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Why Do Doctors Ask (Dumb) Questions About Suicide?

If you’re in treatment for depression and have ever mentioned a desire to die, you’ve probably heard these questions:

  1. How would you commit suicide?
  2. Have you make a plan to commit suicide?

And others.

So a commenter recently mentioned that this is just a way of “covering their backs,” and “. . . if I were serious about killing myself and had made a plan, why on earth would I tell them?”

This is a logical question, but an uninformed one. In studies, we know that people who attempt suicide do reach out for help and do not really want to die.

mp9002016851Suicide is a Serious Problem

Suicide is the 11th leading cause of death in the US and is the 3rd leading cause of death among adolescents and young adults. Suicide is not to be taken lightly and doctors are trained (rightfully) not to take it lightly.

95% of people who commit suicide have a mental illness. (Depression is the leading mental illness indicator of suicide, but depression combined with other conditions like anxiety or an eating disorder is more dangerous than depression alone. Anorexia has the greatest rate of suicide with more than 1-in-5 anorexics dying of suicide.)

Lifestyle Suicide Predictors

Suicide has been studied extensively by the mental health community and in addition to mental illness predictors we know many other predictors of suicide:

  • Demographics (such as age, sex, ethnic background and religion)
  • Substance abuse
  • Occupation
  • Gun availability
  • Media / internet content
  • Life experiences (recent and past)
  • Prior attempts

And many others.

Mindset Suicide Predictors

Most people who commit suicide are under the care of a doctor or see a doctor within three weeks of committing suicide. These people want help but they commonly don’t ask for it directly. Many people come to doctors for complaints not related to suicide so the doctor must ask questions to determine if suicide is actually the underlying concern.

So, understanding that we know many of the predictors of suicide and understanding that most people do, in fact, want help, the questions doctors ask try to determine if that is what the patient is really saying. While it is logical to think people who want to commit suicide would lie, this isn’t actually the case.

ExamWe know the mindsets to investigate are:

  • Do you have thoughts of hurting yourself or others? (For some, suicidal feelings can become homicidal.)
  • Do you have a plan to commit suicide? (The more specific the plan, the more likely suicide is.)
  • What do you think your suicide would achieve? (People who feel other would be better off without them are more likely to attempt suicide.)
  • Do you have hope for the future? (Hopelessness is a major factor in suicide attempts.)

Suicide Questions Do Prevent Suicide

Suicide likelihood is a hard thing to assess and in many cases the doctors seeing the patients do not have a well-developed relationship with them and so it is hard to gauge the patient’s true crisis. These questions are a way of doctors trying to assess clear indicators to prevent a person’s death.

While, absolutely, a patient can lie to a doctor about their intentions, the fact of the matter is, the patient is in front of a doctor proving that, on some level, they do want help. People do not really want to die. People want to escape their pain. People need help to do that.

Resources

If you’re considering suicide, call a helpline right now. There are caring people sitting on the other end of the line and they want to help you. Reach out to them.

Read fellow HealthyPlace blogger Amy Kiel’s recent accounting of her suicide attempt: Never Going Back: Memories of A Suicide Attempt

Information in this article was mostly found here. Only a tiny portion of suicide predictors are mentioned above so I recommend looking at the article for all the details.

You can find Natasha Tracy on Facebook or @Natasha_Tracy on Twitter.

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate and author of Lost Marbles: Insights into My Life with Depression & Bipolar.

Find Natasha Tracy on her blog, Bipolar Burble, Twitter, Google+ and Facebook.

28 thoughts on “Why Do Doctors Ask (Dumb) Questions About Suicide?”

    1. Hi Mary,

      I’m so sorry you are feeling that way right now. I have had that feeling many, many times. In fact, I have attempted.

      What I can tell you, though, is that things can improve with help. There are new treatments every day. RTMS, ECT, ketamine and so on. While I can definitely understand why you might feel the way you do, you don’t have to feel that way forever.

      Please call a hotline to start getting help: http://www.healthyplace.com/other-info/resources/mental-health-hotline-numbers-and-referral-resources/

      There is more out there. Don’t give up.

      – Natasha Tracy

    2. I would like to encourage you to read the Bible. Surprisingly the Bible Verses that have to do with several different types of emotions. There are a lot of called books “God’s Promises” but you can also just look up “Bible Verses about Depression and Suicide” and a list will come up. I do not know whether you are a believer or not, but, regardless, I encourage you to consider doing this.

