Shirin S's List: Suicide

• In the Western world, males die much more often by means of suicide than do females, although females attempt suicide more often. This pattern has held for at least a century.^{[citation needed]} Some medical professionals believe this stems from the fact that males are more likely to end their lives through effective violent means (guns, knives, hanging, etc.), while women primarily use less severe methods such as overdosing on medications.
• In countries where firearms are readily available, many suicides involve the use of firearms. Over 52% of suicides that occurred in the United States in 2005 were by firearm.^[21] Asphyxiation methods (including hanging) and toxification (poisoning and overdose) are fairly common as well. Together they comprised about 40% of U.S. suicides during the same time period. Other methods of suicide include blunt force trauma (jumping from a building or bridge, self-defenestrating, stepping in front of a train, or car collision, for example). Exsanguination or bloodletting (slitting one's wrist or throat), intentional drowning, self-immolation, electrocution, and intentional starvation are other suicide methods. Individuals may also intentionally provoke another person into administering lethal action against them, as in suicide by cop.
• Studies show a high incidence of mental disorders in suicide victims at the time of their death with the total figure ranging from 98%^[22] to 87.3%^[23] with mood disorders and substance abuse being the two most common. A person diagnosed with schizophrenia may commit suicide for a number of reasons, including because of depression. Suicide among people suffering from bipolar disorder is often an impulse, which is due to the sufferer's extreme mood swings (one of the main symptoms of bipolar disorder), or also possibly an outcome of delusions occurring during an episode of mania or psychotic depression. Major depressive disorder is associated with a higher than average rate of suicide, especially in men.

• It is estimated that each suicide in the United States leaves an average of six people intimately affected by the death, either as a spouse, parent, significant other, sibling, or child of the deceased person. These people are referred to as survivors.^[28]

   

  It is estimated that 80% of all in home suicide scenes are cleaned up by a close friend, significant other, or a family member. Those that clean up a suicide scene of a close friend, significant other, or a family member are 75% more likely to commit suicide later on in life
• Switzerland has recently taken steps to legalize assisted suicide for the chronically mentally ill. The high court in Lausanne, in a 2006 ruling, granted an anonymous individual with longstanding psychiatric difficulties the right to end his own life. At least one leading American bioethicist, Jacob Appel of Brown University, has argued that the American medical community ought to condone suicide in certain individuals with mental illness
• In most forms of Christianity, suicide is considered a sin, based mainly on the writings of influential Christian thinkers of the Middle Ages, such as St. Augustine and St. Thomas Aquinas; suicide was not considered a sin under the Byzantine Christian code of Justinian, for instance.^[34][35] The argument is based on the commandment "Thou shalt not kill" (made applicable under the New Covenant by Jesus in Matthew 19:18), as well as the idea that life is a gift given by God which should not be spurned, and that suicide is against the "natural order" and thus interferes with God's master plan for the world
• Judaism focuses on the importance of valuing this life, and as such, suicide is tantamount to denying God's goodness in the world.
• Suicide is not allowed in the religion of Islam^[41]; however, martyring oneself for Allah (during combat) is not the same as completing suicide. Suicide in Islam is seen as a sign of disbelief in God.^[42] The use of suicide attacks is strictly forbidden in Islam,^{[citation needed]} however it is practised by Radical groups such as Hamas and Al-Qaeda in Iraq.
• In Hinduism, suicide is frowned upon and is considered equally sinful as murdering another. Hindu Scriptures state that one who commits suicide will become part of the spirit world, wandering earth until the time one would have otherwise died, had one not committed suicide.^[43]
• Some see suicide as a legitimate matter of personal choice and a human right (colloquially known as the right to die movement), and maintain that no one should be forced to suffer against their will, particularly from conditions such as incurable disease, mental illness, and old age that have no possibility of improvement.
• A narrower segment of this group considers suicide something between a grave but condonable choice in some circumstances and a sacrosanct right for anyone (even a young and healthy person) who believes they have rationally and conscientiously come to the decision to end their own lives.
• Adherents of this view often advocate the abrogation of statutes that restrict the liberties of people known to be suicidal, such as laws permitting their involuntary commitment to mental hospitals.

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• 
  Fifty-two percent of all people who kill themselves do so with a firearm, accounting for almost 17,000 deaths each year in the U.S. Use of a firearm is the number one method in those aged 35 and up.

• Research has shown that graphic, sensationalized or romanticized descriptions of suicide deaths in the news media can contribute to suicide contagion, popularly referred to as “copycat” suicides.

  • The media cannot do it, but YOU can!

• Despite its often complex origins, suicide can be prevented. Communities and societies that are well integrated and cohesive have fewer suicides.

• Between 25 and 50 percent of people who kill themselves had previously attempted suicide. Those who have made suicide attempts are at higher risk for actually taking their own lives.
• • Fifty to 75 percent of all suicides give some warning of their intentions to a friend or family member.
  • Imminent signs must be taken seriously.

• • Observable signs of serious depression:
    Unrelenting low mood
    Pessimism
    Hopelessness
    Desperation
    Anxiety, psychic pain and inner tension
    Withdrawal
    Sleep problems
  • Increased alcohol and/or other drug use
  • Recent impulsiveness and taking unnecessary risks
  • Threatening suicide or expressing a strong wish to die
  • Making a plan:
    Giving away prized possessions
    Sudden or impulsive purchase of a firearm
    Obtaining other means of killing oneself such as poisons or medications
  • Unexpected rage or anger

• At least 90 percent of people who kill themselves have a diagnosable and treatable psychiatric illnesses -- such as major depression, bipolar depression, or some other depressive illness, including:
  Schizophrenia
  Alcohol or drug abuse, particularly when combined with depression
  Posttraumatic Stress Disorder, or some other anxiety disorder
  Bulimia or anorexia nervousa
  Personality disorders especially borderline or antisocial
• Sex: Males are three to five times more likely to commit suicide than females.
  Age: Elderly Caucasian males have the highest suicide rates.
• Changes in Behavior
  Speech suggesting the individual is close to suicide. Such speech may be indirect. Be alert to such statements as, "My family would be better off without me." Sometimes those contemplating suicide talk as if they are saying goodbye or going away.

