The Act and Follow-through of Suicide: Part IV

Compilation of Statistics Regarding Suicide

Scott Anderson in his NYT article weaves the grim statistics of suicide in and out of his story. Here’s the morbid list:

General

  • mental illnessThe nation’s suicide rate (11 victims per 100,000 inhabitants) is almost precisely what it was in 1965.
  • In 2005, approximately 32,000 Americans committed suicide, or nearly twice the number of those killed by homicide.
  • The National Institute of Mental Health says that 90 percent of all suicide “completers” display some form of diagnosable mental disorder.

Demographics

  • Both elderly men living in Western states and white male adolescents from divorced families are at elevated risk.

Premeditation vs. Passion

  • [T]he person who best fits the classic definition of “being suicidal” might actually be safer than one acting in the heat of the moment — at least 40 times safer in the case of someone opting for an overdose of pills over shooting himself.
  • In a 2001 University of Houston study of 153 survivors of nearly lethal attempts between the ages of 13 and 34, only 13 percent reported having contemplated their act for eight hours or longer. To the contrary, 70 percent set the interval between deciding to kill themselves and acting at less than an hour, including an astonishing 24 percent who pegged the interval at less than five minutes.
  • “Sticking one’s head in the oven” became so common in Britain that by the late 1950s it accounted for some 2,500 suicides a year, almost half the nation’s total. By the early 1970s, the amount of carbon monoxide
    running through domestic gas lines had been reduced to nearly zero. During those same years, Britain’s national suicide rate dropped by nearly a third, and it has remained close to that reduced level ever since.

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The Act and Follow-through of Suicide: Part III

Premeditation vs. Passion

Author Scott Anderson in his NYT magazine article, "The Urge to End It All," notes:

Just as with homicide, researchers have long recognized a premeditation-versus-passion dichotomy in suicide.

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The Act and Follow-through of Suicide: Part II

The British Coal-Gas Story

According to Scott Anderson’s NYT article, the little-known British coal-gas story — even among mental health professionals — is a good example of how suicides can be prevented if one takes away the means:

Coal-gas ovenFor generations, the people of Britain heated their homes and fueled their stoves with coal gas. While plentiful and cheap, coal-derived gas could also be deadly; in its unburned form, it released very high levels of carbon monoxide, and an open valve or a leak in a closed space could induce asphyxiation in a matter of minutes. This extreme toxicity also made it a preferred method of suicide. “Sticking one’s head in the oven” became so common in Britain that by the late 1950s it accounted for some 2,500 suicides a year, almost half the nation’s total.

Those numbers began dropping over the next decade as the British government embarked on a program to phase out coal gas in favor of the much cleaner natural gas. By the early 1970s, the amount of carbon monoxide running through domestic gas lines had been reduced to nearly zero. During those same years, Britain’s national suicide rate dropped by nearly a third, and it has remained close to that reduced level ever since.

Experts seems to insist that committing suicide is proof of an underlying mental illness. Suicide that stems from impulsivity, among these experts, is also considered part of a mental illness. Anderson subtly argues against this, and I find myself agreeing with him:

How can this be? After all, if the impulse to suicide is primarily rooted in mental illness and that illness goes untreated, how does merely closing off one means of self-destruction have any lasting effect? At least a partial answer is that many of those Britons who asphyxiated themselves did so impulsively. In a moment of deep despair or rage or sadness, they turned to what was easy and quick and deadly — “the execution chamber in everyone’s kitchen,” as one psychologist described it — and that instrument allowed little time for second thoughts. Remove it, and the process slowed down; it allowed time for the dark passion to pass.

Would this mean that if people had less access to suicidal means that promoted “ease, speed, and certainty of death” (ESCOD), a number of suicides could be averted? It appears so. Anderson continues to make a case using the Ellington Bridge in Northwest Washington as an example:

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The Act and Follow-through of Suicide: Part I

“What was immediately apparent was that none of them had truly wanted to die. They had wanted their inner pain to stop; they wanted some measure of relief; and this was the only answer they could find. They were in spiritual agony, and they sought a physical solution.”Dr. David Rosen, psychiatrist and Jungian psychoanalyst

A recent article in New York Times magazine suggests that those who exhibit suicidal behavior or have had unsuccessful attempts are least likely to die by way of suicide.

The author, Scott Anderson, delves into the psyche of what drives a person to commit suicide. And he attempts to answer the "what" question by evaluating the "how."

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Last night

Current Mood Rating: 4

Last night, my mood was a 2. I keep contemplating all the ways I could possibly die but it's tough to do that when I have my husband sitting next to me telling me "I love you" and "You're my best friend."

(sigh)

The ironic thing is that the majority of my suicidal attempts aren't planned. They're impulses – they feel like something I can't control.

All this thinking and trying to plan out the perfect attempt is working contrary to what I want; I just end up talking myself out of it. Planning means that I'm being rational. Mixed-mood episodes are NOT rational.

