What's the point in committing suicide?
Suicide (Suicide, suicide): Voluntary termination of one's own life through a self-determined act, often through hanging, shooting, an overdose of medication or by omitting a vital medication. In the 15 to 35 age group, suicide is the second most common cause of death (after accidental death), but in absolute terms there are ten times as many suicides over the age of 70. In Germany around 11,000 suicides occur every year, and 100,000–150,000 Suicide attempts. Three quarters of those who successfully commit suicide are men, and two thirds of those attempting suicide are women.
More than half of "successful" suicides are committed by the mentally ill, especially those who are depressed. But also addicts, old people, young people in the phase of separation from their parents' home as well as chronically and terminally ill people are at increased risk of suicide.
According to the suicide researcher Erwin Ringel, a suicide or attempted suicide is preceded by almost regular phenomena, which he calls presuicidal syndrome (Suicidality) can be described: The person concerned experiences a narrowing of personal possibilities on all levels and an associated hopelessness. He increasingly withdraws from his environment and develops aggression against others, but above all against himself, and is constantly occupied with thoughts of death.
Typical warning signs for preoccupation with suicide are:
- Sudden inexplicable calm and joy that can be interpreted as relief from the decision to commit suicide (presuicidal lightening)
- Writing a will
- Giving away things
- Collecting medication
- Blame against yourself
- Statements that life is pointless
- Talking about suicide, to be taken particularly seriously when specifying specific ideas and plans (80% of people who commit suicide attempt announce it in advance).
- Mention of strange voices who would have ordered the suicide.
Immediately when the described suicide warning signals are perceived.
If the patient is already in psychiatric therapy, the treating psychiatrist or psychotherapist is the right contact. If this is not available, the patient's general practitioner or the emergency medical service should be contacted.
Only a few suicides are real balance sheet suicides, in which a mentally healthy person takes stock of his life and then kills himself. Much more often, acts of suicide are short-circuit reactions that occur in the course of life crises or serious mental illnesses. The person concerned sees no other way out than "to break up". Usually there are only a few hours between the decision to commit suicide and its execution, and the direct “trigger” can be a banal argument - the famous drop that makes the (almost) full barrel overflow.
In the case of severe depression or psychosis, the doctor will review the therapy for this underlying disease and, if necessary, adjust the dosage or the choice of medication. A psychotherapeutic crisis intervention is rarely possible for the psychotically ill because the patients insist on their distorted view of themselves, their illness and the world.
In the case of non-psychotic patients, on the other hand, acute crisis intervention is most successful. It begins with the establishment of a relationship with the patient through an experienced therapist who breaks through loneliness and isolation. After attempting suicide, the person concerned often builds up a facade behind which he hides his problems. However, this makes it impossible to cope with the life crisis that triggered the suicide (attempt).
In accordance with the mostly correct assumption that the acute crisis was only the trigger, but not the actual reason for the suicide attempt, the patient's background must be discussed with the patient. For example, the reasons for the failed relationship or the loss of your job. Sometimes the affected person succeeds in making profound changes in their way of life. He usually needs long-term psychotherapeutic help in order to be able to withstand the crisis and ultimately overcome it.
If the person concerned is unwilling to therapy. If the patient does not consent to hospital admission - which is normally necessary - and if there is no legal possibility of hospital admission against the will of the person concerned (compulsory admission), the relatives only have one choice: They must try to create more security for the patient that he cannot take care of himself at the moment. The most important are:
- Continuous closeness, but without "crushing" the person affected
- Locking away all medicines, car keys and household toxins (e.g. pesticides and cleaning agents)
- Regular and emphatic attempts to bring people who are determined to die back into relationship with their environment.
It is useless to blame the patient (“You can't leave your children alone”). It is just as wrong to play down suicidal thoughts (“It's not that bad, it will be all right”). Such statements do not take the patient's desperation seriously and leave him alone.
- www.suizidprophylaxe.de - very readable website of the German Society for Suicide Prevention, Dresden.
- P. G. Quinett: There is something better than death. Herder, 2000. Advisory guide written in dialogue between “patient” and “therapist”, which takes up questions that concern suicidal persons (at night).
- M. Otzelberger: Suicide. The trauma of the bereaved. Experiences and ways out. DTV, 2002. Good and differentiated advice for relatives with a suicide case in the family, but also for those affected with suicidal thoughts.
AuthorsGisela Finke, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 14:25
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