By Dr. Mercola
Cases of suicide are on the rise in the U.S., according to new data from the U.S. Centers for Disease Control and Prevention (CDC). From 1999 to 2014, the suicide rate increased 24 percent from 10.5 to 13 suicides per 100,000 people.1
The pace of the increase was greater after 2006 and varied by age, race and ethnicity. For instance, female adolescents aged 10 to 14 had the greatest increase, with suicide rates rising 200 percent. Middle-aged males, ages 45 to 64, also had a steep increase of 43 percent during the study period.
Among racial and ethnic groups, rates of suicide among American Indians rose the most with an 89 percent increase among women and a 38 percent increase among men.
The trend is concerning, especially since suicide rates had been decreasing in the '80s and '90s. Further, the data only show part of the picture because there are far more suicide attempts than there are suicide deaths, and these data (attempts) are not included in the CDC numbers.
Sally Curtin, a statistician with the CDC's National Center for Health Statistics who co-authored the study, told NPR:2
"I've been losing sleep over this, quite honestly … You can't just say it's confined to one age group or another for males and females. Truly at all ages people are at risk for this, and our youngest have some of the highest percent increases … The deaths are but the tip of the iceberg."
What's Causing the Surge in Suicides?
Multiple factors are likely to blame, and there are many theories about why suicide rates stopped decreasing and started climbing around 1999. Among them is the economic downturn, which left many out of jobs and lacking health care.
In particular, past research has found suicides related to job, financial, and legal problems were most common among individuals aged 40 to 64 years.3
Earlier puberty among adolescent girls may be another factor, as this is a period of significant changes in a girl's life. This is also the age when psychological disorders such as depression may emerge.
Another factor is the ongoing trend away from use of cocaine and crack in favor of heroin and prescription painkillers, which are associated with an increasing number of opioid deaths. Antidepressants may also be playing a roll.
Dr. Maria Oquendo, a psychiatry professor at Columbia University Medical Center and president-elect of the American Psychiatric Association, suggested the addition of a black-box warning label to drug labels in 2004 may be partly to blame.
The label warned that the medications may increase the risk of suicidal thoughts and actions in young people, which Oquendo suggested may have discouraged doctors from prescribing the drugs and therefore led to an increase in suicide as a result of untreated depression.4
Antidepressants Linked to Suicidal Thoughts and Behaviors in Youth
What must be factored in is the likely possibility that these drugs (and others) are contributing to the suicide increase. There is increasing evidence that antidepressants intensify violent thoughts and behaviors, both suicidal and homicidal, especially among children.
And, since the late 1980s, there have been frequent reports of increased violent behavior, including homicides and suicides, among individuals taking antidepressant drugs.
Research published in Pharmacogenomics and Personalized Medicine even revealed that a genetic mutation in the CYP450 gene family may cause a metabolic disturbance resulting in uncontrollable violent impulses and behaviors, including suicide, in some individuals taking these drugs.5
So if you or your children are taking an antidepressant drug, it's important to be aware that suicidal thoughts may be a side effect. Further, antidepressants are not the only drugs to watch out for. Other medications linked to increased suicide risks include:
✓ The stop-smoking drug Chantix
✓ Accutane, an acne drug
✓ Singulair, an allergy drug
✓ Certain epilepsy drugs
✓ Tamiflu, a flu drug
✓ Cholesterol-lowering drugs
Drug Overdoses, Suicide Blamed for Drop in Life Expectancy Among Some White Americans
Life expectancy for white Americans declined slightly in 2014, to 78.8 years in 2014 from 78.9 in 2013. Researchers blamed the drop largely on drug overdoses, liver disease and suicide.6
Increasing numbers of middle-age Americans are becoming hooked on painkillers, often after using the drugs for back pain. Seeking ever-stronger highs, more potent drugs are now reaching the black market.
There's W-18, a synthetic opioid that's said to be 100 times more potent than opioid pain reliever fentanyl and 10,000 times stronger than morphine. Fentanyl is also being picked up by drug traffickers, who are selling it mixed with (or instead of) heroin.
It's cheaper to make and far more potent than heroin, making it extremely easy to overdose. In New Orleans, deaths caused by Fentanyl are now higher than the murder rate.7
Meanwhile, according to the CDC lethal heroin overdoses nearly quadrupled between 2000 and 2013 in the U.S., escalating from 0.7 to 2.7 deaths per 100,000 during this timeframe.8
In 2013, more than 46,000 Americans died from drug overdoses, with prescription drugs and heroin topping the list.9 Half, or about 23,000, of these lethal overdoses were due to prescription drugs, with painkillers accounting for about 16,000 deaths.10 About 8,000 deaths were due to heroin.
Greenland's Suicide Rate Is the Highest in the World
The reasons why people die by suicide are complex, sometimes stemming back to problems created decades prior. In Greenland, where the suicide rate in 2010 was nearly 83 people per 100,000, young men are the most vulnerable population.
Similar to the plight of American Indians in the U.S., in Greenland those most affected in 2010 were native people whose traditional ways of living had become impossible in an increasingly modernized world. NPR reported:11
"Like native people all around the Arctic - and all over the world - Greenlanders were seeing the deadly effects of rapid modernization and unprecedented cultural interference.
