Bipolar Suicides

Most suicides can be prevented. The statistics on bipolar suicides are very distressing so I want to give you the good news up front. Please keep in mind two things:

1. Dramatic reductions, both for attempts and completions, is one of the most striking impacts of lithium and other effective mood stabilizers

2. Interventions DO WORK and there is nothing inevitable about bipolar suicide, even in the most depressed or at risk individual.

Stress is often an IMPORTANT SUICIDE PREDICTOR. This is crucial to understand, given the role of stress in causes of bipolar disorder.

Suicide statistics

Never doubt the risk of bipolar suicide. Many studies indicate a 15% rate of suicide amongst individuals with bipolar disorder. This rate is about 30 times higher than than that of the general population.

The rate of suicides amongst bipolar people is even higher than that for schizophrenics.

Some studies have come up with rates as high as 30%-50%.

More recent studies, however, have been finding lower rates. There are two reasons for this. The first reason is that now studies tend to take in a wider range of bipolar people, whereas earlier studies focused on patients who were already hospitalized. The second reason is the increase in the use of lithium and other medications that effectively treat bipolar.

The absolute most conservative figure suggested for patients diagnosed today is AT LEAST a 5% lifetime suicide risk. This is a fabulous improvement and a great testament to the power of lithium for treating bipolar, but it is still too high.

Reminder

Lithium has a good track record of preventing bipolar suicides.

One way to keep an accurate picture in your mind of the danger is to know that a suicide attempt is made each minute of every day.

Different studies come up with different statistics. This 2005 symposium presents a good overview of some of the issues: Bipolar disorder is a potentially fatal disease.

Bipolar suicide myths

Bipolar suicides are still way too common.

Some popular misconceptions are especially harmful and contribute to these high rates for bipolar self injury.

In particular, please remember THESE ARE ALL MYTHS:

Myth 1: people who talk about suicide won't really do it. Reality: Most suicidal people give clues and warnings first.

Myth 2: If a person decides to suicide, nothing is going to stop them. Reality: What most of these people are seeking is relief from their suffering. They can be diverted from death if other options are presented convincingly.

Myth 3: Suicidal people are unwilling to help themselves or to seek help. Reality: One study found that 70% of those who completed their suicide had been in touch with a doctor within the previous month, and nearly 50% within the week before their death. Each year 6%-10% of suicides actually occur within hospitals.

Myth 4: Talking about suicide may give someone the idea. Reality: If you are worried about someone, asking them directly if they are considering self-harm, and talking about it openly, is the most helpful thing to do.

Caring for loved ones

What do you do if you are afraid that a loved one may harm themselves?

This is often a particular concern in relation to bipolar kids.

1. Take the situation seriously.

2. Talk to them directly and candidly about suicide and don't be afraid to ask them if they are considering harming themselves.

3. Involve other people such as their therapist, psychiatrist or emergency services.

4. Urge treatment with lithium in preference to other mood stabilizers as lithium is the strongest protective medication against suicide.

5. If the threat seems urgent or immediate, consider taking the person's car keys, cash and credit cards until the crisis has passed.

6. Get informed. Read the DBSA (Depression and Bipolar Support Alliance) short brochure Suicide Prevention and Mood Disorders.

Caring for yourself

Write out the Suicide Hotline number and keep it in your wallet or purse and taped somewhere prominent at home:

The National Hopeline Network 1-800-SUICIDE11-800-SUICIDE1-800-SUICIDE800-SUICIDE provides access to trained telephone counselors, 24 hours a day, 7 days a week.

It is critical to take your medication. Lithium decreases the likelihood of suicide by a factor of more than 7 times.

(Even though Depakote is the most prescribed mood stabilizer in the US, a 2003 research study by the George Washington Medical Center in Washington, D.C., found that the risk of completed suicide death was nearly 3 times higher during treatment with Depakote than during treatment with lithium.)

Read more here: Lithium Best to Stop Bipolar Suicide.

Know yourself

One of the most important things we can do to manage our own bipolar condition is to know our own triggers and stressors and keep on the lookout for them

In August 2007, researchers in Melbourne, Australia announced dramatic success with a 12 week program that halved bipolar relapses. (Read more here.) This is significant in relation to bipolar suicides, because rapid cycling, or recent onset of either a depressive or manic episode, are two of the strongest acute risk factors for bipolar suicide.

Therefore anything that prevents cycling or onset of episodes will also prevent suicide.

