Warning Signs for Suicide

The best predictor of suicide attempts in both women and men is a verbal or behavioural threat to commit suicide, and such threats should always be taken seriously.

 

One of the most destructive myths about suicide is that people who talk openly about suicide are just seeking attention and do not actually intend to carry out the act. Yet research shows that a high proportion of suicide attempts - perhaps 80 percent - are preceded by some kind of warning (Bagley & Ramsay, 1997). Sometimes the warning is an explicit statement of intent, such as 'I don't want to go on living' or 'I won't be around for much longer'. Other times, the warnings are more subtle, as when a person expresses hopelessness about the future, withdraws from others or from favourite activities, gives away treasured possessions, or takes unusual risks.

 

Other important risk factors are a history of previous suicide attempts and a detailed plan that involves a lethal method (Chiles & Strossahl, 1995; Shneidman, 1998). Substance abuse also increases suicide risk (Yen et al., 2003; Passer & Smith, 2009).

 

There's an enormous amount of pain in the world. Not physical pain but psychological pain. It's an ache in the mind. It's an ache of the negative emotions. It's the ache of guilt and of shame, and of loneliness and rejection. It comes from thwarted, blocked, frustrated, trampled upon psychological needs. And if I were to commit suicide, it would be in terms of my frustrated needs. And if you were my therapist, I would be grateful if you understood me, not in terms of my biology or my parents or my psychodynamics, but in terms of what needs were bugging me.

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''The grief of the worshippers left behind, the awful famine in their hearts, these are too costly terms for the release''
                                                                                                                                                                     ~ Mark Twain

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Depressive Disorders

The causes of depression are mixed. There is no one cause for depression - even for a single person. And so we think of it as a risk factor model: where depression develops in the context of risks, and when those risks get high enough, the person goes over some threshold to develop this self-sustaining depression. Those risks might be divided into three categories; psychological, environmental and biological.

On the biological side we have genetics and other physiological factors which can give the person a predisposition towards being depressed. The psychological aspect can include thinking patterns or cognitive style personalities that may leave a person at a greater risk for depression. While environmental factors can include the stressors the person faces and a lack of social support. When the sum total of all these risk factors get high enough, then that can push us over some threshold and we go into a period of clinical depression. For some people, one of those three factors may be stronger than the other but it's unlikely that there is one cause - there's usually some balance of all of the factors. Nevertheless, all of the risk factors should be attended to.

As depression begins to take hold, people stop performing behaviours that previously provided reinforcement, such as hobbies and socialising. Moreover, depressed people tend to make others feel anxious, depressed and hostile (Joiner and Coyne, 1999). Eventually, these other people begin to lose patience, failing to understand why the person just can't snap out of it. This diminishes social support even further and may eventually cause depressed people to be abandoned by those who are most important to them (Nezlek et al., 2000). Additionally, longitudinal studies show that reductions in social support are a good predictor of subsequent depression (Burton, 2004).

 

In short, behavioural theorists believe that to begin feeling better, depressed people must break this vicious cycle by initially forcing themselves to engage in behaviours that are likely to produce some degree of pleasure. Eventually, positive reinforcement produced by this process of behavioural activation will begin to counteract the depressive affect, undermine the sense of hopelessness that characterizes depression, and increase feelings of personal control over the environment.
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''If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather. Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.''
              ~ Stephen Fry

Hedgehog's Dilemma

The hedgehog's dilemma, or sometimes the porcupine dilemma, is an analogy about the challenges of human intimacy. It describes a situation in which a group of hedgehogs all seek to become close to one another in order to share heat during cold weather. They must remain apart, however, as they cannot avoid hurting one another with their sharp spines. Though they all share the intention of a close reciprocal relationship, this may not occur, for reasons they cannot avoid.

 

From 'Studies in Pessimism' (Schopenhauer, p. 142);

''A number of porcupines huddled together for warmth on a cold day in winter; but, as they began to prick one another with their quills, they were obliged to disperse. However the cold drove them together again, when just the same thing happened. At last, after many turns of huddling and dispersing, they discovered that they would be best off by remaining at a little distance from one another.

 

In the same way the need of society drives the human porcupines together, only to be mutually repelled by the many prickly and disagreeable qualities of their nature. The moderate distance which they at last discover to be the only tolerable condition of intercourse, is the code of politeness and fine manners; and those who transgress it are roughly told - in the English phrase - to keep their distance. By this arrangement the mutual need of warmth is only very moderately satisfied; but then people do not get pricked. A man who has some heat in himself prefers to remain outside, where he will neither prick other people nor get pricked himself.''

                            

Both Schopenhauer and Freud have used this situation to describe what they feel is the state of individuals in relation to others in society. The hedgehog's dilemma suggests that despite goodwill, human intimacy cannot occur without substantial mutual harm, and what results is cautious behaviour and weak relationships.

 

The dilemma is also used to justify or explain introversion and isolationism. The concept originates from Arthur Schopenhauer's 'Parerga and Paralipomena'. It then entered the realm of psychology after the tale was discovered and adopted by Freud in 1921.

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Sometimes love can be a spiky situation.

Hikikomori

This culture bound syndrome is found almost exclusively in Japan, most commonly among male teenagers and young adults.

 

It is characterized by extreme social withdrawal and near total severance of contact with the outside world, without any other evidence of psychiatric or neurological disorder. It is usually triggered by an upsetting experience, such as being bullied, failing an examination, or experiencing a broken love affair. People with the disorder usually lock themselves in their bedrooms and refuse to come out for weeks, months, or even years.

 

A theory, advanced by Ryu Murakami in an essay entitled, "Japan's Lost Generation," suggests that Japan's worship at the alter of high-technology may in some way be responsible:

 

"Japanese society is caught in a paradox: it is concerned with the increase of socially withdrawn kids, while at the same time it applauds gizmos like the new Sony PlayStation, which comes equipped with an Internet terminal and a DVD player. Technology like that has made it possible to produce animated movies and graphics, as well as conduct commercial transactions, without ever stepping out of the house. It inevitably fixes people in their individual space. In this information society, none of us can be free from being somewhat socially withdrawn."

 

The disorder was first recognized in the 1970's and the word hikikomori was first applied to it by the Japanese Health and Welfare Ministry in 1991.