16 ms·
Suicide Attempters’ Long-Term Survival
- cm2012 7y agoGreat summary of the suicide literature. This is why it's okay to restrain suicidal people against their will - it's temporary madness most of the time If your happy but very drunk friend wanted to tapdance on the edge of a tall building, would you restrain them if necessary? Or if someone high on shrooms was trying to drink bleach? A suicidal mind is often one caught in the temporary throes of delusion and irrationality, even if it comes from internal wiring going haywire instead of external substances. Preventing someone from killing themselves is in their best interest most of the time for that reason. Suicidal impulses are most often fleeting relative to normal lifespan.
- jMyles 7y ago> Or if someone high on shrooms was trying to drink bleach? Wait, what?
- stevewodil 7y agoIt would be interesting to talk to these people and ask if it was the suicide attempt itself that made them not attempt again. If you prevent the attempt will it have the same effect?
- staticautomatic 7y agoI think it probably depends on whether they tried because they lost all their coping mechanisms or because they were angry. I'm one of the former and I don't think I'd ever attempt it again but it seems people who attempt as an act of rage are more likely to repeat. I'm not confident that stopping someone would have the same effect as them living through it.
- aj91fl48znv3mpk 7y agoSpeaking for myself, virtually all self administered methods used can be quite painful with an uncertain outcome, due to imperfect information. As I started going through an attempt, as the pain increased, I backed off and realized I had no idea what I was doing and needed to stop. I suppose people that attempt suicide don't see another way of solving whatever they perceive to be the doomsday singularity in their life.
- DoreenMichele 7y agoI attempted suicide at age 17. I have been hospitalized twice on a suicide watch. For me, yes, the failed attempt has served as a deterrent. Due to various intractable issues, my life has sucked for a long time. Adding more scars, more people thinking I'm merely crazy and more medical bills won't in any way enhance my life. I don't want to survive another failed attempt and I'm usually in no position to make sure I succeed. So, for me, yes, it's been a factor. /Anecdata
- bayesian_horse 7y agoIn my opinion the misconception is that suicidal ideation means no will for self-preservation. On the opposite, the urge to think, speak and act on suicidal ideation is at odds with various other emotions and instincts. One way of threading this needle is to perform attempts which are obviously going to fail, maybe eben intentionally so. It may take any kind of attempt, be it intentionally or accidentally unsuccessful to lead to treatment or at least the acknowledgement of all parties involved that the problem is actually bigger than a bout of self-pity or lack of character.
- rincebrain 7y agoI know people who have said the primary reason they don't attempt suicide again is not that they feel life is improving or worth living, but because each attempt further reduced their QoL and they're terrified of what another unsuccessful attempt might yield.
- AnIdiotOnTheNet 7y ago> the temporary throes of delusion and irrationality On the other hand, this phrase describes about 80% of all human behavior in my experience.
- autokad 7y agoi agree to a large degree, though even 1/10 is an appalling rate of suicide vs the general population of 1/5000~
- robocat 7y agoIt looks to me like you are comparing a lifetime figure against a yearly figure. Suicide figures are usually given on an annual basis, but we often mistake the figures for lifetime risk, and we are then surprised with how common suicide is within our own experience/extended acquantancy.
- autokad 7y agothats true, but my statement remains correct regardless. correct me if i fudge my math. 1- 1/5000 =.9998. .9998^72 = .985702, thus <1.5% chance of suicide over a life time. .1 is still appallingly high vs .015 (and I think 1/5000 is actually a generous estimate, rates are age adjusted so its hard to apples to apples, but according to wikipedia its 13.42 / 100k - much less than 1/5k).
- bayesian_horse 7y agoFrom the numbers it could very well be that a lot of the ones who die in a subsequent attempt could be bipolar or have some other serious comorbidity in addition to "just" major depression. There are multiple conditions which can lead to depressive symptoms and suicidal tendencies. Some are more malign than others, which is a strange thing to say about conditions that make you want to kill yourself. But basically, suicidality in bipolar patients can only be significantly reduced by exactly one specific medication.
