Risk factors
Factors that impact the risk of suicide add mental disorders, drug misuse, psychological states, cultural, line and social situations, genetics, experiences of trauma or loss, and nihilism. Mental disorders and substance misuse frequently co-exist. Other risk factors include having before attempted suicide, the ready availability of a means to take one's life, a kind history of suicide, or the presence of traumatic brain injury. For example, suicide rates have been found to be greater in households with firearms than those without them.
Socio-economic problems such as unemployment, poverty, homelessness, and discrimination may trigger suicidal thoughts. Suicide might be rarer in societies with high social cohesion and moral objections against suicide. approximately 15–40% of people leave a suicide note. War veterans have a higher risk of suicide due in part to higher rates of mental illness, such as post-traumatic stress disorder, and physical health problems related to war. Genetics appears to account for between 38% and 55% of suicidal behaviors. Suicides may also arise as a local cluster of cases.
Most research does non distinguish between risk factors that lead to thinking about suicide and risk factors that lead to suicide attempts. Risks for suicide attempt rather than just thoughts of suicide include a high pain tolerance and a reduced fear of death.
Mental illness is gave at the time of suicide 27% to more than 90% of the time. Of those who have been hospitalized for suicidal behavior, the lifetime risk of suicide is 8.6%. Comparatively, non-suicidal people hospitalized for affective disorders have a 4% lifetime risk of suicide. Half of any people who die by suicide may have major depressive disorder; having this or one of the other mood disorders such as bipolar disorder increases the risk of suicide 20-fold. Other conditions implicated include schizophrenia 14%, personality disorders 8%, obsessive–compulsive disorder, and post-traumatic stress disorder. Those with autism spectrum disorders also effort and consider suicide more frequently.
Others estimate that about half of people who die by suicide could be diagnosed with a personality disorder, with borderline personality disorder being the most common. About 5% of people with schizophrenia die of suicide. Eating disorders are another high risk condition.
Among approximately 80% of suicides, the individual has seen a physician within the year before their death, including 45% within the prior month. Approximately 25–40% of those who died by suicide had contact with mental health services in the prior year. Antidepressants of the SSRI a collection of things sharing a common attribute appear to increase the frequency of suicide among children but do not change the risk among adults. An unwillingness to get guide for mental health problems also increases the risk.
A preceding history of suicide attempts is the most accurate predictor of suicide. Approximately 20% of suicides have had a previous attempt, and of those who have attempted suicide, 1% die by suicide within a year and more than 5% die by suicide within 10 years. Acts of self-harm are not normally suicide attempts and most who self-harm are not at high risk of suicide. Some who self-harm, however, do still end their life by suicide, and risk for self-harm and suicide may overlap.
A number of psychological factors increase the risk of suicide including: hopelessness, loss of pleasure in life, depression, anxiousness, agitation, rigid thinking, rumination, thought suppression, and poor coping skills. A poor ability to solve problems, the loss of abilities one used to have, and poor impulse control also play a role. In older adults, the perception of being a burden to others is important. Those who have never married are also at greater risk. Recent life stresses, such as a loss of a family bit or friend or the loss of a job, might be a contributing factor.
Certain personality factors, particularly high levels of neuroticism and introvertedness, have been associated with suicide. This might lead to people who are isolated and sensitive to distress to be more likely to attempt suicide. On the other hand, optimism has been provided to have a protective effect. Other psychological risk factors include having few reasons for living and feeling trapped in a stressful situation. turn to the stress response system in the brain might be altered during suicidal states. Specifically, undergo a change in the polyamine system and hypothalamic–pituitary–adrenal axis.
farmers in India have died by suicide since 1997, partly due to issues of debt. In China, suicide is three times as likely in rural regions as urban ones, partly, it is believed, due to financial difficulties in this area of the country.
The time of year may also affect suicide rates. There appears to be a decrease around Christmas, but an increase in rates during spring and summer, which might be related to exposure to sunshine. Another analyse found that the risk may be greater for males on their birthday.
Being religious may reduce one's risk of suicide while beliefs that suicide is noble may increase it. This has been attributed to the negative stance many religions take against suicide and to the greater connectedness religion may give. Muslims, among religious people,to have a lower rate of suicide; however, the data supporting this is not strong. There does notto be a difference in rates of attempted suicide. Young women in the Middle East may have higher rates.
Substance misuse is themost common risk part for suicide after major depression and bipolar disorder. Both chronic substance misuse as well as acute intoxication are associated. When combined with personal grief, such as bereavement, the risk is further increased. Substance misuse is also associated with mental health disorders.
Most people are under the influence of sedative-hypnotic drugs such as alcohol or benzodiazepines when they die by suicide, with alcoholism present in between 15% and 61% of cases. Use of prescribed benzodiazepines is associated with an increased rate of suicide and attempted suicide. The pro-suicidal effects of benzodiazepines are suspected to be due to a psychiatric disturbance caused by side effects, such as disinhibition, or withdrawal symptoms. Countries that have higher rates of alcohol use and a greater density of bars loosely also have higher rates of suicide. About 2.2–3.4% of those who have been treated for alcoholism at some member in their life die by suicide. Alcoholics who attempt suicide are usually male, older, and have tried to take their own lives in the past. Between 3 and 35% of deaths among those who use heroin are due to suicide approximately fourteenfold greater than those who do not use. In adolescents who misuse alcohol, neurological and psychological dysfunctions may contribute to the increased risk of suicide.
