The most horrendous consequence of depression is suicide. Of the 30,000 people who reportedly end their lives in the United States each year, most suffer from depression. However, since not all suicides are known (some are hidden due to stigma fears, and besides, many accidents may actually be the result of suicide), the number of actual suicides seems to be approaching 50,000 a year. The number of people who tried, but could not commit suicide, is estimated to exceed the number of registered suicides by anywhere from 2 to 8 times (Shneidman, 1985).
Women attempt suicide about 3 times more often than men, but men are more likely to succeed in an effort to kill themselves. A greater number of suicide attempts among women may be due to their higher incidence of depression. The fact that men are more successful in their attempts is connected with the choice of the method. Until recently, women tended to use insufficiently lethal means, such as cutting veins on their wrists or a large dose of sleeping pills; men are more likely to use firearms, carbon monoxide fumes, or hang themselves. However, with a noticeable increase in the number of women with weapons, suicide took first place among women with it (Wintemute et al., 1988). As a result, the proportion of fatal outcomes among women has changed. When using firearms, success reaches 80% of attempts, while using drugs and poisons only 10% of attempts are fatal – a strong argument against having weapons in the house.
Among the reasons for attempting suicide, depression, loneliness, poor health, marital problems, and difficulties with money and work are most often cited (Petronis et al., 1990; Shneidman, 1985).
The highest number of suicides has traditionally been and still remains among the elderly, but in percentage terms, the proportion of such people is decreasing. The proportion of suicides of teenagers and young adults (traditionally low), on the contrary, is growing. The number of suicides among people aged 15 to 24 years in the United States over the past 40 years has increased 4 times. During a recent nationwide survey of high school seniors, 27% of them reported that they “seriously thought” of committing suicide, and every 12th said that he really tried to do it (Centers for Desease Control, 1991).
College students kill themselves twice as often as non-students of the same age (Murphy & Wetzel, 1980). An increased proportion of suicides among college students has been found not only in the United States, but also in Europe, India and Japan. The growing despair among college students has a number of possible reasons: the need for the first time to live away from home and cope with new problems; an attempt to lead in academic performance with stiffer competition than at school; fluctuations in career choices; loneliness due to the absence of old friends and anxiety due to new ones.
Studying the life and school affairs of college students who committed suicide showed that they were more sullen, kept stricter and more often depressed than their more prosperous fellow students. They also periodically informed others about their suicidal intentions. The main triggering event seems to have been concern about school, physical health, and difficulties in dealing with others (Seiden, 1966). However, there is no certainty that it was precisely these factors that led to suicide, or that educational and interpersonal problems took second place in relation to severe depression.
It is possible that, before entering college, students who conceived suicide never learned to cope with personal problems and emotions. In one study, for example, it was found that students with suicidal thoughts were no more stressful than other students, but they had less power to cope with problems and strong emotions (Carson & Johnston, 1985).
In college students who commit suicide, academic performance is higher than average, whereas in teenagers who committed suicide, academic performance in secondary school is extremely poor. Suicidal adolescents were usually excluded from school or had behavioral difficulties, although some were academically gifted and felt a desire for perfection and the need to remain among the first in the class (Leroux, 1986).
A distinctive feature of adolescents who have attempted suicide is social isolation: they considered themselves lonely, most parents divorced, many parents drank, and parental affection was weak (Berman & Jobes, 1991; Rohn et al, 1977).
In addition to depression, the main factor contributing to suicide was addiction to drugs. For example, in one study, 283 cases of suicide found that almost 60% of the dead were drug addicts, and 84% had an addiction to alcohol and other drugs (Rich et al., 1988). It is unclear whether drug addiction caused these people to be depressed and caused their death, or whether they resorted to drugs as a remedy for depression and killed themselves when it did not help. But in many cases, drug addiction preceded psychological problems.
Young suicides who committed suicide (up to 30 years old) had strong interpersonal conflicts, the loss of a marriage partner or a romantic partner in the weeks preceding suicide was more common than expected. Perhaps they felt that they had lost their only support in life. And if their personal powers were not undermined by drugs, they could cope with stress without resorting to suicide.
Some commit suicide because they are not able to endure their emotional suffering and see no other solution to the problems that have fallen on than death. Their only motive is to end their lives. In other cases, the person does not really want to die, but seeks to impress others with the seriousness of his problems. The suicide attempt in this case is motivated by the desire to talk about their despair and influence the behavior of others. An example is a woman who takes a strong dose of sleeping pills, because her lover threatens to leave her, or a student who does the same when his parents demand more than his abilities allow. Such a suicide attempt is a cry for help.