Suicidal acts seldom happen spontaneously. They are typically planned events triggered by a chain of stressful internal and external circumstances. In other words, most suicide occurs as a reaction to stressful events. Since suicidal impulses are reactive, such urges typically fade as stressful events pass. It is not inevitable that you will continue to feel the urge to commit suicide just because the idea enters your head. If you can find a different, more effective way to cope with or think about the stressful events that have caused you to think in a suicidal direction, your suicidal thoughts and the impulse to act upon them will usually decrease.
As suggested previously, suicidality is often described as happening along a continuum of potential lethality and intent. Lethality has to do with how likely some action is to cause death. Intent has to do with how determined you are to succeed. The more you are determined to kill yourself, and the more lethal the methods you choose to end your life with, the more dangerous is your situation.
Your moment-to-moment level of risk is influenced by multiple factors including whether you have:
- a specific and defined plan for committing suicide
- easy access to the tools you need to carry out your plan
- a history of past suicidal gestures.
All of these things increase your present risk of committing suicide.
Your psychological state is, of course, a vital component in determining your risk. If you are in a good place in life, your risk is lower than if you are experiencing a stressful life crisis. If you are able to cope and manage the level of stress you are currently experiencing, your risk is lower than if you are feeling overwhelmed by circumstance. We will discuss other factors that contribute to your suicide risk in a later section of this center. Right now, it's important to understand that people often move backwards and forwards across this spectrum of suicide-danger-risk as the circumstances that trouble them change and their related emotions come and go.
The Suicide Crisis
Suicidal ideation is relatively common and is not necessarily associated with a crisis situation. Instead, it may be a symptom of an ongoing problem that is difficult to address without outside assistance (such as depression). In contrast, suicidal gestures typically happen in the context of crisis periods, or periods that are associated with overwhelming stress. These periods can feel unbearable with unendurable emotional and/or physical pain, and can seem to have no possible solution other than suicide.
The stresses endured by people in a suicidal crisis are undoubtedly severe and overwhelming, but they are not typically unsolvable or permanent. However, they seem that way to people who are experiencing the crisis. Their strong emotions overwhelm, interfere with and reduce their ability to think rationally and to place their problems in perspective.
The thinking of people who are experiencing a suicidal crisis is typically clouded and negative, intensely self-focused, and highly emotional. Homicidal feelings may be mixed with suicidal feelings if there is a sense that someone else has deliberately caused harm. Feelings of loneliness, isolation, alienation, anger and rage are common, as well as the following kinds of thoughts of hopelessness:
- A sense that things will never get better
- A feeling of inability or lack of motivation to change the situation
- A belief that your emotional pain is permanent or too much to bear
- A sense of personal worthlessness, self-hatred or self-loathing
- A sense that all meaning has been removed from life
- A sense that suicide is the only way to make the stressors stop (founded upon the utter sense of hopelessness described above).
Even though it is very hard to believe it in the moment of crisis, the following statements are almost always true:
- Suicidal crises are temporary conditions.
- The intensity and urgency associated with suicidal crises tends to disappear or diminish with time.
- People CAN be helped through suicidal crises if they are open to accepting appropriate help and treatment.