Christmas, Depression, and Suicide

Medical Reviewer

It's a popular misconception that suicide rates increase over the Christmas period. In fact the evidence points in the opposite direction. This is encouraging news but the fact remains that, for many people, the Christmas period is often charged with negative emotions. However, once we move into January there is often a spike in the number of suicide attempts and actual suicides. In this Sharepost I'm taking a look at depression and suicide in a fairly general sense before going on to consider some of the factors around Christmas.

Although suicide is not uniquely associated with depression the fact remains that at least 50 percent of suicides, or attempted suicides, occur during an episode of depression. Rates of suicide vary considerably in terms of trends and nationality. Russia, for example, has one of the highest rates of suicide at approximately 40 suicides per 100,000 people per year. Greece, by contrast, may have as few as 4 suicides per 100,000. Roughly two-thirds of attempted suicides occur in young people under the age of 35.

Attempts at suicide during depression often occur as the person seems to be getting better. Such attempts are often impulsive and follow a period of very low motivation and usually deep depression. During the uplift from depression the sense of hopelessness continues but levels of motivation have actually increased. This helps to explain a seeming paradox where the most deeply depressed are actually less likely to attempt suicide than those with moderate depression.

Although three times as many women as men attempt suicide, three times as many men actually succeed. It is estimated that up to 60 percent of suicides take place following alcohol intake. Alcohol is as much a contributory cause of suicide as it is a vehicle to embolden people who have already decided on suicide.

According to Hawton (1997) over 70 percent of attempted suicides relate to difficulties in interpersonal relationships. Twenty-six percent had employment problems, 26 percent problems with children and nearly 20 percent financial problems. In adolescents, a higher proportion of homosexual males (up to 28 percent according to some sources) attempt suicide compared with around 4 per cent of heterosexuals.

Rates of suicide drop off as people get older but tend to spike again during old age. Loneliness and depression frequently follow the death of a spouse and men appear to have greater difficulties in coping with bereavement.

Various researchers have noted a dip in the rates of attempted and actual suicide just before and after Christmas, with Christmas Eve sometimes showing the lowest rates of all. Speculation as to why suicide rates decrease include the fact that many organizations like Samaritans, outreach programs, Salvation Army, etc step up their help campaigns. Also, the movement and engagement of families and friends changes and this may be sufficient to protect those who feel vulnerable. Then of course the individual may feel their own mood lift a little as certain pressures (work for example) are removed and the memories of happier times come to the surface.

The promise of a New Year holds up hope and optimism for some and abject misery for others. The so-called 'broken promise theory' is an attempt at explaining the mechanism behind the suicide rate increase; it goes like this. Christmas holds up a certain optimism that people will get together, presents will be exchanged, and a supportive and peaceful atmosphere will prevail. The reality is typically very different. The promise of Christmas quickly becomes dashed and despair resumes or is perhaps even amplified as a result.

There's little doubt that the festive season works for some and doesn't for others. Even the most capable and resilient people find certain aspects of Christmas stressful, even if it's just shopping or being stuck in traffic. For others the problems are deeper and more personal.

It's now easier than ever to find support quickly. If you are using the internet a quick search engine query using terms like 'suicide help' or 'suicide support' will instantly throw up a number of possible options.