By Stacy Kess
Anecdotal stories have shown spring mirrors the pattern of depression: just as the risk of suicide rises as a person with depression begins to feel better, so does the risk of suicide when the weather begins to warm from the coldest months of the year.
But in Delaware, fall is the suicide season.
Between Monday and Wednesday, Delaware Police responded to five calls regarding suicide threats or attempts; when police responded to one of those calls, the victim was dead on arrival.
“Anecdotally there’s been that notion around for a long time that in the spring suicides increase,” said Max Lencl, the Suicide Prevention Program Director for Helpline of Delaware and Morrow Counties. “People who are severely depressed often don’t have the energy to cognitively plan or attempt suicide. (When they feel better) they have just enough energy to go through with that. There isn’t enough research to support that yet, but there is some statistics.”
Lencl said that overall, Delaware actually shows the highest rates of attempts and suicides in the fall, followed by the spring. Delaware Police spokesperson Capt. Adam Moore said statistically, it appears January and February are the months his officers have taken the most reports over the last two years.
Lencl said there is also a concern of talking about suicide in the media and whether it increases rates.
“When you’re talking about it from the media standpoint, it’s good to raise awareness about it,” he said. “But we have to be careful about talking about the impact it’s having.”
He said the media needs to be careful to present suicide as a mental illness issue, and never to give graphic details of suicides. He said there is some evidence that younger people, teenagers especially, will experience “contagion” from suicide presented graphically or if the media covers it in a way that shows the victim receiving a lot of sympathy. That could cause more impressionable youth to threaten or attempt suicide based on the idea that they too could get sympathy.
“It is OK for the media to talk about it, we just have to be careful,” he said.
What is most helpful, according to Lencl and resources such as the National Alliance on Mental Health and the American Foundation for Suicide Prevention (AFSP), is knowing the warning signs, who is at risk and intervening with help and support when necessary.
And prevention is key.
AFSP lists mental disorders, such as depression or bipolar (manic-depressive) disorder, alcohol or substance abuse or dependence, schizophrenia, borderline or antisocial personality disorder and anxiety disorders as a major risk factor. But a previous suicide attempt; family history of attempted or completed suicide; or a serious medical condition or pain can be just as dangerous.
That means help must be available before a person nears the point of contemplating suicide. Mental health experts are pushing for more education in recognizing symptoms of mental illness, early treatment of disorders that are considered risk factors and teaching better coping mechanisms for anxiety and depression.
Although teens are often the focus of suicide prevention campaigns, the Centers For Disease Control collected data, most recently in 2010, on suicide. More than 38,300 suicides were reported that year – the 10th leading cause of death in America.
That year, the highest rate of suicide was among people 45 to 64 years old, accounting for 18.6 percent of suicides. Adults 85 and older accounted for the second highest age group: 17.6 percent. Adolescents and young adults accounted for only 10.5 percent of suicides in 2010, a trend seen consistently across years of data by AFSP.
In 2010, the highest suicide rate (18.6) was among people 45 to 64 years old. The second highest rate (17.6) occurred in those 85 years and older. Younger groups have had consistently lower suicide rates than middle-aged and older adults. In 2010, adolescents and young adults aged 15 to 24 had a suicide rate of 10.5
According to the CDC, almost 79 percent of suicide deaths were men.
AFSP said there are no complete studies on suicide attempts, but that CDC reported nearly 465,000 people visited hospitals in 2010 for non-fatal injuries from self-harm behaviors. According to the AFSP, it is difficult to classify all such visits as suicide attempts versus non-intentional self-harm behaviors.
Since 2011, Helpline has been collecting follow-up data from callers who agree to participate in follow-up studies. In 2013, Helpline received a grant by the Substance Abuse and Mental Health Services Administration for a three-year follow-up study. The goals are to increase the understanding of warning signs, as well as to create protocols for first responders, crisis hotlines and clinicians on managing suicide risk.
Knowing the risk factors and knowing the warning signs is most important for everyone, Lencl said. Friends and family can often be the best person to see the warning signs and can talk to the person at risk one-on-one.
“You don’t have to be a psychiatrist or a psychologist to know these things,” he said.
Those highest at risk are those who have attempted before, Lencl said. The Journal of Suicide and Life Threatening Behavior estimates the chance of people who have attempt at least twice as having a 70 percent chance of completing suicide.
Warning signs include a feeling of helplessness or hopelessness; a sudden use or increase of use in drugs or alcohol; giving away personal items; making plans, settling things long put off or making a will; or a sense of guilt or feeling like a burden.
One warning sign that is often overlooked is a simple threat, Lencl said.
“But when a person makes a threat – I just want to end this or this is too much - it should be taken seriously,” he said.
That’s where Helpline and the National Suicide Prevention Lifeline come in. The line is anonymous and does not necessarily tell its clients to go seek help immediately. Sometimes, he said, it’s just a place to talk or help create a safety plan. Helpline can also refer callers to resources in the community.
Reporter Stacy Kess can be found on Twitter @StacyMKess.