In overly simple terms, suicidal thoughts and behaviors start when vulnerable individuals encounter stressful events. They become overwhelmed by the situation and decide, based on their faulty way of thinking, that suicide is the only reasonable way to stop the pain they are experiencing. Determining what makes events stressful is difficult because of the everyone copes in different ways and has different perspectives. What may seem pretty meaningless to one person may seem devastating or unbearable to another.
Both negative and positive events can be sources of significant stress. Examples of events that cause positive stress include:
- moving (when it is a desired move)
- having a child
- changing jobs (when that is desired).
Examples of negatively stressful events include:
- losses related to health, significant relationships and jobs
- peer pressure to be thin and beautiful,
- similar difficult or challenging situations.
Some suicidal people never developed the skills necessary to successfully cope with stressful situations. They may also have personalities that are sensitive to becoming overwhelmed by negative circumstance. Other suicidal people may have had reasonable coping skills in place at one point, but find themselves worn down by circumstance to the point where they can no longer manage.
The most frequent stressful event leading up to suicide (what is often called a precipitating event) today is mental illness. It is estimated to account for about 90 percent of all suicides. As we discussed earlier, a newly diagnosed and/or poorly treated mental illness can trigger a suicide in some cases. In addition, a change in someone's existing mental illness (for the worse or better) can function as a precipitating event for suicide. Most people incorrectly assume that only deteriorating conditions should be monitored. However, as was previously discussed, people who have been severely depressed and are now starting to regain their energy may suddenly find themselves with enough energy to carry out suicide plans.
Depression is the most common mental illness in people who commit suicide, so we will briefly detour from the topic of suicide to discuss this common disorder, which is discussed in significant detail in our Depression topic center. According to the DSM-5 (the latest version of the manual used by clinicians to diagnose mental disorders) you must meet the following criteria in order to qualify for a diagnosis of Major Depression:
At least five of the following symptoms are present during the same period. At least (1) depressed mood or (2) loss of interest or pleasure must be present. Symptoms are present most of the day, nearly daily for at least 2 weeks.
- Feelings of sadness, emptiness, or hopelessness (in children, this may be irritability)
- Having no interest or feeling no pleasure in all or almost all activities
- Weight loss or weight gain by greater than 5% when not trying to lose or gain weight OR a change in appetite nearly every day
- Sleeping too little or too much
- Physical agitation or restlessness that is observed by others
Being tired and having a lack of energy
- Feelings of worthlessness, self-hate, and guilt
- Not being able to concentrate, think clearly, or make decisions
- Ongoing thoughts of death or suicide - either thinking about suicide without a plan for how it would happen, having a specific plan or attempting to commit suicide
- Never having a manic or hypermanic episode (being very excited or energetic which would be possible symptoms of bipolar disorder)
It's helpful to know the criteria that professionals use to diagnose depression, but it is not a good idea to attempt to diagnose yourself. One reason why this is true is that the consequences of getting the diagnosis wrong can be quite negative. Depression is a serious condition that is associated with significant suicide risk and does end up being a lethal disorder sometimes. However, it is also a very treatable disease which can be addressed by either medical or psychological methods (or both). If you wrongly conclude that you are not depressed when you are, you might very well miss out on treatment opportunities that a diagnosing clinician could offer you.
Don't assume that you must feel sad and depressed in order to qualify for a diagnosis of major depressive disorder, as this is not the case. You may experience irritability during the required two-week period of symptoms. Or, you may experience your depression as physical pain. If you even meet one of the symptoms listed above (particularly the suicide symptom), it would be a very good idea to consult with a mental health professional. If you have several symptoms, you definitely should schedule an appointment.
