Suicide, defined as intentionally ending oneâ€™s life, can be committed for varied, complex, and deeply personal reasons, though there are a number of common factors usually involved. Like cannibalism and incest, suicide is taboo in most societies, though cultural perceptions of suicide do vary greatly from nation to nation. The reasons behind a personâ€™s suicide often determine how his or her suicide is viewed by the people of a particular society or culture.
Reasons for Committing Suicide
According to Dr. Alex Lickerman, people end their lives for one or more of six reasons both intentionally and unintentionally:
- A means to cry out for help
- Physical illness
- By accident, including drug overdose
Depression is the reason most people associate with suicide, and it is also the most common reason for attempted and completed suicides. Feelings of hopelessness, worthlessness, and despair become pervasive in severely depressed individuals, and they see suicide as the only means to relieve suffering. They typically plan their suicides weeks or even months in advance, often without the knowledge of family or loved ones. Additionally, family and friends of people who are suicidal may be in denial that someone they love dearly is at risk to commit such an extreme and often violent act. Depression can be successfully treated with talk therapy and medication.
Psychosis, particularly schizophrenia, is another major cause of suicide. Though often manageable with medication, many medicated schizophrenics are unable to fulfill their pre-psychotic potential, which can lead to depression. People who are psychotic often hear voices commanding them to either harm others or harm themselves. Psychosis must be treated with medication, and may require hospitalization in the worst situations. Approximately 1% of the worldâ€™s population is known to suffer from schizophrenia.
Impulsivity, a common trait among those suffering from addiction, bipolar disorder, and “particularly” borderline personality disorder, is often linked with self-harm, a precursor to the act of taking oneâ€™s life. People who experience mental illness have a heightened risk of addiction, and drug and alcohol use increases the userâ€™s lack of inhibition and impulsivity towards high risk behavior. Sometimes an â€œimpulsiveâ€ suicide may be committed in the spur of the moment after weeks or months of planning. Though people who attempt or complete the act of suicide tend to be more impulsive than the overall population, most suicides are planned rather than impulsive acts.
People who attempt suicide as a means to seek help for emotional suffering do so with the belief that their attempt will not be lethal. Sometimes the person attempting suicide does so to inflict guilt or shame on someone who has harmed him or her in some way, be it real or perceived. This kind of suicide attempt is considerably more common in adolescents and young adults and can cause unintended permanent damage or even death.
Some people dying from terminal illnesses commit suicide to alleviate suffering in their last months, weeks, or days of life. Depending where they live, assistance may be provided by a health care professional.
A person may kill him- or herself by mistake, through an accidental gunshot wound, oxygen deprivation (used to get high or to achieve sexual arousal, as in the case of erotic asphyxiation), or an unintentional drug or alcohol overdose.
REASONS NOT TO COMMIT SUICIDE
What to do if you feel suicidal (in the non-euthanasia context)
Here are the common refrains heard again and again in the rooms of 12-step meetings and therapeutic contexts:
- Suicide is a permanent solution to a temporary problem.
- Ask for help. Reach out.
- Call a suicide hotline 1-800-273-8255.
- Get to a hospital and tell them you are feeling suicidal. Tell a therapist or doctor.
- Call 9-11.
- You can recover. There is help and hope.
- You are worth it.
More than 32,000 people commit suicide each year in the United States. Additionally, there are more than half a million unsuccessful suicide attempts. Nearly 1 million people commit suicide worldwide annually, and the estimated number of suicide attempts ranges from 10 million to 20 million.
Males commit suicide at nearly four times the rate of females, while females attempt suicide at three times the rate of males. In the United States, boys aged 10-14 commit suicide at twice the rate of girls their age. At ages 15-19, males commit suicide at five times the rate of same-age females. By ages 20-24, the ratio increases to six times. Suicide is the 8th leading cause of death among males in the U.S. and the 16th leading cause of death among females.
In terms of ethnicity, non-Hispanic whites and Native Americans have the highest rates of suicide in the United States, while non-Hispanic blacks, Asians, Pacific Islanders, and Hispanics have the lowest. People in rural areas and western states have higher incidences of suicide than their counterparts in urban areas and eastern states. Worldwide, former Eastern bloc European nations have the highest rates of suicide and countries in South America have the lowest. These patterns reflect current trends and change over time.
Nearly 60% of suicides in the U.S. are committed with firearms, and older people are more likely to use a firearm when killing themselves than young people.
