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 in, both suicide 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 the causes of Bipolar Disorder.
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.1
The rate of suicides amongst Bipolar people is even higher than that for people who suffer from Schizophrenia.
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, from various backgrounds and treatment histories, 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 symptoms.
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 a rate that is still too high.
Lithium has a good track record of alleviating symptoms, which ultimately prevents Bipolar suicides. It is also the preferred medication due to patients experiencing less weight gain while on the medication.
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
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 display warning signs first.
Myth 2: If a person decides to commit 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-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 rate 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.
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, sleep disturbance, which is a classic trigger of and a warning sign for mania.
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 your pets, letting your boss know you need some time off, or setting aside some additional time for self-care. 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.2
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.
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.
In the US general population (not just among Bipolar people), women are 3 times more likely than men to attempt suicide. However, nearly 4 times more men than women actually kill themselves indicating that the methods used by men are more lethal and tragically result in a completed suicide.
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!
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.
No way! I have taken lithium (1050 mg/day) for 37 years and I still find myself with a loaded shotgun in my mouth, or standing on the edge of a cliff, or playing Russian roulette on occasion. Are you saying lithium won’t stop me from putting the shotgun in my mouth, but will stop me from pulling the trigger?
ECTs damn near killed me all on their own. ECT’s SUCK! They will destroy my engineering degree and laugh at me at the same time.
Agreed. Lithium Carbonate sucks.
Lithium is a horrible archaic drug. It caused me to have neurological problems. I had slurred speech and was walking into walls. My uncle took it for decades and has Parkinson like symptoms. Harsh dangerous meds like lithium cause side effects that make people want to die even more than they did before. Instead of dealing with the intense, excruciating mental anguish of bipolar they now have to deal with horrible, permanent physical damage on top of it. I have bipolar and didn’t take meds for 10 years and did pretty well with yoga and meditation until I got really stressed recently. I should have trusted my instincts and not gone back on meds but I was desperate and now I have permanent tardive dyskensia. There was a study that showed people who took psychiatric medicine had more psychotic breaks with their illness than those who did not. Please edit and remove the outdated information on lithium. The studies that were done on the med are outdated and didn’t have a good reliable sample.
I think stress is a key factor – no matter the source. i’ve been diagnosed BP 23 years and have been faithful to my meds (Depakote and Wellbutrin) with just one lapse after a new doc said he didn’t think I was BP but just ADD. I learned doctors are fallible the hard way. He was wrong and I returned to my meds after a 6-month hiatus. I’m on them for good now. I run a company in a highly volatile industry and it seems since I hit my early 50s I’ve lost a lot of tolerance for stress (maybe because I’ve become more risk averse). Anyway, I was over it all back in December of ’15 and woke up in a psych unit after my first (only and hopefully last) suicide attempt. I was never so relieved to get home after living in a hospital gown for a week and communing with other broken souls. But, the grim thoughts returned. Journaling has helped quite a bit. In my darkest moments I can go back and see my cycles unfold on the pages and take at least a modicum of comfort in the fact that the sun will rise again. For me it always has. Wishing peace and good living for all those reading this page. I know you’re suffering at some level. It can get better.
I agree that “Stress” or the inability to be able cope with it, is definitely a key factor for me.
Excessive stress, yep. For me, a sudden burst of stress will tear down my resilience barrier and allow the floodgates of hell to consume me entirely. On the bright side, it makes life more interesting.
Suddenly stopping lithium increases the risk of suited tenfold. Antidepressants are one of the leading causes.
Lithium is poison. I took it when I was in a good phase. Change of mediactions indicated by my doc. It was the worst experience. Within 3 days I was totally suicidal. At the 7th day I was ready to throw myself at the rails of metro….
I had a clear moment and didn’t take Lithium that very evening and alas the next morning, no suicidal thoughts….How can that happen?
Eight years ago, at the age of 45, I finally found a psychiatrist who diagnosed me correctly with bipolar disorder and started me on lithium carbonate as the main drug in a cocktail of meds (5 in all, small to tiny doses of everything else.) The lithium has been a godsend for me. Subsequently my kid dropped out of uni, my husband divorced me, my business went belly-up. So now I’m unemployed and nearly broke. Oh, and somehow we got bed bugs in the middle of all that (They’re gone now.) All in all, it is stress like I’ve never seen before, but the lithium has kept me sane. I feel blessed; I know it doesn’t work for everyone.
I overdosed and went into respiratory arrest for a whIle & had to be tuned and put on life support for 2 days, this was a few mths ago..I spent 5 wks in a psych ward, for the 1st 19 days I was manic as and screamed for mood stabilizers to bring me down but was ignored…I was finally given lithium & seroquel…but i am suss that the lithium is making me more suicidal! & its causing severe trauma to my thyroid…I want to try tegretol..any comments? Since I “died” I am so unfeeling and blank…
I take Lithium and lamotrogine, I think about death everyday, I go to sleep at night hopping I dont wake up.
My wife is a nurse and she can’t seem to understand what my condition is all about. she will do and say things that upset and stress me out every day.
After 10 years of living with someone you will know exactly what to do and say to upset that person and what to say to make them happy.
Yet she will always do the same thing over and over, causing me a lot of stress, I bought her a house and asked her to leave, she wont go.
I don’t know what to do, its too much for me, I have Bipolar and my wife is completely insane, its not going to end well.