Full details are not available from the initial press releases - what we do know is that this is a groundbreaking behavioral treatment. The new program is the first course in the world to halve participants' depressive episodes and cut manic relapses completely.

The key to the program is recognizing the early warning signs, for example the classic trigger of sleep disturbance.

Once those signs are picked up, medication may be increased and a reduction in stress is crucial. This may involve small but significant stress reducers like asking your partner to look after the pets. Even such seemingly trivial stressors are cumulative and must be controlled.

One way we can all adopt these strategies right now is through the use of a Bipolar Mood Chart.

A bipolar mood chart is a simple, patient driven tool that requires only a few minutes a day to complete. However, mood charts are extremely powerful and effective.

Bipolar mood charts provide a visual image of how important pieces of information such as mood, medication, and life events all fit together.

Suicide risk factors

Recent research has overturned much of the conventional wisdom about risk factors for bipolar suicides.

Traditionally it was believed that suicidal ideation, suicide attempts, and feelings of hopelessness were THE MAIN PREDICTORS. More recent studies paint a different picture.

In a way this is good news as many of the acute risk factors for bipolar suicide are very treatable:

1. Recent onset of mixed states.

2. Recent onset of mania or depression.

3. Rapid cycling.

4. Severe anxiety.

5. Panic attacks.

6. Pronounced agitation.

7. Severe insomnia.

8. Recent alcohol abuse.

9. Loss of pleasure in normally pleasurable events like eating, and socializing or sex.

10. Recent or anticipated loss of job, personal relationship, financial loss or criminal or legal proceeding.

11. Acute psychosis, especially featuring command hallucinations, paranoid fears of punishment, or delusional guilt.

Many studies indicate a 15% rate of suicide amongst individuals with bipolar disorder.

Protective factors against bipolar suicide

1. Restricted access to highly lethal methods of suicide.

2. Children in the home; sense of responsibility to family.

3. Pregnancy.

4. Strong religious beliefs.

5. Life satisfaction; reality testing abilities.

6. Positive coping and problem-solving skills.

7. Positive social support.

8. Access and adherence to care, with a positive therapeutic relationship.

A VITAL FACTOR is medication. Lithium reduces suicide risk seven-fold, and lithium is nearly 3 times more effective than Depakote in preventing suicide. (It is also far cheaper and leads to much less weight gain.)

Gender issues

In the US general population (not just bipolar people), women are 3 times more likely than men to attempt suicide. However, nearly 4 times more men than women actually kill themselves.

For the bipolar population, bipolar women also attempt suicide more often than do men.

The difference is that in bipolar suicides, there is no clear predomination of male completions. In fact, the bipolar male suicide rate seems to be slightly lower than for women.

In other words, for suicide attempts the general population and the bipolar population show the same pattern - more women than men try to kill themselves. However, bipolar women are much more likely to complete their attempt, so in contrast with the general population, the rate for actual completed suicide is slightly higher for bipolar women than for bipolar men.

To everything there is a season

There are seasonal patterns for bipolar suicides. Deaths hit a peak in late spring/early summer.

Famous bipolar suicide quotes

I'm going to be a superstar musician, kill myself, and go out in a flame of glory . . . I want to be rich and famous and kill myself like Jimi Hendrix. - KURT COBAIN (1967-1994)

I'm not worried about what's going to happen when I'm thirty, because I am never going to make it to thirty. You know what life is like after thirty - I don't want that. - KURT COBAIN (1967-1994)

I don't like standing near the edge of a platform when an express train is passing through. I like to stand right back and if possible get a pillar between me and the train. I don't like to stand by the side of a ship and look down into the water. A second's action would end everything. A few drops of desperation. - WINSTON CHURCHILL (1874-1965)

[E]very seventeen minutes in America, someone commits suicide . . . Mostly, I have been impressed by how little value our society puts on saving the lives of those who are in such despair as to want to end them. It is a societal illusion that suicide is rare. It is not. - KAY REDFIELD JAMISON (1946- ) (From her book "Night Falls Fast")

If you liked these quotes, check out our page of Quotes on Bipolar, and keep scrolling!

Sources

Bipolar suicide

Our motto here at www.bipolar-lives.com is Fact NOT Fiction. The following authoritative text was used as the main source for compiling this page: Frederick K. Goodwin & Kay Redfield Jamison Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression, Oxford University Press, 2007.

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