- Past History of Attempted Suicide
Between 20 and 50 percent of people who kill themselves had previously attempted suicide. Those who have made serious suicide attempts are at a much higher risk for actually taking their lives.
- Psychiatric Disorders
Substance Abuse, particularly when combined with depression
Personality Disorders, especially Borderline, Antisocial
- Genetic Predisposition
Family history of suicide, depression or other psychiatric illness.
A clear relationship has been demonstrated between low concentrations of the serotonin metabolite 5-hydroxyindoleactic acid (5-HIAA) in cerebrospinal fluid and an increased incidence of attempted and completed suicide in psychiatric patients.
Impulsive individuals are more apt to act on suicidal impulses.
Sex: Males are three to five times more likely to commit suicide than females.
Age: Elderly Caucasian males have the highest suicide rates.
A suicide crisis is a time limited occurrence signaling immediate danger of suicide. Suicide risk, be contrast, is a broader term that includes the above factors such as age and sex, psychiatric diagnosis, past suicide attempts, and traits like impulsivity. The signs of crisis are:
- Precipitating Event. A recent event that is particularly distressing such as loss of loved one or career failure. Sometimes the individuals own behaviour precipitates the event: for example, a manâ€™s abusive behaviour while drinking causes his wife to leave him.
- Intense Affective State in Addition to Depression Desperation ( anguish plus urgency regarding need for relief), rage, anxiety, guilt, hopelessness, acute sense of abandonment.
- Changes in Behaviour
- Speech suggesting the individual is close to suicide. Such speech may be indirect. Be alert to such statements as, â€œMy family would be better off without me.â€ Sometimes those contemplating suicide talk as if they are saying goodbye or going away.
- Actions ranging from buying a gun to suddenly putting oneâ€™s affairs in order.
- Deterioration in functioning at work or socially, increasing use of alcohol, other self-destructive behaviour, loss of control, rage explosions.
All of the danger signs are magnified in importance if the patient is depressed. Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is rather expressed as a loss of pleasure or withdrawal from activities that had been enjoyable.
Depression is present if at least five of the following symptoms have been present nearly every day for at least two weeks:
- depressed mood
- change in appetite or weight
- change in sleeping patterns
- speaking and/or moving with unusual speed or slowness
- loss of interest or pleasure in usual activities
- decrease in sexual drive
- fatigue or loss of energy
- feelings of worthlessness, self-reproach or guilt
- diminished ability to think or concentrate, slowed thinking or indecisiveness
- thoughts of death, suicide or wishes to be dead
Source: The American Foundation Suicide Prevention website