Suicide: a taboo subject

Suicide in Spain, it is the main external cause of mortality, tripling deaths from traffic accidents. Every day 10 people commit suicide in this country. The figures speak for themselves, however, perhaps even more concerning is the fact that for every person who commits suicide, 20 attempt it. If, in addition, we take into account that each suicide intimately and deeply affects at least six people, we will be able to understand the magnitude of this wide and devastating problem.

More than 800,000 people commit suicide each year in the world. It is estimated that every 40 seconds, someone consumes it. Mortality for this reason is higher than that of wars or homicides.

Who?

Three out of every four people who commit suicide are men. Most of them are between 55 and 65 years old, although there is an alarming increase between. Poverty, unemployment and low educational level are associated with an increased probability of suicide. There are no appreciable differences in ethnicity.

Risk factors in suicide?

• Mental disorders (depression, bipolar disorder, psychotic disorders, personality disorders, anxiety disorders, eating disorders).
• Alcohol or drug abuse.
• Previous suicide attempts or suicidal ideation.
• Family history of suicide or violence.
• History of childhood sexual abuse.
• Having a serious physical illness.
• Impulsive or aggressive tendencies
• Hopelessness, all-nothing thinking and mental rigidity.

What can precipitate suicide?

Stressful situations such as:

• Personal losses: divorces, deaths ...
• Living a traumatic event: abuse, harassment, violence ...
• Financial loss: loss of money or job.
• Legal issues.
• Interpersonal problems: major conflicts in relationships.
• Have accessible means or methods of suicide (weapons, medications ...).
• The aggravation of any of the risk factors mentioned.

What factors protect?

It is important to know them in order to prevent. Basically of two types:

• Individual: skills to solve problems, to relate and to be flexible, to trust oneself and have self-esteem, have cultural and religious beliefs that disapprove of suicide, emotional self-control, take care of one's own mental and physical health, fear of pain and risk behaviors, being an optimistic person and having high resilience, etc.
• Social: Having quality family and social support, having access to clinical care services and seeking help, a stable environment, being integrated and participating socially, having religious, spiritual or ethical beliefs and / or practices, feeling a cultural identity, etc. .

Some false myths about suicide

• "All suicides want to die" (the vast majority want to stop suffering, not living, it is not the same).
• "He who wants to kill himself does not say so" (of every 10 people, 9 state their intention).
• "He who says it, does not do it" (he makes a request for help understood as manipulation and leaves no option to help).
• "Talking about suicide can lead a person to do it" (it has been shown that talking about suicide reduces the probability of committing it).
• "Every suicide is mentally ill" (people with mental illness commit suicide more frequently than the general population but not all suicides have a mental illness).
• "He who tries to commit suicide is a coward" or "he who tries to commit suicide is a brave man." Personal attributes are not quantified by actions one takes to kill or respect oneself. It can also lead to inciting the person).
• "If he had really wanted to commit suicide, he would have succeeded" (the method chosen to die does not reflect the desire to die, it has to do with cultural issues).
• “The person who recovers from a suicidal crisis is not in danger in the future” (almost half of those who commit suicide did so after the first three months after the initial crisis, when everyone thought that the danger had passed ”.
• "Suicide occurs by impulse" (this belief limits preventive actions. In reality, before committing suicide, people show warning signs, the so-called "presuicidal syndrome").

Some red flags

He talks or writes about dying, hurting himself or killing himself, even specifying a plan.

• Look for ways to commit suicide.
• Isolation, loss of interest towards the environment, activities, etc.
• Reduced aggressiveness (reserve towards oneself) or even unexpected good humor.
• Behaviors that involve unnecessary or irresponsible risk.
• Alcohol or drug abuse.
• Changes in sleep (you sleep a lot or very little).
• He gives up possessions or says goodbye to people.

To do?

If we detect the warning signs in someone close:

• Be vigilant and prepared to act for your safety.
• Do not be afraid to talk about it: Be available, listen to their feelings without judging them, express that help is available, that crises are temporary, avoid reprimands, blackmail or trivialize their problems.
• Stay calm.
• Do not leave him alone and limit his access to any suicide method.
• Assess the risk: if you have a plan and know how to do it, call 061 or 112 or go to an emergency service with you.
• Talk to other people who know him and find out if they also think he might commit suicide. Try to coordinate.
• Offer to help with practical tasks.
• Ask him to promise not to silence his discomfort and to communicate it with you or with whoever he decides, if suicidal ideas appear.
• Tell them where to go for help: mental health services, social services, online and telephone help services, school counselors / educators, religious services…. Make an emergency plan too.
• Stay involved, persevere. Suicidal thoughts don't go away easily.
• Take care of yourself: Helping someone in this situation can be very stressful.

Cristina Agud Clinical Psychology Specialist Advance Medical Consulting Psychologist