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Suicide and suicidal behavior

Contents of this page:


Depression in children
Depression in children
Depression among the elderly
Depression among the elderly

Definition    Return to top

Suicide is the act of deliberately taking one's own life. Suicidal behavior is any deliberate action with potentially life-threatening consequences, such as taking a drug overdose or deliberately crashing a car.

Causes    Return to top

Suicidal behaviors can accompany many emotional disturbances, including depression, bipolar disorder, and schizophrenia. More than 90% of all suicides are related to a mood disorder or other mental illness.

Suicidal behaviors often occur in response to a situation that the person views as overwhelming, such as:

The elderly have the highest rate of suicide, but there has been a steady increase among adolescents. Risk factors for suicide in adolescents include:

Suicide attempts that do not result in death far outnumber completed suicides. Many unsuccessful suicide attempts are carried out in a manner that makes rescue possible. These attempts often represent a desperate cry for help.

The method of suicide can be relatively nonviolent (such as poisoning or overdose) or violent (such as shooting oneself). Males are more likely to choose violent methods, which probably accounts for the fact that suicide attempts by males are more likely to be completed. Many suicides involve a firearm, especially in elderly men.

Relatives of people who seriously attempt or complete suicide often blame themselves or become extremely angry, seeing the attempt or act as selfish. However, when people are suicidal, they often mistakenly believe that they are doing their friends and relatives a favor by taking themselves out of the world. These irrational beliefs often drive their behavior.

Symptoms    Return to top

Early signs:

Critical signs:

Danger signs in young people:

Treatment    Return to top

Adolescents may fail to seek help for suicidal thoughts, for all of the following reasons:

Emergency measures may be necessary after a person has attempted suicide. First aid, CPR, or mouth-to-mouth resuscitation may be required.

Hospitalization is often needed to treat a suicide attempt and to prevent future attempts. Mental health intervention is one of the most important aspects of treatment.

Outlook (Prognosis)    Return to top

Suicide attempts and threats should always be taken seriously. About one-third of people who attempt suicide will repeat the attempt within 1 year, and about 10% of those who threaten or attempt suicide eventually do kill themselves.

Mental health care should be sought immediately. Dismissing the person's behavior as attention-seeking can have devastating consequences.

Possible Complications    Return to top

Complications vary depending on the type of suicide attempt.

When to Contact a Medical Professional    Return to top

A person who threatens or attempts suicide MUST be evaluated immediately by a mental health professional. NEVER IGNORE A SUICIDE THREAT OR ATTEMPT!

Prevention    Return to top

Many people who attempt suicide talk about it before making the attempt. Sometimes, simply talking to a sympathetic, nonjudgmental listener is enough to prevent the person from attempting suicide. For this reason suicide prevention centers have telephone "hotline" services. Again, do not ignore a suicide threat or attempted suicide.

As with any other type of emergency, it is best to immediately call the local emergency number (such as 911). Do not leave the person alone even after phone contact with an appropriate professional has been made.

References    Return to top

Zuckerbrot RA, Cheung AH, Jensen PS, Stein RE, Laraque D. GLAD-PC Steering Group. Guidelines for Adolescent Depression in Primary Care (GLAD-PC):I. Identification, assessment, and initial management. Pediatrics. 2007;120:e1299-e1312.

Institute for Clinical Systems Improvement. Health Care Guidelines: Major Depression in Adults in Primary Care. 10th edition. May 2007.

Bridge JA, Iyengar S, Salary CB, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA. 2007;297:1683-1696.

Cheung AH, Zuckerbrot RA, Jensen PS, Ghalib K, Laraque D, Stein RE. GLAD-PC Steering Group. Guidelines for Adolescent Depression in Primary Care (GLAD-PC):II. Treatment and ongoing management. Pediatrics. 2007;120:e1313-e1326.

Update Date: 1/15/2009

Updated by: Christos Ballas, MD, Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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