Other means of committing suicide include:
- Drug overdose
- Jumping from a tall structure
- Vehicular crash
Some have taken extreme measures when committing suicide, including intentional starvation, self-immolation, decapitation, drowning, and lying on a train track as an oncoming train approaches.
According to the National Institute of Mental Health, risk factors for suicide include:
- Depression and other mental disorders, or a substance-abuse disorder (often in combination with other mental disorders). More than 90 percent of people who die by suicide have these risk factors.
- Prior suicide attempt
- Family history of mental disorder or substance abuse
- Family history of suicide
- Family violence, including physical or sexual abuse
- Firearms in the home; firearms are the method used in more than half of all suicides
- Exposure to the suicidal behavior of others, such as family members, peers, or media figures.
People diagnosed with borderline personality disorder (BPD) are particularly vulnerable to suicide, and people with the disorder are more likely to succeed than individuals with any other psychiatric disorder. Approximately 10% of people with the BPD commit suicide, compared to 6% of people with mood disorders. The rate of suicide for people with BPD is more than 50 times greater than that of the general population. Individuals with BPD tend to suffer from rapid and intense mood swings, impulsivity, and negative self-image and emotional experiences, all factors contributing to suicidal behavior. Additionally, BPD often co-occurs with substance abuse, another major risk factor for suicide.
Jack Kervorkian became famous and infamous in the 1990â€™s after inventing a so-called â€œsuicide machineâ€ to administer lethal doses of substances, hastening the deaths of mostly terminally ill clients. The media-dubbed â€œDoctor of Deathâ€ helped more than 130 people end their lives, and spent eight years in a Michigan prison after being convicted of second-degree murder in March 1999. The widow and brother of his terminally ill client supported Kervorkian during his trial. In November 1998 the voters of Michigan defeated a ballot initiative that would have legalized physician-assisted suicide by a wide margin. Laws authorizing physician-assisted suicide were passed in Oregon in 1994, Washington in 2008, and Montana in 2009. The Oregon law, known as the Death with Dignity Act, was enacted in 1997 and upheld by the U.S. Supreme Court in 2006. Since going into effect, an average of 40 people per-year in Oregon have obtained lethal prescriptions from their doctors and ended their lives following the completion of a waiting period. In 2009, 60 individuals ended their lives by physician-assisted suicide.
There are certain common signs that a person is planning to kill him- or herself. Those signs include making a will, getting his or her affairs in order, suddenly visiting friends and family members, purchasing instruments of suicide (including a gun, rope, or pills), sudden and significant changes in mood, talking about death or suicide, or writing a suicide note.
MedicineNet lists the following risk factors for suicide:
- Sex (male)
- Age younger than 19 or older than 45 years of age
- Depression (severe enough to be considered clinically significant)
- Previous suicide attempt or received mental health services of any kind
- Excessive alcohol or other drug use
- Irrational thinking
- Separated, divorced, or widowed (or other ending of significant relationship)
- Organized suicide plan or serious attempt
- No or little social support
- Sickness or chronic medical illness
Widespread treatment is available for people at risk for suicide. Comprehensive inpatient and outpatient treatment plans can be devised by mental health professionals to address an individualâ€™s needs. Talk therapy, including cognitive behavioral therapy (CBT), has been shown to be effective in helping patients better understand their thoughts, emotions, and behaviors, and how the three affect and feed each other. Pharmacology is also used to treat mood-related symptoms of suicidality. Mood stabilizers, such as lithium and lamictal, and anxiety medications, including chozpine (Clozaril), risperidone (Risperdal), and aripiprazole (Abilify), have been effective in relieving depression, mania, and/or anxiety-related symptoms in patients exhibiting suicidal behavior.
Historical Context of Suicide
Though the earliest instances of suicide are not known, and the act of suicide likely originates long before any written history. The practice of intentionally ending oneâ€™s life was known to ancient Egyptians, who viewed suicide as an acceptable means of dealing with unbearable physical or emotional suffering. Killing oneself as a form of martyrdom was also as acceptable when done to escape or protest perceived civil, religious, or political persecution.
Though Socrates opposed the act of suicide, believing human life was the property of the gods, the Greek philosopher was forced to carry out his own execution by consuming the poisonous plant hemlock after being found guilty of impiety and corrupting the youth.
