the suicide gene

There’s a new study out on the journal Molecular Psychiatry that studied thousands of people with bipolar disorder, and found that genetic factors may influence the decision to attempt suicide. Scientists from Johns Hopkins have identified that  a small region on chromosome 2 is associated with increased risk for attempted suicide. Interestingly, the protein associated with this region is also thought to influence the same biological pathway as that of lithium (Read the whole story on Medical News Today).

This is definitely good news for suicide research since this could lead to different and better suicide prevention efforts or take drug development on a new path. But on a personal level, having come from a family tree that does include a suicide attempt makes me wonder if I am still vulnerable to keep making more suicide attempts. I’ve already tried a few times and have certainly done enough thinking about it. Is it ever going to end, or am I genetically bound to the path of completing a suicide one of these days? I realize the scientists are talking only about factors that influence the decision and not a definitive correlation, but I do worry if what I do for treatment, e.g. ECT, therapy, medication, is never really enough to change some series of action that may already be ingrained in my genes. Also, we’ve been told that there’s a genetic link in passing down mental health issues like depression. Because I’ve dealt with depression and also suicidal thoughts, does this mean that, should I choose to have children, I would be making my offspring susceptible not just mental illness, but also to suicidality? I’m not sure I could watch another person(s) suffer through that pain, and also know that I knowingly passed down that particular molecular combination to his/her blood.

Overall, this finding is a really good one, but it’s one that will keep me thinking when my next suicidal thought is coming. This worry never ceases to stop.

 

Side note: in searching stuff for this post, I found a PDF document from the Risk Management Foundation at Harvard of Guidelines for Identification, Assessment, and Treatment Planning for Suicidality.

after a suicide

My friend’s co-worker committed suicide this week. It took the authorities a few days to identify the body because he jumped in front of a moving train. My friend told me that his co-worker stopped coming to work a month ago when he checked himself into a hospital for having suicidal thoughts. He was released, but decided to check back in again. The suicide happened sometime after he was released from the hospital the second time around.

I did not know this person, so I can’t really speculate on what could’ve been done to help somehow, even though he did take steps to keep himself safe several times. Only thing I could think to do is to post some facts about suicide prevention on this page.

Some suicide warning signs or suicidal thoughts include (from the Mayo Clinic):

• Talking about suicide, including making such statements as “I’m going to kill myself,” “I wish I was dead” or “I wish I hadn’t been born”
• Getting the means to commit suicide, such as getting a gun or stockpiling pills
• Withdrawing from social contact and wanting to be left alone
• Having mood swings, such as being emotionally high one day and deeply discouraged the next
• Being preoccupied with death, dying or violence
• Feeling trapped or hopeless about a situation
• Increased use of alcohol or drugs
• Changing normal routine, including eating or sleeping patterns
• Doing risky or self-destructive things, such as using drugs or driving recklessly
• Giving away belongings or getting affairs in order
• Saying goodbye to people as if they won’t be seen again
• Developing personality changes, such as becoming very outgoing after being shy

Warning signs aren’t always obvious, though, and they vary from person to person. Some people make their intentions clear, while others keep suicidal thoughts and feelings secret.

NIH’s page: http://www.nlm.nih.gov/medlineplus/suicide.html has a great compilation of resources regarding suicide.

But perhaps the most important information to post here is the suicide prevention lifeline number: 1-800-273-8255.  www.suicidepreventionlifeline.org

eighth anniversary of my first suicide attempt

People remember their first kiss. I remember my first suicide attempt. It was February 16, 2003, when I tried to kill myself in my college dorm room.  It might not be considered a ‘serious’ attempt since the amount of sleeping pills I took would’ve never killed me, but I was nothing but serious when I came to a conclusion that I needed to end my life then. I have no recollection of how the ambulance came and took me to the ER, but I do remember waking up in the ER and then being told that I needed to be admitted to the psychiatric hospital. And I remember those few days of my first stay at a psych hospital.