  1. I was just diagnosed with Major Depressive Disorder, Manic Episodes, Bipolar Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, Panic Disorder and Panic Attacks. I was 16 when my mom left me with my step dad to go to a party. My step dad molested me that night. I went a week with no sleep and no food. I was living on water and fat and muscle that was left In my body. That was the first time I ever cut myself. I also put a rope around my throat, got on a chair and was about to jump when my dog walked in. He looked up at me with his puppy dog eyes. I untied the rope and I got down and just broke down he cuddled with me and loved on me. The cops came and my mom blamed him touching me on me. I told the cops it was an accident and they left. A week later my mom was in the other room and I felt like I had been drugged. I opened my eyes and I saw him move my shorts. Than he saw I was awake and he left. He threatened me multiple times to punch me in the face, he even called me a B****. My mom accused me of stealing her narcotics, even though I knew who did it and I’m pretty sure she did too. I’m 19 now and I went a whole year without cutting. I relapsed 2 days ago. Last night i went as much as shoving pills in my mouth to get the memories to go away and get the voices to stop talking to me. I only ended up making myself have an anxiety attack. I had heat flashes, my head became fuzzy, I was dizzy, my arms and legs were shaking uncontrollably, I couldn’t move, and I could hard breath, when I could finally move again I almost vomitted everywhere, I need serious help. I did this all because of voices and also because my dad told me that I’m doing all this for attention. He didn’t see the cuts or scars on my arms

    1. Hi Katelyn,

      I’m so sorry to hear what you have shared in this comment. I want you to know that it does get better.

      I don’t just say this as a person with bipolar or an advocate, I say this as a person who has been sexually assaulted as well. I know what it’s like to have images and voices haunt you. Please understand, that while this can be torture, it _can_ get better.

      I also say this as a person who has attempted suicide. Even though I felt nothing could help my pain at that time, I was wrong. I have been helped since then.

      Please reach out and get help. Please find a therapist who specializes in what you need. Please find a support group. Please see a doctor. Please be open about how you feel and what you have experienced.

      We have a hotlines and resources page here where you can start: http://www.healthyplace.com/other-info/resources/mental-health-hotline-numbers-and-referral-resources/

      I am with you in this. You are not alone.

      – Natasha Tracy

  2. After ending up locked in the hospital against my will on one more than occasion for the crime of trusting doctors I will never again tell them anything. The last two times it happened I told the doctor that I did not want to die but to be “safe” he violated my trust and my rights and locked me up. That is not ok.

    In less than 2 years I have been raped and nearly killed twice. I am falling apart. I have lost everyone. I can’t sleep. I can’t eat. I have panic attacks every time I have to leave my home. I have panic attacks when the phone rings or someone knocks on my door. Some days I am ok. Some days I do nothing but cry myself sick. Some days I am full of rage. And some days I am nothing at all. I hate my body. I hate being female. I hate myself. I hate this life. I am scared by my own thoughts. I am scared that if I tell anyone what i’m truly feeling they will harm me by locking me up against my will.

    Before any appointments I practice my smile. By smiling I can keep myself from telling. By not telling I keep myself safe. It’s ridiculous that I have to do this. I don’t even see the point anymore. If doctors and therapist actually want to help people then they need stop hurting them. If they want people to trust them then they need to remove the threat of imprisonment.

  3. “People do not really want to die. People want to escape their pain. People need help to do that.”

    Avoid that kind of generalisation please.

    Some people do want to die or rather “not live” and not for the reason you mentioned, without any medical problem, for philosophical reasons for example.

    It is uncommon but it exists.

    I am a living proof.

  4. Pdocs need to work harder to see things from their patients perspective and build more of a collaborative style relationship that is if they are truly interested in ‘helping” them at all. They need to listen to and understand why patients lie and then work with them to overcome these roadblocks

    I’ve never ever told a pdoc that I felt suicidal before even when I was, not because I didn’t want help but because I was fearful of the type of help that might be offered. I don’t want to be held against my will, or over medicated again like I have been in the past nor would I want to take a chance that I might have my memories erased with ECT performed on me against my will. I’ve been involuntarily committed before (apparently I lacked insight) and it was extremely stressful. Some of the medication side effects were worse than the illness. I felt like a wild animal trapped in a cage that would do anything to get out. If I had a very good relationship with a down to earth pdoc who I’d gotten to know well and trusted (I’m working on that) I might consider being more open but I would still have to test the waters first before I’d completely come clean with that type of revelation. In the past pdocs were too agressive and jumped to conclusions because unfortunately I have many of the risk factors working against me before I even open my mouth

  5. I have to be with Julie here.Didn’t die in Jan. although I tried.My estranged adult daughter has been so cruel to me (the one person I thought it might matter to).My meds are maxxed out.My plans I tell my pdoc are more of the long term variety,get my affairs in order first etc.Who knows maybe something will change,or maybe I will get sick with something else.

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