“Killing yourself is a major commitment, it takes a kind of courage. Most people just lead lives of cowardly desperation. It’s kinda half suicide where you just dull yourself with substances.” – Robert Crumb
Suicide is the 10th leading cause of death in the US for all ages. It is much more prevalent with males who account for 79% of suicides. Every day, approximately 105 Americans die by suicide. Worldwide over 800,000 people die by suicide every year. (Suicide Awareness Voices of Education). Yet compared with other life threatening conditions there has been scant research on how to identify potential suicide attempters and reduce suicidality.
Depression and other mood disorders are the number-one risk factor for suicide, but alcohol and drug abuse – even without depression – are a close second. In fact, research has shown that the strongest predictor of suicide is alcoholism, not a psychiatric diagnosis. People with substance use disorders are about six times more likely to commit suicide than the general population. To make matter worse people with substance abuse are often incarcerated. In prison suicidality is even higher than outside. It is not the primary effects of the substances that promote suicide as the likelihood of suicide does not decline after complete withdrawal from the drugs or alcohol.
So there is a great need to study suicidality especially in conjunction with substance use disorders to identify predictors and potential methods to prevent actual suicide attempts. In today’s Research News article “Trait Mindfulness, Reasons for Living and General Symptom Severity as Predictors of Suicide Probability in Males with Substance Abuse or Dependence”
Mohammadkhani and colleagues studied incarcerated and outpatient substance abusers and measured mindfulness, psychiatric symptoms, reasons for living, and suicide probability. These groups were indeed high risk as 36% of the outpatients and 42% of the incarcerated participants had attempted suicide. They found that the strongest single predictor of suicide probability was the severity of the individuals’ psychiatric symptoms and the second was fear of social disapproval. Importantly, they found that the higher the level of mindfulness, the lower the probability of suicide.
These findings are interesting and suggest that mindfulness training might be an effective intervention to lower suicidality and the risk of attempting suicide in the high risk population of substance abusers. Of course, a randomized clinical trial is needed to establish effectiveness.
The findings also raise interesting questions as to why mindfulness might be an antidote to suicidality. There are a number of known effects of mindfulness that might account for its negative association with suicidality. Mindfulness has been shown to decrease psychiatric symptoms and depression, the leading causes of suicide attempts. Indeed, they found that high mindfulness was associated with lower levels of psychiatric symptoms. Mindfulness also improves emotion regulation allowing the individual to respond more adaptively to sometimes overwhelming emotions. In addition, it is known to reduce physiological and psychological responses to stress which might lower stress’ ability to prompt a suicide attempt. In addition, suicide is often associated with hopelessness about the future. Mindfulness by increasing focus on the present moment lowers worry and rumination about the future and may thereby reduce the likelihood of a suicide attempt. Finally, mindfulness is known to help prevent relapse after successful withdrawal from addiction and this may make the individual more hopeful about the future.
Regardless of the reasons, mindfulness appears to be able to buffer the individual against the forces that can promote and prompt suicide.
CMCS – Center for Mindfulness and Contemplative Studies