- hiram112 7y agoAre you referring to Lithium or just saying they need one more medication, on average, to get them out of their very deep hole?
- bayesian_horse 7y ago
- manicdee 7y agoYou made quite the leap of logic there. The article is about people whose suicide attempts failed, and ended up with them alive in hospital. Of these people, only about 10% will successfully suicide later. There is no connection between these incidents and your justification for restraining suicidal people against their will. I am certain that there is evidence to support your claim, but this is not it.
- JKCalhoun 7y agoI see your point, but I also don't see much of a leap. If 90% who survived suicide did not attempt suicide again it sort of does suggest that had more people survived their suicide impulses they would also be one-timers. Sadly, sometimes one impulse is the last. I read about bridge jumpers who survived (I think it was the Golden Gate Bridge, FWIW) and most said the instant they left the bridge they had a rush of clarity and profoundly regretted what they had just done. Haunts me still to think about the ones that didn't survive but likely had that same moment of horror.
- temporaryvector 7y ago>If 90% who survived suicide did not attempt suicide again it sort of does suggest that had more people survived their suicide impulses they would also be one-timers. It might also suggest that those who survived a suicide attempt used half-hearted measures because it was an impulsive act, while at least some (though we'll likely never know that actual proportion) of those who did not survive their attempt went to greater lengths to ensure their death because their act was more premeditated and planned out than impulsive. What about the other 10%? Was there a second impulse, then a third one? Sad as it may be to contemplate, not all suicide is a spur-of-the-moment thing, some people will go to great lengths to get their affairs in order and ensure their own death.
- manicdee 7y agoI think the point is that they have to execute to get the release from the insanity. Pulling people back from the brink might stop them trying this time, but perhaps it’s that moment of clarity after all the noise and chaos inside their head has finally been resolved by making a decision and following through, that leads them to recognise the more sensible decisions they should have taken.
- duxup 7y agoI remember working through rounds of depression and constantly confused and doubting my interpretation of .... anything / everything. It was hard to understand the differences I perception when depressed and not. One day a doctor almost as an aside said "When you are depressed, you don't see the world the way it is, but you also can't comprehend that entirely or maybe at all." I finally understood why it was just so different on either end of the depression and non depression world and also how far "off" my ability to understand certain things were.
- drivingmenuts 7y agoWhat is the difference? I mean, the world is the world and the things that happen don’t change just because one sees them in a different way. Put another way, even if I wasn’t depressed, I’d still be single, diabetic and have a ton of debt. What about that would change?
- agumonkey 7y agosome people still see these problems are not damaging enough to be sad - failing love relationship can also be pain, some love the peace of being single - diabetic may be managed (maybe your case is harder though, I cannot assume it's easy) - some can find support to fill debt and like to rise above it as a challenge Much in life is interpretation, and accepting damaging emotions as truer than neutral or positive is not my favorite choice. Best wishes
- bayesian_horse 7y agoOptimism for one thing. Non-depressive people usually think their problems are conquerable and they can find some enjoyment here and there. For another, the perception/prediction of effort is very much different. In a depressive episode patients will estimate all tasks as fundamentally harder, leading to huge problems in motivation and making decisions. It's quite analogous to how increased gravity on another planet would affect your movements and decisions about your movements. When the capacity for enjoyment or positive emotions is reduced, you won't be seeking enjoyment as much. Which is a vicious cycle, of course. So yes, depressive symptoms are a big hindrance, even if you have other big problems, none of which I would want to diminish.
- qwsxyh 7y ago> This is why it's okay to restrain suicidal people against their will Well, it isn't.
- tomjen3 7y agoIf you believe that, then you should also be willing to exempt anyone who has given notice in advance (let say 2 weeks). If you are not, then please don't go and lord your believes about peoples lives over them.
- mrtweetyhack 7y ago9/10 are failures
- Bostonian 7y agoThis could be an argument against assisted suicide, which probably has a higher completion rate than unassisted suicide. If people want to kill themselves, let them do so themselves. There's a good chance they won't actually follow through.