In a way, this event changed everything. For start, it’s certainly changed the way I view February. For the last seven years, I dreaded the coming of the month of February like it was the plague, and when it did get here, I was mostly frozen from the fear that I would do this again. Then, all the suicidal thoughts seem to come up, and I spend the rest of the month just hoping that I can get through it in however many pieces that remains of me. That’s been the routine. In trying to heal the wounds of what my psychiatrist calls February my “personal 9/11,” she referred me to a psychologist trained in EMDR.  I had those treatments late February/early March last year, and while it curbed my suicidal thinking at the time, there wasn’t really a way to tell if the EMDR truly benefitted me until another February came.

So, February did come again, and now we’re mere minutes away from the end of February 2011.  And I can’t say that there was any dreaded countdown, the crippling fear, or the ruminating thoughts of suicide during the 28 days. All in all, I didn’t just survive through it; I lived through it. Just as this month was ushered in without any fanfare, it will close its doors unceremoniously.

Even though this February hasn’t had the ‘excitement’ of the previous seven Februarys, I do feel a sense of relief coming over me as I write this entry. It’s not that I’ve forgotten the details of the attempt. I’m well aware of what happened, and I still want to give a nod to this day and this month because it is such an important part of my development as a person. But what’s looking more clear to me now is that the past doesn’t have to be the anchor that holds me back. Rather, I think I would be honoring that experience properly if I can live on.

Time “Marches” on. And so will I.

When watching ‘the virgin suicides’ ≠ suicidal thoughts

Depression has always made it a bit uncomfortable for me to see a scene in a movie or other programs that included  a suicide attempt. That discomfort escalated to a point of real uneasiness after I made my own first attempt. Since then, seeing those scenes often contributed to triggering a desire to contemplate suicide. So, when a friend asked me this weekend if I wanted to go see “The Virgin Suicides” for free at our local museum, I hesitated. Could I handle a film that involved not just one, but multiple suicides? Will this lead to my having to think about suicide? Despite those worries swirling around me, I agreed to go.

The movie was odd but good (for one that involves multiple suicides of teenage girls…), and the viewing even came with free popcorn. Any other time, I would’ve felt almost frozen from having to see something like that, but even when we went to dinner afterward, the conversation flowed fine. Sure, having to go eat with someone after watching a movie doesn’t leave a person any room to replay those scenes in his/her mind, but I didn’t even think a single bit about the film while we had dinner. After I came back home from dinner and a movie, there was a certain amount of expectation that I would have to deal with my emotions. After all, being left alone to think about things has often been a “good” opportunity to contemplate. I sat down and looked at my wrists. I ran my fingers across each wrist as if I thought I’d find old cut marks from years ago. But even while I stared at my limbs, my thoughts never crossed over to even a moment of contemplating suicide.

I know it’s just a reaction to a single film. But I really am surprised that a movie that’s titled “The Virgin Suicides” didn’t provoke a dark reaction from me. Just maybe this is an indication that I’m doing better, bit by bit.

 

football players and suicide

Owen Thomas, a popular 6-foot-2, 240-pound junior lineman for University of Pennsylvania with no previous history of depression, hanged himself in his off-campus apartment after what friends and family have described as a sudden and uncharacteristic emotional collapse. A brain autopsy of Thomas has revealed the same trauma-induced disease found in more than 20 deceased NFL players, raising questions of how young football players may be at risk for the disease.

The latest article in the New York Times, “Suicide reveals signs of disease seen in NFL,” goes on to talk about Chronic Traumatic Encephalopathy, or CTE, a disease linked to depression and impulse control, whose only known cause is repetitive brain trauma. About 1.4 million children ages 14 to 18 play high school football every fall, and about three million others play in youth leagues at younger ages. Thomas’s parents requested that their son’s case be made public to educate other families about the possible and perhaps addressable risks of football at all levels.

