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Suicide Triggers Continued

Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D.

Anxiety Disorders

The term "anxiety disorders" covers a range of conditions that impairs someone's ability to function, ranging from Simple Phobias (intense fear of a particular item or situation such as spiders or bridges), Panic Disorder (described below), Generalized Anxiety Disorder (a intense, all encompassing sense of worry), Obsessive-Compulsive Disorder (a person experiences obsessions, or repeated unwanted and intrusive thoughts and engages in compulsions, or repetitive and ritualistic anxiety-reducing behaviors), PTSD (described below), and Social Phobia (intense anxiety created by social or public situations). Even though these disorders have very different symptoms, they all share a cardinal feature: intense, extreme, and disabling anxiety that appears in anticipation of or in response to situations which does not subside over time.

Individuals with anxiety disorders may feel overwhelmed, ashamed, or frustrated that they are unable to control their symptoms. Many individuals with severe anxiety symptoms also become socially isolated and/or try to relieve their feelings by using alcohol and/or other substances. These features of anxiety disorders can lead someone to attempt or commit suicide.

Post-Traumatic Stress Disorder

As mentioned several times in this document, PTSD is an extreme reaction to a traumatic event characterized by flashbacks (traumatic memories), trauma-themed nightmares, extreme jumpiness, and difficulties managing emotions. Individuals with PTSD have the highest rate of suicide when compared to all other anxiety disorders.

Panic Disorder

People with panic disorder experience recurrent and unexpected panic attacks (bouts of intense anxiety characterized by unpleasant physical symptoms such as nausea, racing heartbeat, dizziness, etc.). They are extremely anxious about having future panic attacks as well as very worried about what might happen as a result of these attacks (e.g., they worry about being trapped and unable to get help, or driving and wrecking). Approximately 20% of suicide deaths are due to panic disorder (a rate that is below major depression and PTSD, but still relatively high). People with comorbid (co-occurring) panic disorder and depression are particularly at risk.

Schizophrenia

Schizophrenia is a disorder characterized by odd and often highly irrational or disorganized behavior, disorganized thinking, and a loss of touch with reality. Four to 10% of people with schizophrenic disorders commit suicide. Suicide attempts among this group of people are more likely to be moderately to severely lethal with high levels of intent. In other words, individuals with schizophrenia who attempt suicide frequently do not survive.

Personality Disorders

Personality disorders are enduring patterns of behavior and ways of thinking that significantly impede functioning. Between 4 and 8% of people with a personality disorder complete suicide, and approximately 40 to 90% have attempted suicide.

Antisocial personality disorder is a long-standing pattern of a disregard for other people's rights, breaking laws, deceitfulness, irritability and aggressiveness, reckless disregard for safety of self or others, and consistent irresponsibility. People with antisocial personality disorder are often highly impulsive, which, as we discussed before, can lead someone to engage in self-destructive behavior as a means of obtaining intense stimulation and gain attention, without thinking through the possible outcome and ramifications of their actions.

Borderline personality disorder (BPD) is characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This disorder affects approximately 2% of adults, mostly young women. Individuals with BPD have a high rate of self-injurious behavior, suicide attempts, and completed suicide. Often, suicidal behaviors in BPD occur when the person is not showing any signs of depression, so some clinicians suggest that suicide in this population is more of an impulse control problem than some of the other mental illnesses discussed previously

Even though it's important to understand the link between mental illness and suicide it is also important to remember that not everyone who attempts or completes suicide has a mental illness, and not all people with mental illness attempt or complete suicide. As we discussed before, it's likely a combination of factors that propel someone toward engaging in suicidal behavior.

At this point, if you are confused about the difference between risk factors, vulnerabilities, and triggers, don't worry. These are not "cut and dried" categories, and the distinctions between them are often blurry. The important message we're trying to communicate here is that you can and should be alert to circumstances that cause people to become suicidal, ask for help if you find yourself encountering such circumstances, and be concerned enough to reach out to others you know who encounter such circumstances and need assistance.