Some suicides are impulsive, others are carefully planned and some suicides are due to depression or chronic stress. Here we discuss the circumstances and train of thought that can lead to suicide.
Circumstances leading up to a suicide vary widely.
The event may occur in a rash and impulsive manner. A distressing event occurs and circumstances to aid suicide appear at just the point when the person seriously considers it. A student who fails an examination after high anticipation may walk out of the street pondering a bleak future and sees the possibility of escape on a busy road.
Relationship issues that lead to repeated misunderstandings and the feeling that things are bound to fail can lead up to a flashpoint. An innocuous fight can lead to a rash step that has actually been played out in the mind for a long time and have vindictive intent. The act is neither deeply planned nor impulsive, though it may give an impression of impulsiveness.
Suicide may occur after the onset of depression when the person has been through months of moping through life and glides into suicide. The movement from depression to suicide occurs as a natural progression though if the attempt fails, the patient may consider the impact on others. This is not impulse-driven like the first case; rather it is a state of mind.
Then there is the planned suicide. The person may be undergoing depressive thoughts and sees little reason to continue with life. The person then proceeds to plan actions and takes care to ensure that family members are well cared for after the exit. Once the decision is taken and responsibilities completed, the person proceeds to implement the plan.
Phases of thinking
Walter and Schiff (2005, p. 44) point out that the ‘intense emotional strain’ that suicides feel makes them consider death as the way out of the continual stress.
Robinson (2001, p. 169) describes the phases of thought that go into planned suicide. The first and longest phase is that of agitation during which the person resolves the internal conflict about self-killing. At this phase they consider the impact on their loved ones. Once the initial restlessness has been justified and plans made to care for the family after the suicide, the person works out how to do it. This done, there is a state of relief and giving away of belongings and tidying up personal and financial issues. At this point, the person may appear calm and cheerful thereby making the incident of suicide more shocking.
Henden (2008, p. 52) mentions the main findings about the thinking of a suicide victim before the act. Hopelessness, the future appears negative, low self-belief, hyper-critical of the self and low self-evaluation are prime factors that drive the thought that death is preferable to life.
The current thinking when a patient appears to be suicidal is hospitalization and the administration of anti-depressants. A patient on the medication typically ceases to have feelings or motivations and faces the complete loss of happiness. Family members and therapists prefer this route because the possibility of suicide is daunting for them to face. The author considers alternate approaches to managing the breakdown situations that suicides face.
The problem solving capacity of suicide victims has been found to be compromised. They may be taught to adopt suitable behaviors that improve their response to problems. Jade was 17-years old when she committed suicide. Her relationship with her family was strained because of her excessive drinking and she had a stormy relationship with her boyfriend. One day, after another of their many fights, she crashed the car into a wall. Jade had not learned to verbalize her anger and channelize it to achieve a better outcome nor had she matured to less impulsivity.
Suicide victims may blame themselves overly or feel extremely uncertain about themselves in moments of conflict. They need to be taught to widen their perspectives and realistically see their role. The search for solutions rather than acceptance of blame and guilt is the way ahead. Sanli has been in an abusive relationship for a while now. She started to justify the beatings and continued victimization by telling herself that she was to blame, if she changed herself things would become better. The continued taunting and torment and increasing viciousness led her to jump out of the window. She had never seen the possibility of not being responsible for the trouble or that there was a way out of the situation. Her sisters and mother had gone through similar relationships, only Sanli chose to die.
The introduction of learning methods of thinking and focusing on pleasurable activity is found to help overcoming suicidal thought. The extreme emotional stand that victims tend to take has the capacity to convert an innocuous occurrence into a spiral that pushes up the mental note of self-destruction. Statements like, “If she says she won’t be with me, my life is of no value” or “If I lose my job, I’m finished, I’d better die” are examples of extreme thinking. The person requires behavioral interventions that temper the thoughts.
Signs of suicidal thought
Schleifer (p. 40) refers to teens feeling overwhelmed and consider suicide. The telling signs of this are: sudden withdrawal from social circles, staying away from the family, talking about suicide and uncharacteristic risk-taking behavior.
Blumenthal and Kupfer (1990, p. 247) refer to pre-existing psychological disturbances like unipolar depression or substance abuse as causative factors for suicide. An adult may direct hostility towards the self before the act. Physical inability related to age or condition can lead to decisions to end life.
Alters, Sandra & Schiff, Wendy (2005). Essential Concepts for Healthy Living. Jones & Bartlett.
Henden, John (2008). Preventing Suicide: The Solution Focused Approach. Wiley.
Robinson, Rita (2001). Survivors of Suicide. Career Press.
Schleifer, Jay (1999). Everything You Need to Know about Teen Suicide. Rosen.
Blumenthal and Kupfer (1990). Suicide over the Life Cycle. American Psychiatric Publishers