"Ordinary concerns, such as work or friends, have no place here. Futility muffles thought; time elongates cruelly. Who is to blame for this situation? Those with depression think it must be them. Pointlessness and self-loathing govern them. So the natural final step is suicide. People with depression don’t kill themselves to frighten an errant boyfriend. They kill themselves because it is the obvious and right thing to do at that point. It is the only positive step they can think of."

-- Kay McKallan Ipswich general practitioner and consumer with depression, writing in the British Medical Journal

Thursday, March 27, 2008

Suicide in the U.S.: Statistics and Prevention

Studies showed that a type of psychotherapy called cognitive therapy reduced the rate of repeated suicide attempts by 50 percent during a year of follow-up. A previous suicide attempt is among the strongest predictors of subsequent suicide, and cognitive therapy helps suicide attempters consider alternative actions when thoughts of self-harm arise.

Specific kinds of psychotherapy may be helpful for specific groups of people. For example, a recent study showed that a treatment called dialectical behavior therapy reduced suicide attempts by half, compared with other kinds of therapy, in people with borderline personality disorder (a serious disorder of emotion regulation).

The medication clozapine is approved by the Food and Drug Administration for suicide prevention in people with schizophrenia. Other promising medications and psychosocial treatments for suicidal people are being tested.

Since research shows that older adults and women who die by suicide are likely to have seen a primary care provider in the year before death, improving primary-care providers' ability to recognize and treat risk factors may help prevent suicide among these groups. Improving outreach to men at risk is a major challenge in need of investigation.

What should I do if I think someone is suicidal?

If you think someone is suicidal, do not leave him or her alone. Try to get the person to seek immediate help from his or her doctor or the nearest hospital emergency room, or call 911. Eliminate access to firearms or other potential tools for suicide, including unsupervised access to medications.

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