Suicide (cont.)
What are the signs and symptoms for suicide?
Warning signs that an individual is imminently planning to kill themselves
may include the person making a will, getting his or her affairs in order,
suddenly visiting friends or family members (one last time), buying instruments
of suicide like a gun, hose, rope or medications, a sudden and significant
decline or improvement in mood, or writing a suicide note.
Contrary to popular belief, many people who complete suicide do not tell any
mental-health professional they plan to kill themselves in the months before they do so.
If they communicate their plan to anyone, it is more likely to be someone with
whom they are personally close, like a friend or family member.
Individuals who take their lives tend to suffer from severe anxiety, symptoms
of which may include moderate alcohol abuse, insomnia, severe agitation, loss of
interest in activities they used to enjoy (anhedonia), hopelessness, and
persistent thoughts about the possibility of something bad happening. Since suicidal behaviors are often quite impulsive,
removing firearms, medications, knives, and other instruments people often use
to kill themselves can allow the individual time to think more clearly and
perhaps choose a more rational way of coping with their pain.
How are suicidal thoughts and behaviors assessed?
The assessment for suicidal thoughts and behaviors performed by mental-health professionals often involves
an evaluation of the presence, severity, and duration of suicidal thoughts in
the individuals they treat as part of a comprehensive evaluation of the person's
mental health. Therefore, in addition to asking questions about family mental-health history and about the symptoms of a variety of emotional problems (for example,
anxiety, depression, mood swings, bizarre thoughts, substance abuse, eating
disorders, and any history of being traumatized), practitioners frequently ask
the people they evaluate about any past or present suicidal thoughts, intent,
and plans. If the individual has ever attempted suicide, the circumstances
surrounding the attempt, as well as the level of dangerousness of the method and
the outcome of the attempt, may be explored. Any other history of violent
behavior might be evaluated. The person's current circumstances, like recent
stressors (for example, end of a relationship, family problems), sources of support, and
accessibility of weapons are often probed. What treatment the person may be
receiving and how he or she has responded to treatment recently and in the past,
are other issues mental-health professionals tend to explore during an
evaluation.
Sometimes professionals assess suicide risk by using an assessment
scale. One such scale is called the SAD PERSONS Scale, which
identifies risk factors for suicide as follows:
- 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 drug use
- Rational thinking lost
- 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
Next: How are suicidal thoughts and behaviors treated? »
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