Seppuku, or hara-kiri, was a form of ritual suicide practiced by the samurai and daimyo of Japan from the 12th to 19th centuries, and was seen as a heroic and dignified act to avoid shame.
During World War II, Japanese pilots, known as kamikazes, intentionally flew their explosives-laden aircraft into enemy aircraft and warships. Such actions were viewed as honorable and those unwilling to sacrifice themselves for their nation and emperor were often viewed as cowards. Adolf Hitler and his wife Eva committed suicide in 1945 as Soviet troops descended upon the German capital of Berlin. Adolf killed himself with a gunshot wound to the head as a means to either avoid being captured by Allied forces or executed publicly in a humiliating manner similar to his WWII ally, Italian dictator Benito Mussolini. His wife, Eva, died after ingesting a cyanide capsule.
In recent decades, suicide has been glorified in Muslim countries as a means of political protest with the goal of killing as many other individuals as possible, particularly Israelis and people in the West. The 9/11 attacks on the World Trade Center and Pentagon involved the suicide of the terrorists who perpetrated them. Those attacks were celebrated in parts of the Muslim World.
The suicide of Mohamed Bouazizi was the catalyst for the Arab Spring protests of 2010 and 2011 in North Africa and the Middle East. The 26 year-old street vendor set himself ablaze in protest of mistreatment at the hands of Tunisian officials in December 2010, dying from injuries sustained in the burning 18 days later. His suicide sparked outrage in the Muslim world and led to the overthrown of several governments, including those in Tunisia, Egypt, and Libya Cultural Beliefs Around Suicide Through History
People throughout history have committed the act of suicide in order to avoid religious persecution. Early Christians often chose to be martyrs for their beliefs rather than renounce their faith. After Jewish authorities forbade eulogies or public mourning for those who willfully ended their own lives, suicide began to be stigmatized throughout the Judeo-Christian world. St. Augustineâ€™s denouncement of suicide as a sin in the 4th century was the first significant public condemnation of the act by a Christian leader, and came in reaction to the high number of suicides by Christians at that time.
In the 13th century, Italian priest Thomas Aquinas denounced suicide as an unforgivable sin for which there was no repentance. His views on the matter inspired criminal and civil laws that heavily discouraged the act of taking oneâ€™s life.
Suicide was further stigmatized in The Middle Ages as more European societies enacted laws criminalizing suicide. During this time, perpetrators of suicide were not allowed proper burials and their bodies were often disgraced in public. One common practice was to drag the bodies of the dead who died by their own hands in public and deface them. Other common practices were the confiscation of the deceasedâ€™s property and possessions, leaving the bodies for animals to consume, and publicly shaming or even (ironically) executing those unfortunate enough to survive their suicide attempts.
The stigma of suicide began to wane during the Renaissance and Reformation periods, as long-held assumptions were examined and often challenged. Many of William Shakespeareâ€™s plays dealt with suicide; English poet John Donne defended the act of suicide during times of intense personal crisis and suffering; and French philosopher Voltaire wrote in support a personâ€™s right to commit suicide in certain circumstances.
In the 19th century, the burgeoning fields of psychology and sociology examined the role society and external influences played in the decision-making processes of people who committed suicide. Societal stressors, while not the sole cause of a personâ€™s suicidal behavior, was considered a contributing factor for the first time. Early psychologists such as ThÃ©odule-Armand Ribot, Pierre Marie FÃ©lix Janet, and Sigmund Freud connected suicide with mental illness, a medical condition requiring treatment by professionals rather than stigma and condemnation. Laws prohibiting suicide were repealed in most western nations during the 19th and 20th centuries.
Suicide has become increasingly destigmatized in the late 20th and early 21st centuries, and laws allowing for assisted suicide”often referred to as â€œright to dieâ€ laws”have been enacted in several nations, including the United States, the Netherlands, Switzerland, and Luxembourg. Current trends suggest more liberal attitudes towards assisted suicide in certain circumstances, such as severe physical limitations or terminal illness, will continue to be adopted in countries throughout the world.
Suicide in Popular Culture
Suicide has been addressed in popular throughout history. In recent decades, it has been the subject of numerous films, television episodes, and songs.