American Indians and Alaska Natives (many of whom share Inuit roots with Greenlanders) had already seen many of their communities buckle under the same pressures.
In Greenland, the problem was only getting worse. Between 1970 and 1980, the suicide rate there quadrupled to about seven times the U.S. rate (it's still about six times higher).
The suicide rate was, and still is, so high that it's not an exaggeration to say that everyone in Greenland knows someone who has killed himself. Many people … struggled to explain what that felt like, to live in a place where suicide is so pervasive, and most of them settled uncomfortably on the same word: normal."
Adding to the complexity of the problem is a lack of resources to help residents deal with a pervasive loss of identity. In Greenland, small villages have been shut down and native residents forced to move to cities, abandoning their cottages along the coastline for tenement buildings in the city.
Meanwhile, despite its commonality, virtually no one would speak of suicide, even parents who had lost their children. With few psychologists available, and those that were often speaking a different language there was increasing isolation and few resources for those in need of help.
Suicide-Prevention Course Launched for Greenland's Youth
In response to two suicides among young men in a period of two weeks in one small town with 3,000 people, help arrived from Greenland's capital in the form of social workers and family therapists.
Sometimes suicides are considered to be "contagious;" they spread through local areas and are known as "suicide clusters." A course for the town's youth on how to talk about suicide was launched in the hopes of getting students to open up and talk about their problems and feelings.
There is hope the course will help save lives in a community that’s been fundamentally disrupted, leading to increases in alcoholism, child neglect and physical abuse, all of which raise suicide risk. As NPR noted, without strong families and other forms of support, virtually all youth are at risk:12
"There's … something broader - a loss of identity that happens when a culture, in this case Inuit culture, is demonized and broken down. When a culture is largely erased over less than a generation, as it was in Greenland, a lot of young people feel cut off from the older generations, but not really part of the new one.
It's especially difficult for young men, whose fathers and grandfathers were hunters, and who struggle to understand what it means to be an urban Inuit man. Without strong families and communities to help them cope, some of them are so overwhelmed and lost, they take their own lives."
The Primary Risk Factors for Suicide and Suicide Signs to Watch For
If you have a family history of suicide, have been exposed to suicidal behavior (such as from other family members or friends) or have suffered/witnessed physical or sexual abuse or domestic violence, your risk of suicidal behavior increases. And typically it's a combination of factors that leads to this desperate act. However, the primary risk factor for suicide is depression in combination with substance abuse, which could include alcohol, illicit drugs, and prescription drugs.
It's estimated that more than 90 percent of those who end up taking their own lives fit into this category.13 I know firsthand that depression and suicide are devastating. It takes a toll on the healthiest of families and can destroy lifelong friendships. Few things are harder in life than losing someone you love, especially to suicide.
Also be aware of the following red flags that someone has a high risk for self-harm. Besides straightforward or "sideways" comments about not wanting to live any longer, suicide signs to watch for in your teen (or anyone) include:
✓ Acquiring a weapon
✓ Hoarding medication
✓ No plan for the future
✓ Loss of interest in extracurricular activities
✓ Changes in eating and sleeping habits
✓ Begins to neglect hygiene and personal appearance
✓ Declining grades in school and loss of interest in school
✓ Increased risk-taking behaviors
✓ Does not respond to praise
✓ Trouble concentrating or paying attention
✓ Frequent complaints of boredom
✓ Emotional distress leads to physical complaints of fatigue, migraines, pain, etc.
✓ Putting affairs in order
✓ Making or changing a will
✓ Giving away personal belongings
✓ Mending grievances
✓ Checking on insurance policies
✓ Withdrawing from people
How to Help Someone Who Is Suicidal
A person who appears suicidal needs urgent professional help. Help the person to seek immediate assistance from their doctor or the nearest hospital emergency room, or call 911. Eliminate access to firearms or other potential suicide aids, including unsupervised access to medications.
If you’re not sure if someone is contemplating suicide, ask not directly about suicide but about how they’re feeling. Jill Harkavy-Friedman, Ph.D. of the American Foundation for Suicide Prevention explained to NPR:14
“If you're worried about somebody, ask. It's a little scary to ask, and you don't start off with, ‘Are you thinking about suicide?’ You want to base your questions on what you've seen and what you notice. Like, ‘You seem very down lately and you're not with your friends. Is something going on? Are you feeling OK?’ or ‘You look kind of sad. Are you?’
Then the next step is to just listen to what they have to say and try to really hear them, and interact with them so they know you've heard and understood. These are not quick-fix problems, so even though as parents and friends we want to say, ‘Just snap out of it!’ or ‘It's not that big a deal!’ to that person at that time, it is a big deal.”
If the person doesn't want to open up to you, try to find another trusted person - a friend, family member or school counselor, for instance who they may want to speak with. If you think someone is suicidal, do not leave him or her alone. Most suicide attempts are expressions of extreme distress, not harmless bids for attention.
If you are feeling desperate or have any thoughts of suicide, call the National Suicide Prevention Lifeline, a toll-free number 1-800-273-TALK (8255), or call 911, or simply go to your nearest hospital emergency department.