In addition to major depressive disorder, depressive symptoms may also be caused by bipolar disorder, or may happen with another condition. Bipolar disorder is typically characterized by alternating moods and energy levels happening over months, weeks or days. Symptoms may include periods of hyperactivity, fast speech, hyper sexuality, lack of need for sleep, feelings of inflated-well-being; and corresponding periods of depression where some or all of the symptoms listed above are present. Extensive information concerning bipolar disorder can be found in our Bipolar Disorder topic center.
what is life? is it worth living? - IloveYou - May 9th 2013
im a 20 year old student who has 2 abortions n is currently hiv positive, infected by a boyfriend that i loved dearly. i see no use for my existance now. i feel ending my life is the only soltution. im sad most of the time n dont see what my purpose of life is. id like to get help if such exists but what i actually need now is for resting in peace!
so sad - - Nov 13th 2012
I know I am severly depressed, I have been for more than 2 years. I use to run EVERYDAY, but now I dont know who I am. I miss 'my old life'. I miss 'my old self' I am so tired, so very tired. I go to work & come home & sit in my chair. I see all weekend. My house is a mess, I have gained 70 pounds in less than 2 years. I dont know who I am. I am so unhappy with myself but I cant do anything to change it. I am not the same person I have been my whole life, I want 'myself' back. I am sad everyday, I am embarrased, I wish go back to the old me. I dont know how to be this 'person' I am now. I hate this person. I am an embarrasment. I have urinary incontenance & it just keeps gettingn worse. I don't have freinds any longer because I am fat & embarrassed. I avoid people, all people. I just want to go away but I have to young adult sons in college. Both very bright. One is well adjusted, the other I am very concerned about. My worry over him adds to the bad-ness of my life. I cant believe this is my life now, & I dont have the power to change it. I am afraid this is how it will be for me the rest if my life, I cant do that. I would be gone except for my sons, I cant do that to them, so for now I will have to live this horrible horrible existance. Help me somebody please
suicide & Depression - Bill Van Mechelen - Aug 6th 2012
I want to thank all involved with the videos. I'm 63 & can't read very well so the videos about depression have been very helpful. I feel you all helped stop me from trying suicide again tonight. Because of your time & efforts you saved a life. Thank You, Bill
what is love??? - - Nov 3rd 2010
why is it people say they love their grandchildren by trying to tear the family apart??? Why is it that some people just let things go instead of costanlycausing problems for a struggleling family. My daughter and her husband are trying hard to provide for my wife and I and our grandaughters. But my son in law's mother just constantly harrasses us with legal problems It's obvious she is in some mental distress.It's been so hard and so long ago, I forgot what happiness is. When push goes to shove I guess I'll have to take care of things. God please forgive me
god bless you - someone - Mar 18th 2009
I wonder how you are and if you made it through. I wonder if anyone listened to you and let you just be angry. I just read your comment. Its March 2009. God bless you
DEVASTING MEDICAL ISSUES - ROBERT - Oct 11th 2008
I HAVE BEEN DIAGNOSED WITH BLADDER AND PROSTRATE CANCER. HAVE BEEN THROUGH TWO CORRECTIVE SURGERIES AND SIX TREATMENTS. HAVE BEEN IN-FORMED THERE IS REASON TO BELEIVE IT HAS SPREAD. HAVE SOME KIND OF TEST NEXT WEEK TO CHECK THESE ISSUES OUT. I AM JUST TIRED OF FIGHTING IT !!! I KNOW THE QUALITY OF LIFE WILL BE GOING DOWN HILL FAST !!! SEEMS AS IF THIS WOULD BE THE SUREST WAY TO RESOLVE THE ISSUE. NO MORE MEDS ETC. ,,,I DO NOT AND WILL NOT BE A VEG !!! I HAVE OTHER MAJOR HEALTH ISSUES ALSO. HEART,LUNG AND SO ON . THE SILVER LINING FOR ME IS I WILL NOT HAVE TO DO ANYTHING OTHER THAN QUIT MY MEDS AND NO ONE WILL BE THE WISER !!! I DO NOT SEE ANY LIGHT !!!