Suicide Triggers - The Causes of Suicidal Thinking and Behavior

Suicide is an often misunderstood and taboo topic in the U.S. It seems that even the family of suicide victims are ostracized due to the act. Suicide is the act of an individual taking their own life, however, it does not encompass accidental deaths such as one car crashes, accidental overdoses, accidental shootings, or any of the like unless the intent of the act was to take one's own life. This fact makes suicide fairly difficult to study and sometimes determine. For instance, without a note or significant signs of suicidal intent, how can we determine an accidental drug overdose from an intentional one?

Suicide Triggers

Theories and thoughts on suicide have changed over the years both within the psychological community and within the general population. These changes seem to reflect trends in religious beliefs, pop culture, and academics; more specifically research into the subject matter. However, despite the increase in information available, suicide is still a very misunderstood and often confusing topic. Different cultures and individuals view the act of suicide in different ways. Similarly there are a number of different factors that can drive one to commit suicide. These different factors are called "triggers," and reflect different segments of the population that are at risk for suicidal behavior.

It's not uncommon to hear about the dangers of stress; in fact, we're often immersed with warnings that high stress levels affect both mental functioning and physical health. But the dangers of high stress go beyond simple impairment of mental functioning (i.e increased forgetfulness, absent mindedness, lack of concentration), high stress can also lead to suicidal thinking and suicide attempts. Two types of stress in particular increase one's risk of suicidal behavior; the first is immediate stress, the second is long-term stress which bears its own subgroups.

Immediate stress deals with the sudden onset of high stress. While some people are apt to handle this sudden increase in a healthy manner, others turn to suicide as an answer to their grief. I use the word grief because this sudden onset of intense stress is generally due to the loss of a loved one, a divorce, rejection (break-up, etc), or a disaster striking, among other things of a similar nature.

Long-term stress deals with a moderately high to high level of stress experienced by an individual over a long period of time. Common in this group are individuals with long-term or chronic illnesses which tend to tax one psychologically and physically, individuals in abusive environments (prison inmates, abusive relationships, child abuse victims, etc), and those prone to high stress at the workplace. Both China and Japan have high suicide rates; which can, in part, be attributed to the stressful emphasis their culture puts on a career and academics. Additionally, high suicide rates among such professions as psychologists, lawyers, farmers, nurses, and dentists serve to further this theory. Only recently (2006-2007) severe droughts in Australia caused a sharp rise in suicides by farmers who became unable to provide for their families, themselves, and their farms. Furthermore, advances in medicine have allowed individuals to live longer, but often at the cost of comfort. Patients often have low morale due to immobility, use of breathing aids or treatments, and high levels of pain that either aren't managed, or are managed in a way that merely puts the patient in a deep sleep; thus the quality of life is diminished and many would rather end it than live on under such circumstances.

Each of these can lead to a second trigger, which can also present alone without the aforementioned stress-related triggers. These triggers are related to changes in mood or thoughts. As Schneidmen (2007, 1993) puts it, the "key to suicide is psychache, a feeling of psychological pain that seems intolerable to the person (pg 234)*. This psychache can also be accompanied by changes in thought patterns, such as preoccupation with their problems, an inability to see outside their problems; or a loss of perspective on life. In fact, one of the most serious indicators of suicidal thoughts or intentions is the feeling of hopelessness (Comer, 2005). Intake interviews at psychiatric facilities or mental health establishments often engage patients in questions and assessments meant to reveals signs of hopelessness as a means of early suicide detection and prevention. Individuals experiencing hopelessness or increased sadness, stress, anxiety, and the like can turn to a change in thought referred to as dichotomous thinking. As Comer (2005) describes it, dichotomous thinking is the type of thinking in which there is only one solution. "Viewing problems and solutions in rigid either or terms" (pg 235). Meaning, either I kill myself or this will continue. It is my only way out.

You may be thinking that feelings of hopelessness, anxiety, anger, sadness, and/or frustration seem to signal a mental disorder, but this isn't always the case. Many individuals may present with these problems, but have no DSM-IV mental disorder to speak of; or do not display a significant enough shift either to be detected or diagnosed. However, there are also a striking number of mentally disordered individuals that do commit suicide.

Individuals diagnosed with severe depression, chronic alcoholism, and schizophrenia make up a significant portion of the suicidal population. As many as 15% of people with each of these disorders attempt suicide (Comer, 2005), pg 235). Additionally, drug and/or alcohol can influence one's inhibitions toward suicide by stifling them. However, the individual most likely has contemplated suicide before that point. Studies show that around 60% of suicidal individuals drink alcohol right before the act (Comer, 2005). There are similar incidences concerning drugs, but are more closely tied to teenage and young adult population. Co-presenting with alcoholism and a DSM disorder, most specifically depression, significantly increases one's risk of suicide.

Lastly, and a rather controversial trigger, is the influence of modeling on the prevalence of suicide attempts. Clearly, just because one individual commits suicide doesn't mean another individual will do it; but there does seem to be a connection that deals with those already contemplating the act. It is believed that the influence of another can cause an individual contemplating suicide to feel that the act is acceptable and thus encourage it. It can give those experiencing the aforementioned mood or thought change individuals an idea for a way out. Or, it can give a sense of permissibility similar to the aforementioned acceptance. Whatever the specific case, modeling has a certain sway over suicide attempt prevalence, especially among the more youthful and/or impressionable population.

While there is still much to be learned about suicide and those who attempt it, these triggers are investigated and taken into account by mental health professionals seeking to curb the suicide rates, and by researchers into the subject matter.

Comer, R. J. (2005). Fundamentals of Abnormal Psychology, 4th Edition. Worth Publishers, NY.

MedlinePlus. (2007). Suicide. Retrieved November 10, 2007, from http://www.nlm.nih.gov/medlineplus/suicide.html