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• causing almost half of all violent deaths
• Estimates suggest fatalities could rise to 1.5 million by 2020.
• “For every suicide death there are scores of family and friends whose lives are devastated emotionally, socially and economically,“ says Dr Catherine Le Galès-Camus, WHO Assistant-Director General, Noncommunicable Diseases and Mental Health.
• Among countries reporting suicide, the highest rates are found in Eastern Europe and the lowest are found mostly in Latin America, in Muslim countries and in a few of the Asian countries. There is little information on suicide from African countries.
• With the exception of rural China, more men than women commit suicide, although in most places more women than men attempt suicide.
• Suicidal behaviour has a large number of complex underlying causes, including poverty, unemployment, loss of loved ones, arguments, breakdown in relationships and legal or work-related problems. A family history of suicide, as well as alcohol and drug abuse, and childhood abuse, social isolation and some mental disorders including depression and schizophrenia, also play a central role in a large number of suicides. Physical illness and disabling pain can also increase suicide risks.
• The most common methods are pesticides, firearms and medication, such as painkillers, which can be toxic when consumed in excessive amounts. One recent breakthrough was the move by many pharmaceutical companies to market painkillers in blister packs rather than more easily accessible bottles, which had a significant impact on their use as a suicide method.
• Currently attention is focused on encouraging a reduction in access to pesticides and encouraging enhanced surveillance, training and community action on their use, for example, safer storage, and proper dilutions. Pesticides are an especially common cause of suicide deaths in rural regions of China. Restrictions on access to firearms have been associated with a decrease in their use for suicide in some countries.
• Protective factors include high self-esteem and social “connectedness“, especially with family and friends, having social support, being in a stable relationship, and religious or spiritual commitment.

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• Not all suicides can be prevented, but a majority can. There are a number of measures that can be taken at community and national levels to reduce the risk, including:

    
   
  • reducing access to the means of suicide (e.g. pesticides, medication, guns);
   
  • treating people with mental disorders (particularly those with depression, alcoholism, and schizophrenia);
   
  • following-up people who made suicide attempts;
   
  • responsible media reporting;
   
  • training primary health care workers.
• At a more personal level, it is important to know that only a small number of suicides happen without warning. Most people who kill themselves give definite warnings of their intentions. Therefore, all threats of self-harm should be taken seriously. In addition, a majority of people who attempt suicide are ambivalent and not entirely intent on dying.
• Many suicides occur in a period of improvement when the person has the energy and the will to turn despairing thoughts into destructive action. However, a once-suicidal person is not necessarily always at risk: suicidal thoughts may return but they are not permanent and in some people they may never return.
• Every year, an estimated 900 000 people die by committing suicide. This represents one death every 40 seconds. Worldwide, suicide ranks among the three leading causes of death among those aged 15-44 years.

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• Suicide is now among the three leading causes of death among those aged 15-44 years (both sexes); these figures do not include suicide attempts up to 20 times more frequent than completed suicide.
• Although traditionally suicide rates have been highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of countries, in both developed and developing countries.
• Mental disorders (particularly depression and substance abuse) are associated with more than 90% of all cases of suicide; however, suicide results from many complex sociocultural factors and is more likely to occur particularly during periods of socioeconomic, family and individual crisis situations (e.g. loss of a loved one, employment, honour).
• There is compelling evidence indicating that adequate prevention and treatment of depression, alcohol and substance abuse can reduce suicide rates.
• School-based interventions involving crisis management, self-esteem enhancement and the development of coping skills and healthy decision making have been demostrated to reduce the risk of suicide among the youth.
• Worldwide, the prevention of suicide has not been adequately addressed due to basically a lack of awareness of suicide as a major problem and the taboo in many societies to discuss openly about it. In fact, only a few countries have included prevention of suicide among their priorities.
• Reliability of suicide certification and reporting is an issue in great need of improvement.

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• Already in this new century there have been more than 5 million suicide deaths worldwide. Each year approximately one million people in the world die by suicide. This toll is higher than the total number of world deaths each year from war and homicide combined. Suicide is an important public health problem in many countries, and is a leading cause of death amongst teenagers and young adults.
• In addition, it is estimated that there are from 10-20 times as many suicide attempts as suicide deaths.
• At a personal level, all suicide attempts, regardless of the extent of injury, are indications of severe emotional distress, unhappiness and/or mental illness.
• There are also substantial economic costs associated with lives lost to suicide. These costs arise from the loss of economic potential due to lives lost to suicide, from the often devastating effects of symptoms of bereavement by suicide, from the medical and mental health costs associated with suicide attempts, and from the burden of family care for those who have made suicide attempts. Internationally, the annual economic cost of suicidal behaviour is estimated to be in the billions of dollars.
• In the last 45 years, suicide rates have increased by 60 percent in some countries.

  • Also supported by WHO.
• Worldwide, suicide ranks among the three leading causes of death among those aged 15-44 years.

  • all people in the prime of their lives
• In the year 2000, approximately one million people died of suicide. This represents a global mortality rate of 16 per 100,000 or one death every 40 seconds.
• At least 100,000 adolescents die by suicide every year.

  • like me, like you, they die.

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• More than 32,000 people in the United States die by suicide every year. It is this country's 11th leading cause of death,