Suicide

Very few events generate as much sentiment in family members and friends as suicidal actions. Only the person involved in suicide suffers greater emotional turmoil. What often is perceived as being the severest form of auto-aggression--death by suicide --is in reality an attempt to escape psychic pain. In 2001, suicide took the lives of 30,622 people (http://www.cdc.gov/ncipc/factsheets/suifacts.htm). Suicide appears to be the only option left for people who, after trying to solve life's crises, find themselves in an untenable situation (Pahl, 62).

It is important to articulate the psychological and biological factors that predispose one to suicide and precipitate the actual attempt. It is extremely discouraging to note at the outset that current suicide prediction and prevention practices are an inexact science at best. While there are many individuals who would be considered at high risk for suicide, few of them actually end up as completed suicides. If society took the approach of hospitalizing every one of these potential suicide victims, there would not be enough hospital beds left to care for the nation's sick. Psychiatrists are confronted with the daunting task of trying to predict which high-risk individuals are at imminent risk for attempting suicide. Most patients are actively suicidal for only 24 or 48 hours at most, even if they fit a high-risk profile. Psychological risk factors that have been evaluated in the past for their association with suicide include age, sex, race, religion, occupation, marital status, a past suicide history, and physical and mental health. More recently, chemical messengers of the brain have attracted considerable research attention. Multiple risk factors may coexist in an individual, presumably increasing his or her over-all risk. The relative contribution of risk factors varies with the age and particular situation patients find themselves in prior to the attempt (Pahl, 62).

The patient who repeatedly attempts suicide represents a particularly vexing management problem. It is a myth that these patients never actually will carry out their threats. Many of them suffer from borderline personality disorder characterized