- stevewodil 7y agoIt's not socially acceptable, perhaps, but most people already have access to plenty of ways to kill themselves if they really wanted to. Anyone with a car has a number of possibilities, one being carbon monoxide poisoning which we understand to be pretty peaceful.
- XorNot 7y agoThat's the thing - suicide attempts aren't rational because they grab whatever's at hand and pick a really painful way to do it (paracetamol overdose is one of the worst ways to go - you get to die of liver failure over the next week, when you're probably thinking maybe you don't want to but by then there's literally nothing medicine can do for you).
- flukus 7y agoSome, probably most suicides are quite spontaneous, but many are thought out over a long period. People grab what's at hand because it's the best method they know of. Suicide options are a frustratingly hard topic to google, you get a lot of hotlines but useful information is hard to find.
- a2tech 7y agoA friend who does car engineering tells me with modern cars you’d be hard pressed to kill yourself with carbon monoxide poisoning. Now a bottle of helium can be had at almost any party city store and that plus the plastic sack they’ll give you to carry your shopping in will lead to what is essentially a pain free suicide.
- armada651 7y agoThat's a horrible mentality. Assisted suicide is only for people who are suffering from continuous pain with no chance at recovery. You would put them through yet more pain just to see if they were really suffering enough?
- pcr0 7y agoCould VR suicide dissuade people from attempting suicide?
- amfsn 7y agoI don't believe VR could ever reproduce what you feel during an actual suicide, so no
- AdmiralAsshat 7y agoWhat the hell would you do in VR suicide? Be present during your own wake? Experience being buried alive?
- AnIdiotOnTheNet 7y agoProbably parent means something like creating a much more realistic and believable experience of imminent demise, like jumping off a tall building. The idea being if you can make enough of the brain believe it is about to die it might trigger whatever it is that changes its opinion on whether or not it should commit suicide.
- staticautomatic 7y agoThe feeling is a lot more "I'm glad I didn't die." I doubt it could be replicated in VR.
- AnIdiotOnTheNet 7y agoSo do I. I was just clarifying what I believed the original comments intention to be.
- agumonkey 7y agoMaybe a slight chance of cathartic fake realization. By enacting what they want to do in VR they'd be able to slightly live through their own emotions, express and realize some things and change their mind a bit.
- 7y ago
- tomlockwood 7y agoIt's also an interesting argument for stricter gun control - guns make it incredibly easy for suicidal people to follow through on that impulse. The amount of suicide deaths by gun in America is a testament to this.
- hn_throwaway_99 7y agoYeah, but that seems like it is one of many, many reasons for more reasonable gun control, yet the US does nothing. If a school full of slaughtered 1st graders or a parking lot full of murdered country music fans hasn't prompted us to do anything, I don't think arguing about people killed by their own hand will change anything, sadly.
- kerkeslager 7y agoI'm not against gun control--I think there are a number of really "low hanging fruit"-type adjustments that could be made in regulation--but I feel that the amount of political energy liberals put toward it is low priority and loses us a lot of other battles. It's low-priority because guns are much scarier on the news than their actual death counts warrant. More people die in car accidents every year than have died in the entire history of the United States in mass shootings--yet mass shootings are disproportionately used as a talking point. Yearly motor deaths are an order of magnitude more frequent than gun deaths, and that's if you count the more than half of gun deaths which are suicides--if you want to protect yourself from guns, simply not owning a gun is an effective measure. If liberals took proportional action with regard to harm on car safety to how we act on gun safety, we'd be pushing for frequent re-testing for licenses, lower speed limits, easier loss-of-licenses for repeat bad drivers, stricter drunk driving laws, etc. But that's not what's happening. It loses us a lot of battles, because it alienates a lot of potential allies. True libertarians, for example, tend to be fairly pro-choice, but don't feel strongly about it, but very pro-gun, and feel very strongly about it. We'd have them on our side in votes relevant to abortion a lot more often if we didn't alienate them with regards to gun rights.
