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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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