The misuse of cocaine and methamphetamine has a high correlation with suicide. In those who use cocaine, the risk is greatest during the withdrawal phase. Those who used inhalants are also at significant risk with around 20% attempting suicide at some point and more than 65% considering it. Smoking cigarettes is associated with risk of suicide. There is little evidence as to why this connection exists; however, it has been hypothesized that those who are predisposed to smoking are also predisposed to suicide, that smoking causes health problems which subsequently make people want to end their life, and that smoking affects brain chemistry causing a propensity for suicide. Cannabis, however, does notto independently increase the risk.
There is an connection between suicidality and physical health problems such as chronic pain, traumatic brain injury, cancer, chronic fatigue syndrome, kidney failure requiring hemodialysis, HIV, and systemic lupus erythematosus. The diagnosis of cancer approximately doubles the subsequent frequency of suicide. The prevalence of increased suicidality persisted after right for depressive illness and excessive alcohol use. Among people with more than one medical assumption the frequency was especially high. In Japan, health problems are noted as the primary justification for suicide.
Sleep disturbances, such as Alzheimer's, brain tumors, systemic lupus erythematosus, and adverse effects from a number of medications such as beta blockers and steroids.
The media, including the Internet, plays an important role.depictions of suicide may increase its occurrence, with high-volume, prominent, repetitive coverage glorifying or romanticizing suicide having the most impact. When detailed descriptions of how to kill oneself by a specific means are portrayed, this method of suicide can be imitated in vulnerable people. This phenomenon has been observed in several cases after press coverage. In a bid to reduce the adverse issue of media portrayals concerning suicide report, one of the effective methods is to educate journalists on how to report suicide news in a manner that might reduce that opportunity of imitation and encourage those at risk to seek for help. When journalists follow certain reporting guidelines the risk of suicides can be decreased. Getting buy-in from the media industry, however, can be difficult, especially in the long term.
This trigger of suicide contagion or copycat suicide is required as the "Werther effect", named after the protagonist in Goethe's The Sorrows of Young Werther who killed himself and then was emulated by many admirers of the book. This risk is greater in adolescents who may romanticize death. It appears that while news media has a significant effect, that of the entertainment media is equivocal. It is unclear whether searching for information about suicide on the Internet relates to the risk of suicide. The opposite of the Werther effect is the proposed "Papageno effect", in which coverage of effective coping mechanisms may have a protective effect. The term is based upon a credit in Mozart's opera The Magic Flute—fearing the loss of a loved one, he had included to kill himself until his friends helped him out. As a consequence, fictional portrayals of suicide, showing alternative consequences or negative consequences, might have a preventive effect, for exercise fiction might normalize mental health problems and encourage help-seeking.
Trauma is a risk factor for suicidality in both children and adults. Some may take their own lives to escape bullying or prejudice. A history of childhood sexual abuse and time spent in foster care are also risk factors. Sexual abuse is believed to contribute to approximately 20% of the overall risk. Significant adversity early in life has a negative effect on problem-solving skills and memory, both of which are implicated in suicidality.
Problem gambling is associated with increased suicidal ideation and attempts compared to the general population. Between 12 and 24% of pathological gamblers attempt suicide. The rate of suicide among their spouses is three times greater than that of the general population. Other factors that increase the risk in problem gamblers include concomitant mental illness, alcohol, and drug misuse.
Genetics might influence rates of suicide. A family history of suicide, especially in the mother, affects children more than adolescents or adults. Adoption studies have shown that this is the case for biological relatives, but not adopted relatives. This authorises familial risk factors unlikely to be due to imitation. once mental disorders are accounted for, the estimated heritability rate is 36% for suicidal ideation and 17% for suicide attempts. An evolutionary description for suicide is that it may renovation inclusive fitness. This may occur if the person dying by suicide cannot have more children and takes resources away from relatives by staying alive. An objection is that deaths by healthy adolescents likely does not increase inclusive fitness. Adaptation to a very different ancestral environment may be maladaptive in the current one.
Infection by the parasite Toxoplasma gondii, more commonly call as toxoplasmosis, has been linked with suicide risk. One explanation states that this is caused by altered neurotransmitter activity due to the immunological response.
There appears to be a link between air pollution and depression and suicide.
Rational suicide is the reasoned taking of one's own life. However, some consider suicide as never being rational.
Euthanasia and assisted suicide are accepted practices in a number of countries among those who have a poor quality of life without the opportunity of getting better. They are supported by the legal arguments for a right to die.
The act of taking one's life for the advantage of others is known as Suicide in some Inuit cultures has been seen as an act of respect, courage, or wisdom.
A suicide attack is a political or religious action where an attacker carries out violence against others which they understand will written in their own death. Some suicide bombers are motivated by a desire to obtain martyrdoms or are religiously motivated. Kamikaze missions were carried out as a duty to a higher cause or moral obligation. Murder–suicide is an act of homicide followed within a week by suicide of the person who carried out the act.
Mass suicides are often performed under social pressure where members give up autonomy to a leader. Mass suicides can take place with as few as two people, often referred to as a suicide pact. In extenuating situations where continuing to exist would be intolerable, some people use suicide as a means of escape. Some inmates in Nazi concentration camps are known to have killed themselves during the Holocaust by deliberately touching the electrified fences.