suicide, suicide, go away

• Suicide takes the lives of nearly 30,000 Americans every year.
• Many who attempt suicide never seek professional care.
• There are twice as many deaths due to suicide than HIV/AIDS.
• Between 1952 and 1995, suicide in young adults nearly tripled.Over half of all suicides occur in adult men, age25-65.
• In the month prior to their suicide, 75% of elderly persons had visited a physician.
• Suicide rates in the United States are highest in the spring.
• Over half of all suicides are completed with a firearm  
• young people 15-24 years old, suicide is the third leading cause of death
• .Suicide rates among the elderly are highest for those who are divorced or widowed.
• 80% of people that seek treatment for depression are treated successfully.
• 15% of those who are clinically depressed die by suicide.
• There are an estimated 8 to 25 attempted suicides to 1 completion.The highest suicide rate is among men over 85 years old: 65 per 100,000 persons.1 in 65,000 children ages 10 to 14 commit suicide each year.Substance abuse is a risk factor for suicide.The stronges risk factor for suicide is depression.By 2010, depression will be the #1 disability in the world. (World Health Organization)

Countdown to World Suicide Prevention Day

• Every year, almost one million people die from suicide; a “global” mortality rate of 16 per 100,000, or one death every 40 seconds.
• In the last 45 years suicide rates have increased by 60% worldwide. Suicide is among the three leading causes of death among those aged 15-44 years in some countries, and the second leading cause of death in the 10-24 years age group; these figures do not include suicide attempts which are up to 20 times more frequent than completed suicide.
• Suicide worldwide is estimated to represent 1.8% of the total global burden of disease in 1998, and 2.4% in countries with market and former socialist economies in 2020.
• 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 alcohol use disorders) are a major risk factor for suicide in Europe and North America; however, in Asian countries impulsiveness plays an important role. Suicide is complex with psychological, social, biological, cultural and environmental factors involved.

-World Health Organization

It’s only four more days til World Suicide Prevention Day. I thought I’d at least get some facts about suicide in the next few days since this week is Suicide Prevention Week.

I will be bluntly honest; I tend to think that suicide could be a rational act. But I also know that most are and should be totally preventable. In the coming days, I hope I can at least start talking about how suicide prevention and awareness are much more complicated than handing someone a helpline number (though I’m not saying those aren’t important, because they really are). This topic is certainly not easy to bring up, but if I’m going to say something about it, it might as well be during Suicide Prevention Week.

national suicide prevention week 2010

September 5 – 11, 2010

• Suicide is the 11th leading cause of death in the United States with one suicide occurring on average every 15.2 minutes.

• Suicide is the 3rd leading cause of death among 15- to 24-years-olds.

• The elderly make up 12.6% of the population, but comprise 15.7% of all suicides.

• Approximately 864,950 Americans attempt suicide each year.

• It is estimated that five million living Americans have attempted to kill themselves.

• Every year in the United States, more than 17,000 men and women kill themselves with a gun; two-thirds more than the number who use a gun to kill another person.

• An estimated 4.6 million Americans are survivors of the suicide of a friend, family member, or loved one.

Predicting suicide attempts via a computer test

From Medical News Today:

Two powerful new tests developed by psychologists at Harvard University show great promise in predicting patients’ risk of attempting suicide. Both new tests are easily administered within minutes on a computer, giving quick insight into how patients are thinking about suicide, as well as their propensity to attempt suicide in the near future.

In one study, 124 patients in a psychiatric emergency department were administered a modified Stroop test measuring speed in articulating the color of words on a computer screen. Suicidal individuals were found to pay more attention to suicide-related words than to neutral words.

“Suicide Stroop scores predicted six-month follow-up suicide attempts above and beyond well-known risk factors such as a history of suicide attempts, patients’ reported likelihood of attempt, and clinicians’ predictions regarding patients’ likelihood of attempt,” says co-author Christine B. Cha, a doctoral student in psychology at Harvard.

A second study adapted the Implicit Association Test developed by Harvard psychologist Mahzarin R. Banaji, using reaction times to semantic stimuli to measure 157 subjects’ automatic mental associations — in this case, the strength of associations between words related to “self” and words related to either “life” or “death/suicide.” Participants were shown pairs of words on a screen, with response speed revealing unconscious associations between the terms. For instance, a rapid response to stimuli associating self with death/suicide suggests a strong unconscious association between the two.

