Suicide in Adults

by Marianne Cook, LICSW, Clinician, Harvard University Mental Health Service

More than 33,000 Americans commit suicide each year—the equivalent of one suicide every 16 minutes in this country. There may be as many as 25 suicide attempts for every completed suicide. The majority of individuals who attempt suicide have a diagnosable mental health condition such as depression, bipolar disorder, or substance dependence. Suicide is preventable if such conditions are recognized and treated, and if warning signs are taken seriously. Indeed, former Surgeon General David Satcher called suicide “the most preventable form of death in the U.S. today.”

The warning signs of possible suicidal intention include the following:

• Observable symptoms of depression, such as feelings of despair and hopelessness, changes in eating and sleeping habits, withdrawal from family and friends, and loss of interest in usual activities
• Dramatic changes in mood (including sudden cheerfulness)
• Any previous suicide attempt or psychiatric hospitalization
• Seeking access to weapons, pills, or other means of suicide
• Recent impulsiveness and unnecessary risk-taking
• Increased alcohol and/or drug use
• Intense anger or anxiety
• Preoccupation with death
• Giving away or throwing away one’s possessions
• Putting one’s affairs in order prematurely
• Sudden interest or disinterest in religion
• Verbalized feelings, thoughts, or plans regarding suicide

Suicidal people may communicate their intent through direct statements (“I am going to end my life”) or indirect statements (“I can’t go on anymore”; “I won’t be around much longer”; “Soon you won’t have to deal with me anymore”). If you suspect that somebody you know is contemplating suicide, do not be afraid to ask that person about it. It is a common (and false) myth that talking about suicide will “plant” the idea in somebody’s head. In fact, research shows that asking somebody about suicide actually opens up communication and lowers the risk of an impulsive act.

Any person who expresses suicidal thoughts or feelings should be evaluated immediately by trained mental health clinicians. These statements are almost always an expression of extreme distress, not a harmless bid for attention. If somebody you know expresses a desire or plan to commit suicide, take it seriously. Convince that person to seek help from the nearest emergency room or crisis evaluation team, or dial 911. Do not leave the person alone until help is found. Remember, suicide is preventable, and the majority of people who receive professional support for their mental health crises will not go on to attempt suicide. For additional guidance, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

The information in the article above was drawn from the following sources:

• American Foundation for Suicide Prevention (2009). About suicide.

  Centers for Disease Control (2009). Suicide prevention.

  National Institute of Mental Health (2009). Suicide prevention.

  Quinnett, Paul (2007). QPR for suicide prevention. Information available through QPR Institute: www.qprinstitute.com.

Additional Sources of Information

• Fact Sheet: Older Adults and Depression & Suicide, from the National Institute of Mental Health. The web site also features various publications and articles on treatment, prevention, and intervention.
• Suicide in the Elderly, from Suicide.org, a site offering information on suicide intervention, prevention and support with a list of several Helplines including those for military veterans, in Spanish and text telephone
• At a Glance: Suicide Among the Elderly, a fact sheet found on the National Strategy for Suicide Prevention web site.

General Resources on Aging and Wellness

• From Project INTERFACE: Caregiver Resources.
• Geriatric Mental Health Foundation.
• “Older Adults and Mental Health,” from Mental Health: A Report of the Surgeon General.
• PubMed, a collaboration of the U. S. National Library of Medicine and the National Institute of Health, provides a comprehensive list of journal articles regarding mental health and older adults.