Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Suicide is the process of purposely ending one's own life. How societies
view suicide varies by culture, religion, ethnic norms, and the circumstances
under which it occurs.
Nearly 1 million people worldwide commit suicide each
year -- about 30,000 each year in the United States.
Self-mutilation is the act
of deliberately hurting oneself without meaning to cause one's own death.
Physician-assisted suicide is defined as a doctor ending the life of a person
who is incurably ill in a way that is either painless or minimally painful for
the purpose of ending the suffering of the individual.
The effects of suicide on
the loved ones of the deceased can be devastating, resulting in suicide
survivors enduring a variety of conflicting, painful emotions.
circumstances that may immediately precede a suicide include the time period of
at least a week after discharge from a psychiatric hospital, a sudden change in
how the person appears to feel, or a real or imagined loss.
Firearms are the
most common means by which people take their lives. Other common methods include
overdose of medication, asphyxiation, and hanging.
There are gender, age,
ethnic, and geographical risk factors for suicide, as well as those based on
family history, life stresses, and medical and mental-health status.
In children and teens, bullying and being bullied seem to be associated with their committing suicide, and being bullied may put them at risk for committing murder-suicide.
signs that an individual is imminently planning to kill him- or herself may include
the making of a will, getting his/her affairs in order, suddenly visiting or
writing letters to loved ones,
buying instruments of suicide, experiencing a sudden change in mood, or writing
a suicide note.
Many people who complete suicide do not tell any health
professional of their intent in the months before they do so. If they communicate a
plan to anyone, it is more likely to be a friend or family member.
The assessment of suicide risk often involves an evaluation of the presence,
severity, and duration of suicidal thoughts as part of a mental-health
Treatment of suicidal thinking or attempt involves adapting immediate treatment to the sufferer's individual needs. Those with a strong social support system, who have a history of being hopeful and have a desire to resolve conflicts may need only a brief crisis-oriented intervention. Those with more severe symptoms or less social support may need hospitalization and long-term
outpatient mental-health services.
Treatment of any underlying emotional problem using a
combination of psychotherapy, safety planning, and medication remains the
mainstay of suicide prevention.
People who are contemplating suicide are encouraged to talk to a doctor or other health professional, spiritual advisor, or immediately go to the closest emergency room or mental-health crisis center for help. Those who have experienced suicidal thinking are commonly directed to keep a list of people to call in the event that those thoughts return. Other strategies include having someone hold all medications to prevent overdose, removing any weapons from the home, scheduling frequent stress-relieving activities, getting together with others, writing down feelings, and avoiding the use of alcohol or other drugs.
Techniques for coping with the suicide of a
loved one include nutritious eating, getting extra rest, writing about their emotions, talking to others about
the experience, thinking of ways to handle painful memories, understanding their
state of mind will vary, resisting pressure to grieve by any one else's time
table, and survivors doing what is right for them.
To help children and
adolescents cope with the suicide of a loved one it is important to ensure they
receive consistent caretaking, frequent interaction with supportive peers and adults, and
understanding of their feelings as they relate to their age.
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Washington State Legislature. Initiative Measure Number 1000. The Washington Death with Dignity Act 2008 January.