When we try to prevent suicide by an individual or throughout a group of people, knowing why a person arrived at the point of committing suicide is valuable. We know many of the risk factors for suicide including social isolation, recent discharge from the military, depression, post-traumatic stress disorder, traumatic brain syndrome, history of being bullied as a child, and more. We also know that when we can engage with a person at risk of suicide, reduce their isolation, get them effective treatment for their PTSD, or help alleviate their depression these things help. Something that is also important to understand is whether the person has made a decision to end their life and is planning how to do it or if they are acting on a momentary impulse.
How Many Suicides Are Planned?
The issue of suicide brought about by impulse versus planned suicide has been studied. Research figures indicate that about half of suicides are driven by impulse and about half are though out in advance. Researchers have reviewed the histories of many of these individuals and tell us that there is no significant difference in mental health issues between the two types of suicide and not significant difference in number of prior suicide attempts. What is different is that those who plan a suicide are generally older, have more heath problems and more serious health problems. Those who act on impulse are generally younger, have fewer illnesses and less serious illnesses, and are typically not married. To the extent that information is available, those who attempt suicide on an impulse tend to have less frequent thoughts of suicide and less intense thoughts of suicide prior to their attempt.
Which Type of Suicide Attempt Is More Likely to Result in Death?
What research tells us in this regard is that people who have more severe suicidal ideation, are older, have more serious illnesses, and have planned to commit suicide are more likely to succeed in killing themselves and, if they do not succeed, are more likely to cause more physical harm to themselves than those who are younger, have fewer health issues, have less intense suicidal thoughts, and act on impulse.
Preventing Impulsive Versus Planned Suicide
If we are going to succeed in reducing the incidence of veteran suicide or suicide throughout society our efforts need to be accurately targeted. The issue of impulse versus planning in suicide is such that we need to look for different risk factors and different types of intervention for each group. Research tells us that depression and especially a major depressive disorder is common in both impulsive and planned suicide. So are interpersonal conflicts. What is different between the two groups is that with individuals who plan a suicide are more likely to be depressed and to have much more severe depression. Individuals whose suicide attempts are driven by impulse are less likely to be severely depressed and much more likely to have experienced an interpersonal conflict that drove their impulse to end their life.
At No Fallen Heroes we have been especially excited about the impressive results seen with the use of psychedelic medicines for treating suicide risk factors. PTSD, depression, and substance abuse disorders all significantly increase the risk of suicide. The use of psychedelic medicines psilocybin and MDMA as adjunctive therapy along with psychotherapy or coaching significantly improves these conditions. It would appear that the most important group to target with this approach would be those who are older, more severely depressed, have more physical ailments, and tend to plan their suicides.
Social isolation, recent discharge from the military, and trouble in or breakup of a relationship are all significant suicide risk factors. These occur in younger people who are having relationship issues and who are at greater risk of an impulsive suicide attempt. While treatment of depression, substance abuse, or PTSD in these people can be important it would appear than social connection, help sorting out relationship issues, getting a job, and successfully reintegrating into civilian life are more likely to reduce suicide attempts.
At No Fallen Heroes we are dedicated to reducing and eliminating veteran suicide and all suicides by all means possible and this includes accurate targeting of all efforts in this regard.
