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Suicide Among Women
Dr Trisha Macnair
I always enjoy reading the updates of my medical school yearbook. It's great
to hear about old friends reaching consultant status, having new babies and
embarking on fresh adventures. But this time there was sad news. One of the
girls, quiet but popular, had committed suicide. She left behind a family of
young children, a heart-broken husband and a flourishing career in general
practice.
The bleakness of clinical depression (www.rcpsych.ac.uk/campaigns/cminds/
leaflets/dep/depression.htm) can hardly be comprehended unless you have been
there, but what persuades someone to take that final step, to totally give up
hope, to feel so low that even your own children aren't something to live for? I
struggled to find any reasonable answers.
Suicides are decreasing among women
Around the world there are about 1 million suicides a year, including more
than 6,000 people in the UK and Ireland - that's almost double the number dying
from road traffic accidents. And around 1500 of them are women.
Although the number of young men driven to suicide has increased dramatically
over the past couple of decades, suicides among women have fallen substantially.
Perhaps women are simply better at expressing and dealing with their distress,
but the fall has been attributed to suicide prevention strategies, improved
social conditions and changes which have affected the way people try to commit
suicide, such as selling only limited amounts of paracetamol at a time (reducing
the risk of impulsive overdose) and catalytic converters on cars (this makes
suicide using car exhaust fumes more difficult).
Get an idea about what research going on into suicide at the Centre for
Suicide Research in Oxford at http://cebmh.warne.ox.ac.uk/csr.
What leads to suicide?
The factors that lead someone to take their own life are complex. There is
rarely one trigger alone although there may be an important 'last straw'.
People may be more vulnerable because of a genetic pre-disposition,
personality traits, and lack of support. In many suicides there has been a long
story of mental health problems, the main ones among women being depression,
eating disorders, and schizophrenia. Relationship problems are also frequent
among women.
Other factors include physical illness, alcohol and drug abuse, social
isolation, job problems? Even low cholesterol levels and the phases of the moon
have been implicated. But 1 in 5 suicides, especially among the young, show no
previous sign of emotional difficulties - just some sudden upset.
The final straw may be the end of an important relationship, having to face
up to debt or a court case, or simply an event which stirs the emotions. This is
particularly true for women. For example after Princess Diana's death there was
a 33% increase in suicides among women.
The increase was particularly marked among women of a similar age to Diana.
Deliberate self harm (DSH) also increased. It's thought that the Princess's
death may have made people feel worse about their own personal distress.
Can suicide be prevented?
Marriage and a strong religious faith appear to protect against suicide (but
are hardly things that can be prescribed or bought!)
The World Health Organisation have recommended six broad approaches to
prevention:
~ effective treatment of those with mental disorders ~ control of gun
possession ~ detoxification of domestic gas ~ detoxification of car emissions ~
control of availability of toxic substances ~ toning down of reports in the
media
The International Association for Suicide Prevention have a good general
background to suicide and how it can be prevented at
www.med.uio.no/iasp/files/guidelines.htm#challenge.
Attempted suicide more common in young women
Suicide is rare under 14, because young children lack ability or
understanding to act it out. But older children are much more likely to
impulsively consider suicide (info especially for young people about suicide at
www.rcpsych.ac.uk/info/mhgu/newmhgu29.htm).
However it is attempted suicide and deliberate self harm, rather than suicide
itself, which younger women resort to. At least 140,000 people in England and
Wales attempt suicide every year, and this number is rising dramatically,
particularly in the young.
This is not failed suicide but more of a 'cry for help' and it's most common
among teenage girls. However it's a mistake not to take it seriously. Many
repeatedly attempt suicide and about 1 in 100 will die by suicide within a year
of an attempt - this is a suicide risk approximately 100 times that of the
general population. Everyone who has tried to kill themselves - old or young,
female or male - needs to be assessed by a health professional, usually in
hospital.
http://www.bbc.co.uk/health/features/suicide_women.shtml


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