6 reasons why people commit suicide

by Alex Lickerman, MD

Though I’ve never lost a friend or family member to suicide, I have lost a patient.

I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret makes for a bitter drink, the taste of which I’ve seen take many months or even years to wash out of some mouths.

The one question everyone has asked without exception, that they ache to have answered more than any other, is simply, why?


Why did their friend, child, parent, spouse, or sibling take their own life? Even when a note explaining the reasons is found, lingering questions usually remain: yes, they felt enough despair to want to die, but why did they feel that? A person’s suicide often takes the people it leaves behind by surprise (only accentuating survivor’s guilt for failing to see it coming).

People who’ve survived suicide attempts have reported wanting not so much to die as to stop living, a strange dichotomy but a valid one nevertheless. If some in-between state existed, some other alternative to death, I suspect many suicidal people would take it. For the sake of all those reading this who might have been left behind by someone’s suicide, I wanted to describe how I was trained to think about the reasons people kill themselves. They’re not as intuitive as most think.

In general, people try to kill themselves for six reasons:

1. They’re depressed. This is without question the most common reason people commit suicide. Severe depression is always accompanied by a pervasive sense of suffering as well as the belief that escape from it is hopeless. The pain of existence often becomes too much for severely depressed people to bear. The state of depression warps their thinking, allowing ideas like “Everyone would all be better off without me” to make rational sense. They shouldn’t be blamed for falling prey to such distorted thoughts any more than a heart patient should be blamed for experiencing chest pain: it’s simply the nature of their disease.

Because depression, as we all know, is almost always treatable, we should all seek to recognize its presence in our close friends and loved ones. Often people suffer with it silently, planning suicide without anyone ever knowing. Despite making both parties uncomfortable, inquiring directly about suicidal thoughts in my experience almost always yields an honest response. If you suspect someone might be depressed, don’t allow your tendency to deny the possibility of suicidal ideation prevent you from asking about it.

2. They’re psychotic. Malevolent inner voices often command self-destruction for unintelligible reasons. Psychosis is much harder to mask than depression — and arguably even more tragic. The worldwide incidence of schizophrenia is 1% and often strikes otherwise healthy, high-performing individuals, whose lives, though manageable with medication, never fulfill their original promise.

Schizophrenics are just as likely to talk freely about the voices commanding them to kill themselves as not, and also, in my experience, give honest answers about thoughts of suicide when asked directly. Psychosis, too, is treatable, and usually must be for a schizophrenic to be able to function at all. Untreated or poorly treated psychosis almost always requires hospital admission to a locked ward until the voices lose their commanding power.

3. They’re impulsive. Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed. The remorse is usually genuine, and whether or not they’ll ever attempt suicide again is unpredictable. They may try it again the very next time they become drunk or high, or never again in their lifetime. Hospital admission is therefore not usually indicated. Substance abuse and the underlying reasons for it are generally a greater concern in these people and should be addressed as aggressively as possible.

4. They’re crying out for help, and don’t know how else to get it. These people don’t usually want to die but do want to alert those around them that something is seriously wrong. They often don’t believe they will die, frequently choosing methods they don’t think can kill them in order to strike out at someone who’s hurt them—but are sometimes tragically misinformed. The prototypical example of this is a young teenage girl suffering genuine angst because of a relationship, either with a friend, boyfriend, or parent who swallows a bottle of Tylenol—not realizing that in high enough doses Tylenol causes irreversible liver damage.

I’ve watched more than one teenager die a horrible death in an ICU days after such an ingestion when remorse has already cured them of their desire to die and their true goal of alerting those close to them of their distress has been achieved.

5. They have a philosophical desire to die. The decision to commit suicide for some is based on a reasoned decision often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren’t depressed, psychotic, maudlin, or crying out for help. They’re trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death. They often look at their choice to commit suicide as a way to shorten a dying that will happen regardless. In my personal view, if such people are evaluated by a qualified professional who can reliably exclude the other possibilities for why suicide is desired, these people should be allowed to die at their own hands.

6. They’ve made a mistake. This is a recent, tragic phenomenon in which typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems to me, is education.

The wounds suicide leaves in the lives of those left behind by it are often deep and long lasting. The apparent senselessness of suicide often fuels the most significant pain survivors feel. Thinking we all deal better with tragedy when we understand its underpinnings, I’ve offered the preceding paragraphs in hopes that anyone reading this who’s been left behind by a suicide might be able to more easily find a way to move on, to relinquish their guilt and anger, and find closure. Despite the abrupt way you may have been left, those don’t have to be the only two emotions you’re doomed to feel about the one who left you.

Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World.

Detecting and Preventing Suicide among Teenagers

Melissa Ridenour

According to both the American Academy of Child and Adolescent Psychiatry and the Center for Disease Control, suicide is the third leading cause of death for youth ages 15 to 24. Teen suicide affects everyone. Family and friends feel a guilty sense that if they had only done something different, the suicide could have been prevented. Therefore, it’s important to understand its causes, how to detect potential suicidal vulnerability, and how to help prevent it.