Films that have included suicide in their storylines include:
- An Officer and a Gentleman
- Coming Home
- Harold and Maude
- Leaving Las Vegas
- Love and Suicide
- Ordinary People
- The Pallbearer
- Permanent Record
- The Power and the Glory
- Romeo + Juliet
- Vanilla Sky
- The Virgin Suicides
Additionally, numerous documentaries have been made that address suicide. One of the most famous in recent years was Eric Steelâ€™s The Bridge, released in 2006. The film documented numerous people, known as â€œjumpers,â€ who committed suicide by jumping off the Golden Gate Bridge in San Francisco, California.
Popular songs about or that reference suicide include:
- â€œAdamâ€™s Songâ€ by Blink 182
- â€œAsleepâ€ by The Smiths
- â€œBeyond the Gray Skyâ€ by 311
- â€œCemetery Diveâ€ by My Chemical Romance
- â€œDonâ€™t Try Suicideâ€ by Queen
- â€œEverybody Hurtsâ€ by REM
- â€œEverything Endsâ€ by Slipnot
- â€œFade to Blackâ€ by Metallica
- â€œGive Me Novacaineâ€ by Green Day
- â€œGolden Gate Jumpersâ€ by Cold War Kids
- â€œHold Onâ€ by Golden Charlotte
- â€œHome Sweet Homeâ€ by Peter Gabriel
- â€œHurtâ€ by Nine Inch Nails
- â€œJeremyâ€ by Pearl Jam
- â€œLast Resortâ€ by Papa Roach
- â€œThe Ledgeâ€ by The Replacements
- â€œThe Reasons Whyâ€ by The Cure
- â€œSheâ€™s Already Made Up Her Mindâ€ by Lyle Lovett
- â€œThen She Didâ€ by Janeâ€™s Addiction
- â€œTourniquetâ€ by Evanescence
- â€œWilliamâ€™s Last Wordsâ€ by The Manic Street Preachers
The cover of the debut album by Rage Against the Machine features a photograph of ThÃch Quáº£ng Äá»©c, a Buddhist monk who burned himself to death in 1963 in protest of the Vietnamese governmentâ€™s suppression of the Buddhist religion. The musical duo Suicide has been making music since 1970, and the punk/thrash band Suicidal Tendencies has been recording and touring for over three decades.
Famous people who have committed suicide include:
- Iris Chang (author)
- Kurt Cobain (leader of the band Nirvana)
- Ian Curtis (lead singer of Joy Division)
- Brad Delp (lead singer of Boston)
- Spalding Gray (author and poet)
- Ernest Hemingway (author)
- Sylvia Plath (author)
- Freddie Prinze (comedian and actor)
- Junior Seau (NFL linebacker)
- Hunter S. Thompson (author)
- David Foster Wallace (author)
- Virginia Woolf (author)
- â€œKamikaze – Suicide Pilots of World War II.â€ English-Online. Web. 03 August 2012.
- Tanaka, Yuki. â€œJapanâ€™s Kamikaze Pilots and Contemporary Suicide Bombers: War and Terror.â€ The Asia-Pacific Journal: Japan Focus. Web. 03 August 2012.
- Szczepanski, Kallie. â€œWhat is Seppuku?â€ About.com. Web. 03 August 2012.
- Lickerman, MD, Alex. â€œThe Six Reasons People Attempt Suicide.â€ Psychology Today. 29 April 2010. Web. 02 August 2012.
- Cloud, John. â€œThe Mystery of Borderline Personality Disorder.â€ Time magazine. 08 January 2009. Web. 02 August 2012.
- Smith, M.S., April R. Witte, M.S.,Tracy K. Teale, M.S., Nadia E. King, J.D., Sarah L. Bender, M.S., Ted W. Joiner, Ph.D., Thomas E. â€œRevisiting Impulsivity in Suicide.â€ National Center for Biotechnology Information. Web. 08 August 2012.
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- Dryden-Edwards, MD, Roxanne. Conrad StÃ¶ppler, Melissa. â€œSuicide.â€ MedicineNet. 10 February 2011. Web. 02 August 2012.
- â€œSuicide in the U.S.: Statistics and Prevention.â€ National Institute of Mental Health. 27 September 2010. Web. 02 August 2012.
- Knickerbocker, Brad. â€œJack Kevorkian drove the debate on physician-assisted suicide.â€ The Christian Science Monitor. 03 June 2011. Web. 02 August 2012.
- Johnson, Dirk. â€œKevorkian Sentenced to 10 to 25 Years in Prison.â€ The NY Times. 14 April 1999. Web. 02 August 2012.