Suicide is a difficult topic to talk about. It’s even a difficult topic for psychologists to study. With the tragic passing of Robin Williams, there has been a flurry of grief and thoughtful comments in the media, but there has also been hostility and misinformation. The charitable organization Samaritans, devoted to helping those in distress, recently reminded various media organizations to be cautious of being sensationalist or overly simplistic in their descriptions of suicide. Unfortunately, it is not just artists or famous people or even sad people who deal with suicidal thoughts. The World Health Organization (WHO) reports that roughly one person every 40 seconds dies from suicide, with approximately 10-20 times more people attempting suicide each year. Approximately 38,000 people die each year by suicide in the U.S. alone and, as of 2011, suicide was the 10th leading cause of death according to the Centers for Disease and Control Prevention. The National Alliance of Mental Illness (NAMI) reports that over 90% of people who attempt suicide have been diagnosed with a mental illness, with depression, borderline personality disorder, anorexia nervosa, and bipolar disorder ranking amongst the mental illnesses with the highest risk of suicide. In other words, emotion-related mental health issues put people at risk for suicide.
For the average person, it’s hard to imagine what would make someone take their own life. It’s similarly difficult to study the factors that contribute to suicide. In scientific studies, psychologists usually form a hypothesis about how a factor contributes to an outcome and then manipulate that factor to assess whether it does in fact have the predicted effect on the outcome. Yet for obvious ethical reasons, researchers cannot manipulate factors and see if it impacts people’s desires to attempt suicide. Instead, researchers who study suicide rely on correlational methods to see what factors tend to be associated with suicide in the general public. Perhaps not surprisingly, some of the major personality traits that are related to suicidal thoughts and behaviors are strongly linked to emotions. Members of the McGill Group for Suicide Studies conducted a systematic review of 90 studies to examine the personality traits related to suicidal thoughts and behavior. They found that the traits that most strongly differentiated people who attempted suicide from those who did not included a tendency to worry and be anxious, to react to everyday stresses with strong negative emotions, and to experience a variety of emotional “ups and downs” in everyday life (all related to a personality trait known as neuroticism). A predisposition towards impulsivity (particularly impulsivity related to aggression) was also strongly associated with attempting suicide. On the other hand, a tendency to be gregarious and experience positive emotions (related to a trait known as extroversion) was the main factor that differentiated people who did not attempt suicide from those who did. The extent to which people say they feel hopeless — the persistent feeling that one’s life will never improve, no matter what someone does — also influences the likelihood of suicide. A separate review by Ryan M. Hill and Jeremy W. Pettit at Florida International University showed that people who feel like they are a burden to their loved ones are also more likely to think about and attempt suicide.
So it follows that suicide is closely related to aspects of emotion and perceptions of one’s place in the world. But it is important to note the largest predictor of suicidal behavior is unrelated to current emotion or personality: history of previous attempts (read more here). As a clinician, the first question you ask someone who reports suicidal ideation is whether or not he/she has intentionally tried to harm him/herself in the past, and if so, how many times. Other risk factors include history of physical or sexual abuse and alcohol abuse or dependence (read more here). These are important questions we can be asking our loved ones and, if you are feeling in distress or in trouble, questions we should be answering for ourselves, too.
The more knowledge we gain on why some people attempt suicide does not make it any less tragic. Feeling intense negative emotions, hopelessness that their life will not get any better, and as if their own existence is burdensome to their loved ones, some people might try to harm themselves in an impulse that, if they could take it back the next day, they might. Suicide is a tragedy that can lead to many strong emotional reactions: sadness, anger, confusion, relief, judgment, hostility, shock. While there may never be a concrete or universal answer as to why someone would choose to end his or her own life, there are many researchers and clinicians out there attempting the unenviable task of trying to identify the risk factors and, importantly, understand how we can better prevent such tragedies from occurring.*
*If you or someone you know needs to connect to helpful resources, there are many available. Suicide.org lists many resources and suicide prevention hotlines in the U.S., including the National Suicide Prevention Lifeline (1-800-273-TALK) & the National Hopeline Suicide Prevent Hotline (1-800-SUICIDE, or 784-2433). Additionally, the American Psychological Association maintains a list of research-supported treatments for a variety of mental illnesses. If you are in the UK, you can contact Samaritans. Elsewhere in Europe, you can check to see if your country has a European Union emotional support helpline or you can check the International Association for Suicide Prevention’s website. In Australia, you can contact Suicide Prevention Australia or Lifeline.