Behavior Patterns of Attempted Suicides

Medical Reviewer

Over the past week or two suicides have been reported as a direct result of names being disclosed by users of the Ashley Madison website. This particular website deals in infidelity. But when hackers decided to disclose the personal information of its users I wonder whether they fully realized the fatal consequences. Perhaps they anticipated guilt and remorse – but suicide? The suicide note left by a father of two outlined his regret at being unfaithful, the ‘certainty’ of his marriage breakdown and the likely loss of his job. I’m not in the business of passing moral judgments on behavior but I do find it incredibly sad that this and other lives ended in this way.

During 2012, the World Health Organisation estimated that 800,000 suicides occurred worldwide. It’s probably fair to say that such extreme acts are outside of most people’s understanding. How many of us are really sensitized to the possibility of another person ending their life? What are we supposed to look out for?

It is often only with hindsight that we might come to realize that the warning signs of a suicide attempt were there to be seen, but it isn’t always the case. The sad fact remains that we know relatively little about why suicide happens. There are checklists that illustrate some of the warning signs, yet people are constantly caught unawares because they misread or misunderstood the depths to which a person was feeling.

A recent study by the European College of Neuropsychopharmacology (ECNP) concluded that certain characteristic patterns of behavior often occur before attempts at suicide are made. The study, which involved 2,811 patients of which 628 had previously attempted suicide, said the risk of attempted suicide was 50% higher if a depressed person displayed risky behavior such as reckless driving or promiscuity, agitation (pacing, wringing hands), or impulsivity. Another signal is depressive mixed states, that is, depression corresponding with excitation or mania.

Signs and symptoms already well established include people becoming very withdrawn or anxious. Other signs include the way a person talks and behaves and the mood they are in. The content of talk, for example, might include statements to the effect the person feels trapped, burdened or simply sees no particular reason to live. I’ve mentioned risky behavior and agitation but other behaviors might include visiting or calling people to say goodbye, checking the internet for ways to commit suicide, giving away possessions and becoming ever more isolated. Moods can vary from anxiety, to depression, to fury, to complete loss of interest in everything and everyone.

Overall, it’s a complex pattern. Some suicides are carefully planned whilst others appear more spontaneous. Some we see motives and others we don’t. Perhaps in some circumstances there’s little we can do, but maybe in others we can. We certainly need to understand suicide more.

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