On an unrelated note,  I think I'm incapable of playing the Wii for long stretches. My muscle pain is back. And here I am, thinking that the Wii would help me lose weight. I'll miss playing tennis. I made it to pro.

Oh, and speaking of weight, I think Allegra causes weight gain. Somehow I've dropped 3 lbs since I've stopped taking it.

Celebrity Sensitivity: Half of Us

Pete WentzCelebrity Crust has a post on Pete Wentz of Fall Out Boy who is doing a campaign on behalf of Half of Us, a mtvU-site geared toward college students that focuses on mental health issues.

Wentz was joined stars such as Mary J. Blige and Smashing Pumpkins frontman Billy Corgan as a spokesperson for the Jed Foundation’s Half Of Us campaign which is aimed at cutting student suicide rates.

The site also deals with issues such as eating disorders, stress, substance abuse, cutting, anxiety, depression, and bipolar disorder. As part of Generation Y (or Z or XYZ), I grew up loving mtv as a teen. Now I can’t stand it. (Mainly because it’s reality-TV show channel for than music television.) But I have to hand it to the mtv networks this time. They got it right. Use celebrities if you have to so that college students will be less hesitant to seek the help they need.

Suicide: Understanding and Intervening – Part III

A “situational crisis” may lead a person to have “intense psychological pain.” As a result of this psychological pain, a person can begin to experience “distorted thinking” and/or may “abuse medication.”

1. Situational crises

These include financial problems, illness, bereavement, relational conflict, or public humiliation. Black notes that situational crises tend to act as a “catalyst to suicide,” driving the person to believe he or she has no other solutions to solve his or her problem(s).

2. Severe psychological pain
Black gets to the heart of suicide attempts:

“The goal of suicide is often simply to end that pain: ‘I just want the pain to go away.’ … ‘I just want to die’ most often means, ‘I want to stop feeling bad.’”

This, above all things, is the biggest reason behind a suicide attempt. If people felt like they had other options to their problems apart from suicide, most would take the alternate routes. In a suicidal moment – whether planned or not – the suicidal person is thinking about ending the “pain.” Death itself is not the goal; it’s an end to emotional pain. Death seems to serve as a means to that end.

3. Distorted Thoughts
Distorted thinking is a characteristic of suicides. Black writes:

“Problems may seems catastrophic when they are not. Predictions about the future can become arbitrary and unrealistic.

While problems get unbearable and circumstances may seems bleak, instead of looking for assistance, those who are suicidal convince themselves that only death or loss of consciousness can release them from emotional pain.

4. Abuse of medication
A person who attempts to overdose on medication seeks one of two things: death or loss of consciousness. Abuse of medication that requires hospitalization provides a legitimate reason to “escape” the problems of life. Abusing medication is a person’s way of saying that he needs, as Black puts it, “an emotional vacation.” The person feels overwhelmed by the stressors of life and temporarily need to block out all distractions. At this point, it is safe to say a person is mentally ill. The need for escape from problems is the mind’s way of saying that it needs time to recover and become mentally healthy again. Abusing medication is the desperate way of doing this.

Loose Screws Mental Health News

I need a new subject header for “Mental health news.” It’s so blah. I need something snazzy. Perhaps “Loose Screws News”? Okay, nevermind… That’s what I get for being a former copy editor. Renamed as of 2/16/2009.

A new study, published in the scientific journal of the American Academy of Neurology has found that women who experience chronic headaches, namely migraines, are four times as likely to report symptoms of major depressive disorder. Of the 1,000 women surveyed, “593 reported episodic headache (fewer than 15 headaches per month) and 439 had chronic headache (more than 15 headaches per month).” Migraines were diagnosed in 90 percent of the women. Author of the study Dr. Gretchen Tietjen said that more studies are being done to discover whether the a serotonin imbalance in the central nervous system is the cause of chronic headaches, severe physical problems, and major depressive disorder. (source: The Trouble With Spikol)

According to businesswire.com, the non-profit organization Stanley Medical Research Institute (SMRI) will provide up to $9 million to fund Omeros Corporation’s schizophrenia program, which will help the completion of
Phase 1 clinical trials. Business Wire basically listed SMRI’s press release so I’m curious to do some research on SMRI and how this non-profit was able to obtain $9 million. I don’t know much about this organization but a non-profit organization funding a biopharmaceutical company’s program seems out of the ordinary to me. (This may be something normal, but I’m not aware of this.) According to SMRI’s “about us” blurb at the bottom of the PR, they state:

“The Stanley Medical Research Institute (SMRI) is a nonprofit organization that supports research on the causes and treatment of schizophrenia and bipolar disorder (manic-depressive illness), both through work carried out in its own laboratories and through support of researchers worldwide who are working on these diseases. SMRI has provided over $200 million in funding since 1989.”

