Suicidality and Self-Injury

WHAT SUICIDALITY AND SELF-INJURY ARE

Suicidality involves the thoughts, urges, and behaviors associated with a wish or plan to take one’s own life. Suicide is a major public health problem. Suicide is the second leading cause of death in young people, and the tenth leading causes of death in the United States. Suicide rates are on the rise nationwide.

The pattern of chronic suicidality is similar to any other chronic condition. For some with chronic suicidality, the suicidal thoughts may increase in intensity and when they subside it is only temporary and then the thoughts return. For others, they may experience suicidal thoughts on a daily basis.

Warning signs for suicide are not always obvious and can vary from person to person.  However, a warning sign can include making statements about suicide such as “I am going to kill myself,” “I wish I were dead,” or “Everyone would be better off if I were dead.” A person contemplating suicide may take means to end his or her own life by hoarding pills or buying a firearm. He or she may search online for ways to end his or her own life. People contemplating suicide are often preoccupied with death, dying or violence and have hopelessness about the future. Those struggling with suicidal thinking may engage in high-risk behaviors, such as drug use or reckless driving. They may also withdraw from social contact and exhibit increasing isolative behaviors. 

A similar, yet distinct, behavior is called non-suicidal self-injury and includes any behavior that causes damage to the physical self without the intent to die (e.g., cutting or burning self). People engage in self-injury for a variety of reasons, including self-punishment, distraction, or to reduce feelings of numbness or detachment.

Fortunately, treatments are available that target both suicidal and non-suicidal self-injurious behavior. These treatments include both short-term and long-term goals. In the short-term, treatment involves learning more effective and less damaging coping skills for managing intense emotional distress. Over the long-term, treatment is focused on creating a life worth living.

ASSOCIATED CONCERNS

Suicidality and self-injury often co-occur with mood disturbance, anxiety and stress, perfectionism and shame, or traumatic experiences. When individuals have trouble coping with these symptoms, they may also use substances or struggle with anger management. 

EVIDENCE BASED TREATMENTS OFFERED

DBT has been shown to be the most effective form of psychotherapy to treat chronic suicidality. The individual treatment component of DBT focuses primarily on building a life worth living and working to increase the client’s motivation to live and to continue treatment. Along with individual therapy, group therapy is part of the treatment that teaches the skills needed to change and move toward acceptance of self and others.  Research performed by Dr. Marsha Linehan found that DBT can significantly decrease suicide attempts through use of learned DBT skills

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