- povertyworld 7y ago
- yasp 7y agoWhat percentage of those with chronic suicidal ideation attempt suicide?
- datpuz 7y agoI saw a fascinating interview with Kevin Hines, a guy who attempted suicide by jumping off the Golden Gate Bridge, and lived. He said he immediately regretted it after he jumped. It seems like there is something about there being no turning back that totally transforms one's perspective. Why, after weeks, months, or years of planning suicide, are peoples' perspectives able to totally flip in an instant, precisely when it's too late?
- siphon22 7y agoMaybe this is one problem that VR can solve. Virtually simulated suicides? Virtually simulated anything. You don't have to die or hurt yourself, try X in a safe simulation first to see if you really want to go through with it.
- JohnJamesRambo 7y agoVR marriage apps with faceapp induced aging.
- tfha 7y agoThe virtual piece of it would ruin the last second regret. The regret comes from the realization that you've crossed through a door with no return. Can't ever get that in VR unless somehow the subject does not realize it's fake.
- coderintherye 7y agoWould it be ethical to subject someone to a virtual suicide they thought was real...in order to convince them to not attempt in the future? The technology seems to be getting to a place we could create such an experience, terrifying though it may be.
- hiram112 7y agoYou'd think that once VR got to such an advanced state, we'd have already long before synthesized effective medications / electrical-magnetic therapies (e.g. shock therapy or TMS) to effectively treat depression enough that the VR suicide simulation would be pointless. OTOH, the most effective treatments we have for depression are almost a century old, have tons of awful side effects, and were discovered by accident (i.e. MAOIs and electroconvulsive therapy), so I'm not too optimistic in the pharmaceutical and psychiatric industries.
- wetpaws 7y agoThey realize that everything is futile, including the act of suicide itself
- AnIdiotOnTheNet 7y agoA multiple-suicide-attempt survivor I met once remarked that she felt a mixture of rage and despair at "not even being able to die right". As much as people like to believe that people don't really want to die, sometimes they really do.
- starpilot 7y agoIn time, I will be that 1 of 10.
- isatty 7y agoHello! Do you need someone to talk to? I’m not qualified or anything though, just your average software engineer. Ping me.
- deleted 7y ago[deleted]
- zemotion 7y agoIn darker moments I always think that eventually, this is an inevitable outcome for someone like me. But as somebody who's also experienced help that worked, even if for only a time, I wish that you (we) can hold on to some hope and trudge on. Maybe life will surprise us and we'll go at it till the end. Good luck.
- inlined 7y agoIf you ever need someone to talk to, the national suicide hotline is 800-273-8255. It’s free and open 24x7. As someone who struggle(s|d) with ideation, I realized that I too was on that path. If I kept idealizing suicide then I’d eventually succumb. Some recommendations: 1. Find a therapist with whom you can build a relationship. 2. Be open to medication. Even if side effects can hurt your quality of life, you’re clearly already suffering from QoL problems. 3. Keep an emotional journal. In it, also track common culprits like sleep, food, alcohol, etc. this can help you identify and avoid triggers. 4. Strongly consider active exercises to change your outlook. Force yourself to have a social life and hobbies. Cognitive behavioral therapy also has a number of (sometimes touchy-feels, yet effective) exercises. You can learn more from the book “Feeling Good”
- DoreenMichele 7y agoPSA: Most suicides occur while the person is alone. Company can be a strong deterrent to attempting suicide. Thanks in part to an incurable medical condition, I'm sometimes suddenly suicidal and basically deranged. At such times, my adult sons don't leave me alone. They mostly try to avoid discussing it with me. They don't try to make me feel better or act like unpaid therapists because it not only doesn't work, it's actively counterproductive. Their policy is to take care of me physically (food, drink, warmth), keep me company and "do not engage Teh Crazeh." In other words, trying to argue with me at such times about how irrational I am amounts to adding fuel to the fire. It just makes me more upset. I've lived with this a long time, so I'm often able to just tell them "I'm not right and can't be trusted to be alone right now." As my health improves, such incidents have become fewer, farther between and shorter in duration. It happened a lot while homeless. It's been much less common since getting back into housing.