The researchers found that those participants with strong associations between self and death/suicide were six times more likely to attempt suicide within the next six months than those holding stronger associations between self and life.

“Why Suicide?,” Eric Marcus Asks again

You may have heard of Eric Marcus. He is an expert on gay issues and the author of a dozen books, including “Making Gay History” and “Together Forever,” and is coauthor with Greg Louganis of the #1 New York Times bestselling “Breaking the Surface.” He also wrote a book in 1996 called “Why Suicide?: Answers to 200 of the Most Frequently Asked Questions about Suicide, Attempted Suicide and Assisted Suicide.”

Marcus is coming out with a revised and updated version of this book on September 1, titled “Why Suicide?: Questions & Answers about Suicide, Suicide Prevention, and Coping with the Suicide of Someone You Know.”

Here’s the product description:

In our lifetimes 85 percent of us will have some up-close experience with the suicide of someone we know.  And more than 20 percent of us will have a family member die by suicide.  Journalist Eric Marcus knows this better than most people.  In 1970, his father took his life at the age of 44.  In 2008, his 49-year-old sister-in-law took her life as well.

In a completely revised and updated edition of the landmark original WHY SUICIDE?, Eric Marcus offers thoughtful answers to scores of questions about this complex, painful issue from how to recognize the signs of someone who is suicidal to strategies for coping in the aftermath of a loved one’s death.

No matter what the circumstances, those of us who are affected by suicide are left with difficult and disturbing questions: Why did they do it? Was it my fault? What should I tell people when they ask what happened? Is someone who attempts suicide likely to try again? What should I do if I’m thinking of killing myself?

Drawing from his own experience, as well as interviews with people who have been touched by suicide, Eric Marcus cuts through the veil of silence and misunderstanding to bring clarity, reassurance, and comfort to those who so desperately need it.

Marcus recently gave an interview regarding this book to Therese Borchard on beliefnet.com/Psychcentral.

I’m really interested in reading this book, but at the same time, I’m really scared to pick it up. I don’t know if I trust myself to be confronted with this topic so closely. Also, late August was when I had one of my attempts. I just don’t need any ‘temptations’ or triggers around that time. But maybe getting through this book might be a way for me to gain information about it to help me re-evaluate my opinion about suicide.

www.whysuicidebook.com
www.ericmarcus.com

suicide on my mind (but I’m fine, really)

“Overcome writer’s block with Plinky prompts,” said the blog alert I got from WordPress just yesterday. I was intrigued, because honestly, I’ve been having a hard time posting my own words lately. It’s not that there’s been nothing going on in my life. For example, I had a very emotional session last week during therapy with Dr. L. Somehow, I feel the hesitation to write my real thoughts out in my fingertips. The hands just seem to come to a halt or find itself pressing the backspace button to erase whatever I had written out. But my head hasn’t stopped thinking about what I wanted to write about all last week. So, here it goes…

I’m familiar with suicide. I’ve talked about it on several posts in the past. So, when the topic of suicide among the elderly came up in class the other day, I thought I’d be fine about it. The facts on suicide and the elderly were really interesting, and I was just intellectually intrigued, but not emotionally stirred. However, we also talked about when suicide sometimes becomes a ‘rational choice’ for older people, rather than something caused by some mental illness. I began asking myself, ‘can’t young people commit ‘rational choice’ suicide, too, if the elderly can do it?’

I immediately grew frightened by my thoughts.  After all this time, do I still find suicide to be a feasible option for me? While I can usually write openly about these thoughts in this journal, I hesitated to write anything about it because I think the topic of suicide isn’t something that’s discussed honestly…and when it is, I didn’t want people to mistake my thoughts as a sign that I’m suicidal or something. I think I really just want to talk about the topic of suicide with someone, and not just with my therapist.

So, it’s now the following week and the class has moved on to talking about the elderly and dementia, but I seem to be stuck on thinking about last week’s topic.

