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Why do people commit suicide?
No healthy person wants to die.* Suicide occurs when an individual's suffering is severe and he/she believes there is no hope for it to go away. Suicide is perceived as a way to end the suffering, like shooting an injured horse to put it out of it's misery.
Dealing with suicide depends upon working on both aspects: restoring hope, and having a plan to stop the suffering.
Whether it's due to "physical" pain such as spread of cancer to the spine or "emotional" pain like depression and the dysphoria (anxiety, rage, depression and despair) experienced in the borderline personality disorder, the individual is suffering severely. Efforts must be made to stop or at least markedly reduce their suffering. While much can be learned from suffering, it's best to stop and/or prevent it - as long as the treatment(s) don't make the individual worse. There are many ways to accomplish this goal including medication, meditation, physical and psychological therapy, spiritual perspective, etc.
Providing hope is just as crucial. Short term suffering can usually be managed as long as there is a realistic hope that the suffering will stop. Knowledge is extremely important in this regard. When the individual incorrectly believes no hope exists, the suicide risk goes up.
Psychosis - misinterpreting reality - may result in suicide attempts because the incorrect perceptions can cause severe suffering and a false belief that no hope exists.
Some people with terminal illnesses commit suicide before severe suffering starts. These individuals need reassurance that their suffering will be treated medically so the individual can enjoy the time they have left. The Hospice organization has been extremely effective with this goal. People usually need to believe there is a purpose to their life. It is a spiritual issue rather than a medical or psychiatric one. I believe strongly that everyone has enormous value, and can become a loving, purposeful individual. To me, the near death experience gives clues about what happens after we die. Most accounts show that those who have "seen the light" considered it a wonderful experience and they no longer fear death. Those who have unsuccessfully committed suicide yet also "saw the light" report it was a bad experience and the were told not to take their own life - and that the consequences for committing suicide would be great. The books "Embraced By the Light" by Betty Eadie and "Transformed by the Light" by Dr. Melvin Morse have been particularly useful in this regard for my patients and in my efforts to help with suicidal thoughts and urges.
*The exception is when an individual chooses to die because one's life isn't as important as something the individual believes in. This includes both heroism and a belief system that the individual's life isn't important. There are many examples including movies (Armageddon), books (A Tale of Two Cities by Charles Dickens), Japanese kamikaze pilots, and a soldier falling on a grenade to protect his comrades.
Suicide Statistics:
Suicide is the 8th leading cause of death in the US, nearly 31,000 deaths in 1996.
Suicide accounts for 50% more deaths than murder.
530,000 suicide attempts per year in the US.
Suicide rate up 14% among 15-24 year olds (third leading cause of death in this age group).
Suicide are among blacks doubled between 1980 and 1996.
Suicide rate for Native Americans is 50% higher than the national rate.
White men over 84 are the most likely to commit suicide.
Firearms cause most suicide deaths: 59% overall, and responsible for 96% of the suicides in the 15-24 year old age group.
Percentage of suicide deaths by age group:
a) 5-19 = 7%
b) 20-34 = 27%
c) 35-49 = 31%
d) 50-64 = 16%
e) over 64 = 19%
(sources: U.S. Public Health Service, National Center for Health Statistics, Office of the Surgeon General)
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