Why would someone consider committing suicide?
To help understand the factors that can contribute to the risk of suicide, Dr. Seth Rosenwald, a Pennsylvania psychiatrist, points to the “model” that is used in psychiatry. The psychiatric model is an evaluation process that looks at the three major areas of influence that affect behavior, and may predispose a person to suicide.
“First, we look for biological illness,” Rosenwald says. “There is often a very high incidence of symptoms of clinical depression among people who attempt suicide: they can’t eat, they can’t sleep, they have frequent crying spells, low energy, and a basic loss of interest in things. Fifteen percent of people who are depressed eventually commit suicide. So, obviously, clinical depression is a major and important indicator.”
Note: The Mayo Clinic disagrees with Rosenwald in a study it completed in 2000, and which was published by the American Journal of Psychiatry. That study looked at the data for the previous 30 years from more than 100 suicide studies and concluded that while the standard rate of 15 percent had been espoused by the majority of psychiatric practitioners, “a more accurate suicide rate for patients with depression is 2 to 9 percent.” And, according to its study the highest rate of risk for suicide – 8.6 percent – was for patients recently hospitalized for a suicide attempt, while those who are being treated on an outpatient basis for depression have a 2 percent risk rate. The rate in the general population is 1 percent.
“The second influence,” Dr. Rosenwald says, “ is the psychological factor. What’s going on in the patient’s life? What are the issues? Has there been a severe loss (divorce, death, job, for example)? Is there a difficult family conflict? An internal conflict? Does the person feel isolated or disconnected from other people? What is making the person feel so distressed? Unresolved psychological issues can be overwhelming.
“The third thing we look at is the social factors, which may overlap with psychological factors. The social factors include financial problems, medical problems, job problems and the other problems that one faces in living. These can and do weigh heavily on people.”
While Rosenwald believes that none of these influences alone may contribute to a risk of suicide, the combination can be serious for some individuals, especially those in certain high-risk categories, such as those with substance abuse problems, older people and white males.
“Often people commit suicide when all three of these major areas of influence are bearing down on them,” he says. “They feel they have no alternative, they see no light at the end of the tunnel.”
“That’s extremely unfortunate,” Rosenwald says, “because depression and other biologically-based problems can be successfully treated with medication, and psycho-therapy can help with psychological problems. When those two aspects are addressed, people are then better able to handle their social problems. Help is available but the person considering suicide must reach out for it. Getting help with even one factor can make the critical difference — the difference between life and death.”
Based in Rockport, psychotherapist and life coach Susan Britt, M.Ed., a former university director of counseling and career services, teaches individuals, couples and families to resolve relationship conflicts, clarify and achieve life and career goals, and accelerate personal growth. Questions and comments may be addressed to her at firstname.lastname@example.org and by telephone 978 546-9431.