If I write any more about this topic, I know I’ll start tearing up, which is not a good thing since I have get ready to attend a wedding in Bowling Green, Ky., today. Any thoughts?

Suicide and its circumstances

originally appeared in The Psychiatric Times:

Circumstances Associated with Suicide

The Centers for Disease Control and Prevention (CDC) estimated the suicide rate in the United States at 11.6 per 100,000 in 2007 (18.4 and 5.0 per 100,000 in male and female populations, respectively). Mental health problems were the most common known circumstance associated with suicide deaths. Firearm was the most common method used (50.7 percent overall). The full surveillance report on violent deaths, dated May 14, is posted at <www.cdc.gov/mmwr/pdf/ss/ss5904.pdf>.

Share Your Story, Share Your Strength

Before I get to the rest of the post:

Go to http://www.lifeline-gallery.org and share how you may have been affected by your own suicide attempt or someone else’s. Or just express your support for suicide prevention. It’s a “place to share, and listen to, stories of hope and recovery.” You even get to even make your own avatar to go along with your story.

Suicide Stats & Risk Factors

Suicide is the 11th leading cause of death in the United States.

Below are some Risk Factors associated with suicide:

• Family history of suicide
• Family history of child maltreatment
• Previous suicide attempt(s)
• History of mental disorders, particularly depression
• History of alcohol and substance abuse
• Feelings of hopelessness
• Impulsive or aggressive tendencies
• Cultural and religious beliefs (e.g., belief that suicide is noble resolution of a personal dilemma)
• Local epidemics of suicide
• Isolation, a feeling of being cut off from other people
• Barriers to accessing mental health treatment
• Loss (relational, social, work, or financial)
• Physical illness
• Easy access to lethal methods
• Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or to suicidal thoughts

Here’s a map of Suicide rates per 100,000 in the US, 2000-2006 (CDC). Based on death data from 2000 through 2006, this US map of the smoothed, county-level, age-adjusted suicide rates indicate that suicide rates are highest in the western and northwestern regions of the United States. There is also a notable pattern of high suicide rates among counties in the central areas of the midwest and southern regions and in central Florida.

Protective Factors

• Effective clinical care for mental, physical, and substance abuse disorders
• Easy access to a variety of clinical interventions and support for help seeking
• Family and community support (connectedness)
• Support from ongoing medical and mental health care relationships
• Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes
• Cultural and religious beliefs that discourage suicide and support instincts for self-preservation

(U.S. Public Health Service 1999)

Crossing the Line

I am in no way suicidal, but I must write this.

It’s a hard thing to explain, and I don’t even know if other people feel like this. As I’ve said previously, I have made suicide attempts, and I am still alive. When I have made those attempts, I have ended up hurting a lot of people. And I am deeply, deeply sorry that these people had to be tangled up in this selfish mess.

So, how do I feel about suicide now?

I am embarrassed to admit this, but I still feel like suicide is a choice that one should have the right to make. I’m not saying it’s legitimate or the right thing to do, but I’m just saying that I can understand how people come to this decision. And I think my thoughts on this matter has strengthened since I’ve made those suicide attempts.

There’s a line, I believe, between contemplation and action. Regardless of how much your mental illness played a part in carrying out this task, I think that once you’ve ‘crossed that line’ of having made those attempts, you kind of know that you have some capacity of being able to carry out this attempt again. Once that line is crossed, you know something about yourself that you didn’t know before. And I know it’s such an awful thing, but for me, something about me has changed in the way I view life and options in life. And I’m not sure I can ever go back to viewing life to the way I did before I made those attempts.

I don’t know if any amount of any type of therapy can fix how I feel, and whether it even needs to be fixed. Perhaps the only thing to do is to temper this feeling, and keep it well-contained somewhere  where one do not act on his/her feelings should a time like that arise. But I am so scared that this one belief I have about this task will manifest my head if this ‘decision’ must be made again.

Just as you can never take back what’s already been done, can you ever undo the line you’ve crossed within your heart?