Suicide

The Facts

Note: This article is not intended as a replacement for suicide counselling. If you or someone you know may be at risk of committing suicide, contact emergency services in your area immediately to get professional advice. Your local phone book will have the telephone numbers of distress lines and support agencies.

On average, about 4,500 Canadians take their own lives every year – this often exceeds the number of deaths caused by road accidents. Although more women attempt suicide, about 3 times as many men as women die from their suicide attempt. The reason for this is that men generally use more lethal means such as firearms, hanging, or asphyxiation (suffocation). Women often use drug overdoses or asphyxiation, or they cut themselves. Firearms are used in about 15% of all suicides. Of all deaths that involve firearms, about 80% are estimated to be suicides.

Certain groups have disproportionately high suicide rates compared to the general population:

• adolescents – in Canada, suicide is the second leading cause of all death among people who are 15 to 34 years of age
• senior men over the age of 80
• prison inmates, for whom suicide is the leading cause of death
• people of Indigenous descent, particularly amongst youths
• people with prior histories of attempted suicide

While the cause of suicide is unknown, some common risk factors include:

• major psychiatric illness – in particular, mood disorders (e.g., depression, bipolar disorder, schizophrenia)
• substance abuse (primarily alcohol abuse)
• family history of suicide
• long term difficulties with relationships with friends and family
• losing hope or the will to live
• significant losses in a person's life, such as the death of a loved one, loss of an important relationship, loss of employment or self-esteem
• unbearable emotional or physical pain

A person who is at risk of committing suicide usually shows signs – whether consciously or unconsciously – that something is wrong. Keep an eye out for:

• signs of clinical depression
• withdrawal from friends and family
• sadness and hopelessness
• lack of interest in previous activities, or in what is going on around them
• physical changes, such as lack of energy, different sleep patterns, change in weight or appetite
• loss of self-esteem, negative comments about self-worth
• bringing up death or suicide in discussions or in writing
• previous suicide attempts
• getting personal affairs in order, such as giving away possessions, or having a pressing interest in personal wills or life insurance

Though many people considering suicide seem sad, some mask their feelings with excessive energy. Agitation, hyperactivity, and restlessness may indicate an underlying depression that is being concealed.

Many people believe that even though a person might talk about suicide, they will not actually do it. In fact, talking about suicide is a warning sign that the person is at greater risk. If you become so overwhelmed by your problems that suicide becomes a consideration, you deserve to be taken seriously.

Talking about suicide means that the potential exists to take your own life – even if you do not actually do it. Denial will not make the threat of suicide disappear and can only leave you feeling more alone and in anguish. If you are having thoughts of suicide, see your doctor or a counsellor for help.

Do not hesitate to talk about suicide. If you think that someone you know is considering suicide, raise the subject. People are often relieved to talk to somebody about it. Recognizing their agony helps to ease the distress of carrying the burden of pain alone. It is important to listen to what somebody has to say without passing judgment on their feelings. Keep in mind that having no opportunity to talk about how badly they feel will only make a person feel more isolated.

You may sometimes worry that bringing up the subject of suicide will give ideas to an individual who is already depressed. On the contrary, showing your concern lets a person in distress know that somebody is listening to them. If that person really is considering taking their own life, talking provides an outlet for intense, often overwhelming feelings.

Ask direct questions – avoiding the topic may show that you do not take a person's threats seriously enough to inquire. Find out if suicide has been considered, and if they have thought out how and when they want to do it. The more details that have been worked out, the greater the danger that someone plans to commit suicide.

Suicide attempts are often a cry for help. While suicidal people are still alive, they may be holding out hope that they will find the means to cope with their emotions. Urge anybody who is considering suicide to get the counselling and medical or psychological support that they need as soon as possible.

Emergency assistance

Immediate assistance is available for people who are overwhelmed by pain and loneliness and need somebody to talk to. When a person is in distress, telephone counselling, online chats, crisis lines, and suicide hotlines offer a no-pressure context in which to talk to a caring and anonymous counsellor. Telephone hotlines are also useful if you are worried about a friend who is suicidal and want to know what you should do in a particular situation.

Local services are listed in phone books and online directories. You can also call directory assistance or 2-1-1 in some areas for community service agencies. If there is a problem getting through to the phone service, don't give up; either call again or phone a different service. Help is often very close at hand, and can give a suicidal person the extra time they need to reconsider their options and circumstances.

If you are urgently concerned that somebody is in a suicidal state, try to get them to the emergency ward of a hospital. Medical professionals can most effectively deal with suicidal tendencies and ensure that people gets the care required to stay alive.

Individuals who have hit an emotional rock bottom often cannot see how to pull themselves back up. Reaching out and finding support – either among friends and family, or in religious or social institutions – can provide people with some relief and new hope in their lives.

When suicidal thoughts are brought on by an immediate interpersonal life event, then reliving this event or talking with a close friend or family member may resolve the crisis.

Individuals considering suicide should have a professional evaluation by a family physician or mental health professional to consider any of the following treatments:

• ongoing psychological counselling (e.g., psychotherapy, marital therapy)
• medical intervention (e.g., more aggressive treatment of a pain syndrome)
• psychiatric treatment (e.g., treatment of a mood disorder, substance abuse, or schizophrenia)