Suicidal Ideation Disorders
All mental health clinically diagnosed disorders run the risk of suicide ideation. Most are linked to depressive symptoms within the disorder traced to 90% of suicides. To look at some of those:
- Mood disorders, bipolar disorders – manic depression
- Personality disorders, with a high rate of borderline personality disorder
- Eating disorders
- Substance use/abuse disorders
The rate of suicide is forty times greater than the general population for individuals with Anorexia Nervosa. This eating disorder has a strong association with suicide. One study shows a lifetime risk of suicide at 18% and another with 27% related deaths to suicide. Researchers have also found that 31.4% of individuals with a history of bulimia and 22.9% of individuals with a history of binge eating disorder had attempted suicide in their lifetime.
Longitudinal studies over 10 years have shown that between 10-22% diagnosed with schizophrenia have a long-term suicide rate. A more recent analysis shows 4.9% dying from suicide during their lifetime, with more occurrences at the onset of the symptoms related to the diagnosis. Risk factors include previous attempts, degree, severity of the illness, comorbid presentation, isolation and withdrawal behaviors, and prevalence in the male gender, with a higher risk amongst those with a paranoid subtype. The rate occurs more immediately after discharge from a hospital setting.
Bipolar and Mood Disorders
Individuals hospitalized for severe depressive symptoms have a 13% suicide risk. Compared to the general population, individuals with severe depressive symptoms and diagnosed with a mood disorder are 20 times more likely to die from suicide, and individuals with bipolar are 15 times more likely. Risk increases with individuals who experience agitation, severe insomnia, anxiety, and/or substance abuse, mostly alcohol.
Personality disorders are at a high risk of suicide. Most occurrences and elevated risk are in the younger population, comorbid substance abuse, history of childhood sexual abuse, impulsive behavior, and antisocial personality traits. Some individuals with a clinically diagnosed personality disorder, particularly borderline personality disorder (BPD), may present manipulative and engage in contingent suicide threats, which can present difficulties in receiving supportive clinical treatment. Non-contingent suicide threats will likely give in isolation and withdrawal, passive hopelessness, and making few demands. Research shows that about 75% of individuals with BPD will make at least one suicide attempt in their lifetime, and many will make multiple attempts.
Alcohol abuse is common among individuals suffering from depression, and alcohol will enhance those symptoms. Studies have shown that individuals with co-occurring substance use disorders and major depression are more likely to experience suicide ideation, attempt, and complete suicide than those with individual clinical disorders.
Know the Increased Risk Factors
- Individual factors – previous attempts, recent hospitalization, history of depression and other mental health issues, chronic pain, legal issues, occupational and financial problems or loss, impulsive behavior, aggression, substance abuse, history of childhood development or disruption issues, hopelessness and worthlessness, history sexual and/or violent abuse
- Relational factors – bullying, family history of suicide and mental health issues, relationship loss, involvement in abusive relationships, and isolation
- Community factors – lack of healthcare, community suicide clusters, acculturation stress, history of trauma and discrimination
- Societal factors – stigma associated with mental health issues and treatment, access to lethal means, media portrayals of suicide
Reducing the Risk of Suicide
You can reduce risk by addressing these areas, like the risk factor domains. Communities can raise awareness and help protect individuals from suicidal thoughts and behavior.
- Individual factors – increase effective coping and problem-solving skills, emphasize reasons for living such as family and friends and pets in their life, and increasing a strong sense of self
- Relational factors – identifying healthy relationships, supportive partner and/or friends and family
- Community factors – Connected to community or social organizations or to a school, having quality physical and behavioral healthcare
- Societal factors – reduced or extinguished access to lethal means, having a cultural and/or religious or moral objection to suicide
The information presented may be difficult and triggering to some. If you or a loved one is having suicidal thoughts, contact the National Suicide Lifeline at 988 to speak to a trained counselor. For immediate help call 911.
There are many Suicidal Ideation treatment options for ongoing mental health care. Keep in mind hospital settings, residential, and outpatient services are available to provide a safe and healing environment for skill and community building.
- Suicide Prevention Resource Center, https://www.sprc.org/news/suicide-attempts-eating-disorders
- National Library of Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165520/
- Very Well Mind, https://www.verywellmind.com/suicidality-in-borderline-personality-disorder-425485
- Centers for Disease Control and Prevention, https://www.cdc.gov/suicide/factors/index.html
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