, etc.)

• Recent discharge from psychiatric hospitalization

• Anger, rage, seeking revenge

• Aggressive behaviour

• Withdrawal from usual activities, supports, interests, school or work; isolation (e.g. lives alone)

• Anhedonia (inability to experience pleasure from normally pleasurable life events such as eating, exercise, social interaction or sexual activities)

• Anxiety, panic

• Agitation

• Insomnia

• Persistent nightmares

• Suspiciousness, paranoia (ideas of persecution)

• Severe feelings of confusion or disorganization

• Command hallucinations urging suicide

• Intense affect states (e.g. desperation, intolerable aloneness, self-hate)

• Dramatic mood changes

• Hopelessness, poor problem-solving, cognitive constriction (thinking in black and white terms, not able to see gray areas or alternatives), rumination, few reasons for living, inability to imagine possibly positive future events

• Perceived burdensomeness

• Recent diagnosis of terminal condition

• Feeling trapped, like there is no way out (other than death)

• Sense of purposelessness or loss of meaning; no reasons for living

• Negative or mixed attitude toward help-receiving

• Negative or mixed attitude by potential caregiver to individual

• Recklessness or excessive risk-taking behaviour, especially if out of character or seemingly without thinking of consequences, tendency toward impulsivity

It should also be noted that according to the AAS, owning a firearm, or having easy access to one, increases the short term suicide risk for those living in the US. Clearly, for people that are suicidal and not thinking clearly, having the means for an effective suicide to hand makes it that much easier.

The AAS also mention the following heighten the risk in the short term of a suicide attempt:

• Any real or anticipated event causing, or threatening: shame, guilt, despair, humiliation, unacceptable loss of face or status, or legal problems (loss of freedom), financial problems, feelings of rejection/abandonment

• Recent exposure to another's suicide (of friend or acquaintance, or of celebrity through media)