Causes of Teen Suicide
As teens grow up, they often feel stress, self-doubt, confusion, social and interaction problems with friends, peer pressure, concerns about succeeding, and pressure to meet parental expectations. Some teens suffer from clinical depression as well. Most teenagers experience such feelings to a certain degree at some point in their growing years. Those who are overwhelmed with such feelings and are unable to deal with them are more at risk for suicide.

There are several causes for teenagers to potentially want to take their own lives. Anxiety or depression left untreated can be a contributing factor. Feelings of hopelessness, helplessness, and worthlessness can cause teenagers to contemplate ending their lives. Other contributing factors are lack of success in school, bullying at school, violence at home, divorce, death of a loved one, rejection by peers, and the suicide of a friend.

According to the Center for Disease Control, such pressures of life make it too difficult for some teens to cope. As a result, sometimes overwhelmed teens welcome suicide as an escape from the pressure and pain.

Detecting Teen Depression and Potentially Suicidal Teens
According the American Academy of Child and Adolescent Psychiatry, parents should be on the lookout for specific signs in their children that could be indicators for a potential suicide risk. Such indicators include withdrawal from family and friends, as well as a lack of interest in activities the teens formerly enjoyed. Parents should look for any change in eating and sleeping habits or in hygiene and personal appearance.

In addition, parents should watch for personality changes and rebellious or violent behavior. Difficulty concentrating, decline in the quality of school work, and persistent boredom and malaise are possible signs as well. Persistent complaints of stomach aches, headaches and fatigue could be symptoms of emotional problems that can be signs of potential suicidal tendencies.

Equally important signs to watch for include statements from teens that they are bad and that they feel terrible inside. Other verbal hints include such statements as, “I won’t be a problem for you much longer. It’s no use. Nothing matters anyway.” Such statements from teens are clear indicators that they may be at least contemplating suicide.

If teenagers start giving away cherished possessions or throwing away favorite belongings, a way of getting their affairs in order, parents should consider such behavior an indicator of the risk for suicide. In addition, parents should watch for any signs of hallucinations or bizarre or strange thoughts.

Teen Suicide Prevention
According to the American Academy of Child and Adolescent Psychiatry, if teens threaten to commit suicide, parents should take the threat seriously and immediately seek professional help from a qualified mental health professional. Parents should not hesitate to ask their teens if they have suicidal thoughts. Such a question will not put the idea into children’s heads, but will, instead, assure teens that someone cares and open up an opportunity for discussion about it.

Parents should determine if their teens are suffering from depression and, if so, get medical treatment for the depression. Counseling is a good preventive strategy for depressed or potentially suicidal teens as well. Counseling can provide teens with coping strategies for dealing with their life problems. Frequently, once teens learn how to cope with problems, their suicidal desires dissipate.

It is essential for parents to treat their teens with understanding, compassion and respect. Parents should demonstrate unconditional love, offer emotional support, and make their teens feel important, loved and wanted. Parents should demonstrate to their teens that overcoming their problems and life challenges is possible and that they will help them with such challenges.

Resources
Related information can be found in the articles, “Coping with a Bully: How to Stop Bullying” and “Strategies for Dealing with a Bully Dilemma”. The article, “Dealing with Grief” provides related information about dealing with the death of a loved one.

An insight into crime scenes clean up services

Crime scene cleanup companies also clean unattended deaths, damaged environments due to tear gas, and other crime and distress scenes. The larger crime scenes that involve mass murder scenes, terrorist attacks and anthrax and other biochemical damage is also taken care by these companies. Crime Scene Cleanup services may also include bird and rodent infested areas. The cleaners in this case require special experience and equipment than a typical cleaning company’s experience and equipment.

Typically, crime scene cleanups start taking place only after the coroner’s office and other government bodies releases the “scene” back to the owner or some other responsible person concerned with it. The cleaning task can not begin till the police investigation is completely finished on the contaminated scene.

In most cases crime scene cleanup is a small business activity. Mostly, small cleaning services like carpet cleaning or water damage companies add services for Crime Scene Cleanup for diversifying their activities. The prominent and recognized organizations in this field of cleaning consist of the Institute of Inspection, Cleaning, and Restoration Certification (IICRC) and the American Bio-recovery Association (ABRA).

Earlier crime scene cleanup was a loathsome job but today it has become a lucrative business. Crime scene cleanup companies can charge anywhere between $100 to $600 per hour depending on the “level of trauma” and the quantity of hazardous material that the cleaners have to deal with and dispose of.

While a crime clean up service is ultimately a business like any other, advertising and marketing your services can be tricky. In a job that involves tragic death; most companies avoid mainstream methods of advertisement. Some choose the standard phone-book route while many others advertise on the side of their vans. Most of these companies largely depend on discreet options like passing out their business cards at service-industry gatherings, police stations and funeral homes.

An important requirement for success in this industry involves being considerate towards the sensitive nature of the work. There are certain crime scene clean-up companies that provide a grief counselor to the families at no cost while others offer discount to needy people. There are many countries where this type of service is funded by government or by religious organizations.

While some people call this emerging field a social trend of commercializing death, others call it plain capitalism. But for many others it still remains an essential service, a godsend. The fact is that whether you like it or loathe it but if you ever end up with blood and brains splashed all over your bedroom walls, you will definitely be relieved that there is someone you can call to clean it up.