- malms 7y ago> incurable medical condition which is ? seriously wondering
- neonate 7y agoReally glad to hear that your sons are there for you. Even gladder to hear that such incidents are fewer and farther between! I can only imagine how much harder it must've been without housing.
- bayesian_horse 7y agoHaving fought depressions myself, I recognize the pattern of "depressives talking bullshit". In depressive episodes your mind believes strongly in how hopeless your situation is. When people challenge that conviction, you'll only come up with more reasons, no matter how hare-brained or even psychotic at times. It's just the way it works...
- belorn 7y agoParent did not mention the word depression, so I do not want to comment on their story, but I want to comment that major depression does have well documented symptoms of transient mental state where delusions and hallucinations feeds into depression. If I remember right from Robert Sapolsky, the mind is creating a plausible explanation for its current state, which is a thing the mind actually does for everyone, but with major depression it becomes quite extreme. It is not something a person can "snapp out" of or be talked into to see things rational. Robert Sapolsky see depression as mostly a biological condition with biological causes, and a common quote from his is that we don't tell people with diabetes to just get over it and start producing insulin.
- agumonkey 7y agoI had this weird and strong question the other day: how come evolution didn't manage to wipe out suicidal gestures. Why don't we just fall into a partial coma when our mind is overwhelmed by events. It's a bit odd.. alas evolution is no silver bullet (sic):
- arrrg 7y agoWe do have mechanisms that deter us from committing suicide like fear and pain. The good thing about fear and pain is that they are universally useful, e.g. both when we are on the verge of being reckless and suicidal.
- agumonkey 7y agoThere are other levels of emotional pain where you may harm yourself without any fear at all (no external setup required, road, cliff or else). Your mind will still generate aggressive thoughts aimed at yourself, to the point of suicide. This brain aspect seems very .. hard to understand.
- DoreenMichele 7y agoIt isn't necessarily crazy to want your suffering to end and to believe death is the only solution. This is why we have the right to die movement.
- agumonkey 7y agoI meant at the biological/neurological level, not social/moral.
- DoreenMichele 7y agoThe right to die movement is generally about people with terrible medical conditions for which we have no cure. So I don't see the distinction you are trying to make.
- 7y ago
- bayesian_horse 7y agoThese kinds of results also point to how much of an impact guns have on suicide rates. Guns make it a lot easier to attempt suicide and achieve it. In the US, guns are often more readily available than medical treatment. If you have a gun laying around, and you have a short bout of suicidal ideation, that can be an unfortunate combination. On top of that, people believe it will be less painful than other methods, increasing the appeal. Virtually any other method of suicide takes more effort and time. The more time an attempt takes, the less probable the patients are to go through with it, and the more likely the attempt is discovered in time.
- _delirium 7y agoMethods seem to vary a lot by country, and some of the highest-rate countries don't primarily use guns, so I'm not sure other methods can be easily dismissed as less dangerous. For example, Belgium's overall suicide rate is higher than the USA's, and the most popular method there is hanging (a majority of male suicides, and a plurality of female suicides) [1]. Of course I can't say that the rate wouldn't be even higher if Belgium had more guns, but it manages a quite high rate without them. [1] https://jech.bmj.com/content/62/6/545 https://jech.bmj.com/content/62/6/545
- bayesian_horse 7y agoIt's misleading at best to reduce differences between countries to one thing, like gun ownership. Nobody said this was the only factor affecting suicide rates. The article you cite provides virtually no information on how the availability of guns, especially because guns are generally much less available in Europe than in the US. Still, about 30% of suicides in Switzerland are committed with guns. Virtually every country has its own culture around guns and around suicide. Very obviously in the case of Japan with high suicide rates and even ritualistic ways of suicide. Therefore it is impossible to isolate the effect of gun ownership just by looking at different countries. And "not being the primary way of suicide" is a really weak argument against tightening gun controls to save people's lives. Even if it is "just" 10% in Europe, 30% in Switzerland and about 50% in the US. Those lives are very much worth saving, and at least in Europe, it's already the norm to take away guns from people who have these problems. Gun advocates often cite Switzerland as a country with very responsible gun owners. Still, if you compare the rates of gun suicides, accidents and murder to their smaller population, it's still quite shocking. But those stories rarely make news abroad.