Whoa. $200 million since 1989 is not a whole lot. Where in the world did this $9 million come from? Do non-profit organizations actually save up money to blow on a worthy future project? (The cynical patient in me wonders if there’s a drug company like GSK or Wyeth slipping money through SMRI’s back door.)

Liz Spikol usually blogs headlines before I can even get to ‘em so I credit her with discovering the following three links:

According to the Delhi Newsline, yoga can help with cases of severe depression and schizophrenia. (Hm, interesting.) Patients who took yoga classes in addition to meds improved more rapidly than patients only on meds. The connection with yoga seems to be the relaxation component — outdoing counseling and “talk therapy,” which can aid treatment in a mentally ill individual.

Oy. UPI has reported that Swedish researchers have discovered that those who struggle with suicidal ideation have problems with nightmares and sleep problems. Of the 165 patients surveyed, 89 percent of them reported a sleep problem. Nightmares proved to be the highest indicators of those with a high suicide risk. However, lead author Nisse Sjostrom is quick to note,

“Our finding of an association between nightmares and suicidality does not imply causality.”

But

“Our findings should inspire clinicians to include questions concerning sleep disturbance and especially nightmares in the clinical assessment of suicidal patients.”

CPAPMy husband thinks I suffer from sleep apnea – he claims I stop breathing sometimes in the middle of the night. I’m going for a sleep assessment sometime in February so I’ll let you know if I come back with a CPAP (continuous positive airway pressure) machine.

I’ve had increased dreams (or nightmares, what have you) on these psych meds. I haven’t been excessively suicidal and I hope it’s no indication of more suicide attempts on the way. *sigh* Were any of the surveyed patients on meds like Effexor and Lamictal?

(ASIDE: Dang working in a medical industry! I’m becoming more familiar with unfamiliar medical acronyms.)

And finally, News 24 reports that children who suffered from neglect and abuse are more likely to develop severe depression as adults. The study, published in the Archives of General Psychiatry, says the data specifically shows that “depression is a consequence of… abuse.” Um, who wouldn’t be depressed after such a traumatic experience? How do physicians differentiate between major depressive disorder (DSM-IV term for clinical depression) and post-traumatic stress disorder? Ah, once we get the answer, we can use it as a Jeopardy! question.

The Suicide Matrix

"There are three kinds of people in the suicide matrix: those who succeed, those who try it and live, and those who are hounded by suicidal thoughts—ideators, as they are known in the literature." — Philip Dawdy, "One Suicide Too Many," the Seattle Weekly

I'm both a suicide survivor and an ideator. I've tried overdosing on pills many times to no avail. I've also tried jumping out of cars. Each time, the driver has caught me before I could roll out into the street. Most of my other "attempts" have been strong ideations: drinking Windex, stabbing myself, shooting myself in the head, driving my car into a wall, jumping in front of a train, jumping off a high building — TO NAME A FEW.

I'm not proud of it; the list could go on and on. I identify with Dawdy's words in his SW article:

"In each case, there was little warning. One minute I'd be muddling through a weeks-long depression—wound up, angry, and lethargic all at once—and the next I'd be on the lethal precipice."

I can't really remember planning any suicides. I don't plan suicide attempts; the ideations hit me as an impulse. I become obsessed with the thought and I can't distract my mind. It's like a train headed full speed into a wall with no reverse gear.


This is me when I am suicidal.


My Latest Obsession
My latest obsession has been shooting myself in the head with a gun despite Dawdy's stat that "It is uncommon for women to kill themselves with a gun." I've never had access to a gun but if I did, I'd be dead by now. The act of pulling a trigger is final. So much more so than any act of suicide. A person can survive a stabbing, a jump, overdosing, or self-designed accidents. But once a person sticks a gun inside the mouth and pulls the trigger… it's difficult to miss. Survival isn’t impossible but not likely.

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Suicide

I’d like to say, “Been there, done that,” but it’s not something I’m proud to dismiss. February 14, 1997 was the first time I attempted suicide: I tried to jump off a fourth-story balcony. But I’m a drama queen and like standard drama queen fare, I called my pals and left them goodbye messages. People call it a cry for help; I just can’t leave this world without saying goodbye. (I liken it to leaving home for a long trip in another continent You’d say goodbye to those you love and would miss.) It’s become a bad (or perhaps, good) pattern that has kept me alive. I’ve tried jumping out of cars, swallowing pills, slashing, stabbing, drowning, suffocating — and barely stopped short of hanging. I got as far as a chair and a noose until I couldn’t bear to imagine my father walk in the door from work to see his only child hanging from the ceiling fan in the hallway.
I’m not happy to admit all this, but people can learn a lesson from a life as varied as mine. I’ve been to the depths of desolation and desperation and I know the feeling of not being able to “go on” or even wanting to “go on.”