Suicide - a preventable outcome

Suicide is a deceptive cause of death. Even though I know better now, I still think in terms of why someone committed suicide, which makes you wonder why some people commit suicide. The truth is that suicide is usually a result of severe depression, in which people experience some degree of reality distortion. The world and their life seems much more hopeless than it really is. But whether that drives them to suicide, or the emotional pain that accompanies it does, is another question altogether.

Depression, like many mental illnesses is not well understood. The antidepressants raise Serotonin levels at the synapses and people recover. About 80% have a complete recovery with treatment by medication. The general rule is that earlier the intervention the better the chances for a full recovery. Depression is probably a lot more complicated than just running out of Serotonin though.

Several mental illnesses have very high suicide rates. For Bipolar disorder it is 15%. Bipolar is a mood disorder with manic highs and suicidal lows, and many famous people with bipolar have died by suicide, including Vincent van Gogh, Ernest Hemingway, and a classical composer by the name of Schumann. The fact that people with bipolar are often reluctant to take medication because they enjoy the early stages of mania might help explain the high suicide rate.

Forty percent of the people diagnosed with schizophrenia attempt suicide, and 10% die from their suicide attempt. There is a high co morbidity for depression in schizophrenia. In fact a serious depression often precedes a first psychotic episode in adolescents.

Everybody has a certain risk for dying from suicide. It is the second leading cause of death in the 16-39 age group, after motor vehicle accidents. It is also a highly stigmatized cause of death, one that traditionally brings shame to the family. It is not mentioned as a cause of death in the newspapers. Given how treatable depression is, it is also a highly preventable cause of death if only people were willing to recognize depression as a treatable mental illness.

In the last year or two 6 people I personally knew have committed suicide. Four of them had schizophrenia, one had bipolar, and one was a social worker where I work. Two were women and four were men. Recently in Toronto a therapist at an exclusive mental health agency jumped in front of a speeding subway with her newborn child. She was known to have a severe postpartum depression. Her story epitomized our ignorance in preventing suicide. She spent most of the day at the subway station before she jumped. The police picked her up and took her home instead of a hospital. She worked for a prestigious mental health agency and neither she nor her colleagues could recognize postpartum depression.

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