- Theodores 7y agoThe other day a lady jumped off the bridge in a suicide attempt. A passing tourist dived in and rescued her from the river below, someone else went out on a paddle-board to rescue the pair of them and the air ambulance arrived shortly thereafter to take her to the hospital. The river is tidal and not always that deep. Luckily she didn't jump at low tide when she could have broken her legs or ended up crippled for life. As it happened she ended up in the mental health ward. I imagine they will put her on drugs such as lithium and she will lose her mind. Or they might find they have no reason to keep her in and she might discharge herself to try again. However, if she had crippled herself then she would not be able to attempt the same thing - jumping off the bridge. But her body would be a living reminder constantly with her of a failed suicide attempt. There would be some impostor syndrome going on with that, people going the extra mile for her due to her being disabled, not through birth or accident but through a failed suicide attempt. Due to the nuances of a suicide attempt I am not sure that the statistics in this article have much real meaning. Also, what comprises an attempt? A walk into the woods where no rope gets hung from any branch is still an aborted attempt if the intention on the first step was hanging. But actually jumping off the bridge is past that point of no return. There is grey area in this, the teenager taking too many pills can be put down as a 'cry for help' even if there is a point of no return being crossed. Survival is also a grey area, not just in terms of physical quality of life but mental. The mental health wards of a hospital will put people on pills that take out the high and low notes of someone's mind, turning them into a functional zombie. Survival needs to be qualified as not needing the harsh medication that goes with being processed by the authorities.
- hestipod 7y agoI am 45 and am 99% sure I won't make it to 46. This isn't some unexplained "out of nowhere" ideation. It's a consequence of being beat down and taken from over and over, then having to make due with less and less, rinse, repeat. There is a breaking point. In my experience most suicidal people I come across are so because of the same chronic loss and suffering. Pills and therapy and hotlines don't help. They are plasters ignoring root causes. Root causes take time and money and that's too much to ask. I posted over a year ago in a desperate attempt to find a job that I could do despite all my issues. I'd been fighting for that for years. Because there is no social system where I am, not one that helps people. Culture here is about bootstraps and anyone who doesn't pull them or have them is a mooch loser who "deserves" what they get. I couldn't get myself anywhere better because of my issues. So I had to try and make due in the same grind but with far less ability and energy. One kind soul, the only one in all this time, offered such a job and I tried to get there, things got worse for me from a few sides and I slid back and couldn't go. I am still TRYING and hoping, but hope isn't enough. You have to be able to act, and the ground has to stay under you and not collapse. We all know how difficult work and earning can be even when we are young and healthy and love what we do, imagine doing it when in constant pain, with no family who loves you, with no access to high quality medical care. Imagine seeing everyone around you grind and be exhausted and not having the opportunity and endurance they do. Not being able to go home and enjoy something after work because it takes all your mettle just to survive a day. I have taken to using HN to vent my feelings on this topic when it comes up, and probably sound like a one trick pony. I am not even sure I care anymore. I used to worry what impression I would leave. That I might upset someone or ruin an ally with my depressive state. It all seems like it is irrelevant now as I won't make it anyway. Years ago when I still had some shreds of bootstraps I couldn't get any help from people or systems. I am incredibly resentful because I believe I could have built something then to get through this life and do some good. Now I feel most of the time like I won't make it regardless. I feel only social support/financial security/medical access would even possibly give me a chance..and society and family have decided I am not "worth" that. My value has been recorded and notated. You cannot really beat a system like that. Once you lose you means to grind and become a drain on profits you become a thing to be disposed of rather than a person. Nobody WANTS to be in these shoes. Nobody CHOOSES it. Until next time...or not...
- 7y ago