"Attempted Suicides in Anorexia Nervosa
They are frequent and serious.
Suicide is the second leading cause of death in anorexia nervosa (AN), and the suicide rate is eight times higher among young women with AN than in young women generally. To better delineate the issue, investigators analyzed data from 413 participants with current or lifetime AN (95% female) who were enrolled in an NIMH genetics study.
Overall, 17% had made a suicide attempt. An attempt was significantly more common among those with binge-eating, purging, or both (21%–29%) than among those with the restricter subtype (7%).
Of all suicide attempters, 52% reported one attempt; 39% reported two to four attempts; and 9% reported five or more attempts. Fifty-five percent had required medical attention for their most serious attempts, and 47% were hospitalized. Also, 78% reported wanting to die, 57% thought that they would die, and 54% made attempts rated as moderate to extreme.
Impulsivity accounted for 49% of attempts, with the remainder somewhat or thoroughly premeditated (each, 25%). Seventeen percent reported concurrent alcohol abuse at the time of the worst or only attempt, 9% reported concurrent drug abuse, and 82% reported a concurrent depressive episode. After adjustment for depression, attempts were associated with other impulsive behaviors (e.g., self-injurious behaviors, shoplifting), excessive drinking, substance use, panic disorder, post-traumatic stress disorder, and cluster B personality disorders.
Since this study recruited from both clinical and nonclinical populations, the very high rates of severe suicidality in patients with AN, particularly of the binge-eating/purging subtype, are particularly alarming. Clinical studies of AN patients have reported even higher rates.
Clinicians assessing and treating these patients should be alert to the constant risk for suicide, particularly among patients with indications of impulsivity and the other comorbid conditions identified here.
Joel Yager, MD"
Published in Journal Watch Psychiatry on May 23, 2008
Citation(s): Bulik CM et al. Suicide attempts in anorexia nervosa.
Suicide Is Not Painless
The Downside of Suicide
By Nancy Schimelpfening, About.com
"Guns aren't lawful;
Gas smells awful;
You might as well live. "
Dorothy Parker (1893-1967): 'Resume' (1937)
"If the topic of suicide seems particularly gruesome or morbid, that's because it is meant to be. Suicide is not a fool-proof or painless proposition. The fact is that suicides fail and even when they succeed, it may not be at all like what you had imagined.
Even the Best Planned Suicide Can Fail
In 16% of cases where patients tried to kill themselves with drugs prescribed by a doctor, the medication did not work as expected.
Technical problems or unexpected side effects occurred 7% of the time.
Problems occurred so often that in 18% of cases a doctor had to intervene to ensure death.
Even when a doctor performed the procedure, patients took longer to die than expected or awoke from a drug-induced coma that was meant to be fatal in 6% of cases.
Suicide is Not Pretty
When you die, you lose control of your bodily functions. To put it nicely, you defecate and urinate on yourself.
If you have taken an overdose, you may vomit before you become unconscious.
Violent forms of suicide such as cutting ones wrists, hanging or gunshots leave a very grisly task for whoever has to clean up afterwards.
Victims of strangulation and hanging will be bloated and purple.
Your chosen method of self-annihilation may present a safety hazard to whoever finds you.
The High Cost of Living
So what are the consequences if you survive a suicide attempt?
The best is that you will live to discover the truth about depression: that it really is a temporary condition. Circumstances change and medications work. The old saying that suicide is a permanent solution to a temporary problem is sage advice. When the blinders of depression are lifted you see very clearly how true this is.
The worst result of a failed suicide is that you will be worse off than you were before.
Consider these facts:
If your brain goes without an oxygen supply for more than about three minutes, you will suffer permanent brain damage.
Gunshot wounds that miss will leave you with permanent disfigurement and disability.
Overdoses on many substances will leave you with damage to kidneys and liver.
People who have swallowed caustic substances like lye can survive with severe burns to their GI tract.
Just about all suicide methods have the risk of severe, possibly prolonged pain if things go awry.
The Hurt Doesn't Go Away After Suicide
Perhaps the most common reason people commit suicide is to stop the pain the are feeling inside. The thing is, the pain doesn't go away. It gets transferred to those you love. Your parents, your spouse or significant other, your kids, your friends and acquaintances. Everybody you know is touched to some extent by suicide.
Grief is one of the strongest emotions a person can feel. Do you really want to make your loved ones feel the sort of pain you are feeling? Think about it. If you are convinced that people will be better off without you, you are dead wrong.
It's Your ChoiceThis article is not meant to be an all-inclusive list of reasons why you should not take your own life, but is meant to give you a starting point in really thinking about what it is that you are considering.
If you are reading this, then you are an intelligent person who is capable of making informed choices about where you want your life to go. Do you really want your life to end? Or just the pain?
Depression is a treatable illness. If what you really want is relief from your depression then you owe it to yourself to exhaust all of your treatment options before choosing the final solution of death.
Warning Signs of acute risk for suicide
Talking About Dying -- any mention of dying, disappearing, jumping, shooting oneself, or other types of self harm.
Change in Personality -- sad, withdrawn, irritable, anxious, tired, indecisive, apathetic
Change in Behavior -- can't concentrate on school, work, routine tasks
Change in Sleep Patterns -- insomnia, often with early waking or oversleeping, nightmares
Change in Eating Habits -- loss of appetite and weight, or overeating
Diminished Sexual Interest -- impotence, menstrual abnormalities (often missed periods)
Fear of losing control -- going crazy, harming self or others
Low self esteem -- feeling worthless, shame, overwhelming guilt, self-hatred, "everyone would be better off without me"
No hope for the future -- believing things will never get better; that nothing will ever change
Other things to watch for: Suicidal impulses, statements, plans; giving away favorite things; previous suicide attempts, substance abuse, making out wills, arranging for the care of pets, extravagant spending, agitation, hyperactivity, restlessness or lethargy.
If you feel you can't go on, please give yourself a chance to get help by either calling the suicide hotline numbers or clicking on the links listed below:
National Suicide Hotlines USA
United States of America
Toll-Free / 24 hours a day / 7 days a week
Many thanks to Sherrie of pinch of... for bringing the Anorexia Nervosa/Suicide study to my attention.