Depression and Suicide
Depression and suicide affect the lives of millions of people every year. More than 17 million Americans suffer from depression each year, and around 15% of the U.S. population will have a depressive episode at some point in their life. 1 Struggles with depression are not limited to Americans: Every year, depression affects more than 264 million people worldwide. 2
In 2020, suicide was the 12th leading cause of death in the United States, claiming the lives of more than 45,900 people. There were nearly twice as many suicides (45,979) as homicides (24,576). 3
What is Depression?
Depression—aka major depressive disorder or clinical depression—is a mood disorder. People suffering from mood disorders experience emotional moods/states that are distorted in some way. For instance, such moods may be inconsistent with their circumstances and interfere with their ability to function in their daily lives.
Everyone experiences occasional sadness when a loved one passes away, a cherished life goal is thwarted, or an injury or illness disrupts one’s life. This is a natural part of being human. It’s also natural to be able to restore feelings of peace, contentment, and joy.
Clinical depression differs from normal periods of sadness that come and go. People suffering from a depressive disorder experience ongoing and persistent feelings of sadness, hopelessness, and despair.
They lose interest in activities they once enjoyed. They may have every reason (objectively) to be happy yet cannot experience feelings of pleasure, contentment, or joy. Instead, their minds are engulfed in a heavy cloud of hopelessness, pessimism, and frustration.
How Depression Is Diagnosed
Psychiatrists and other mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to officially diagnose a depressive disorder. 4
To be diagnosed with depression, five or more specific symptoms must be present over the course of at least a two-week period. Among these five symptoms, at least one of them needs to be either (1) a depressed mood or (2) a loss of interest or inability to feel pleasure.
In addition, these symptoms must cause the person significant impairment or distress in social, occupational, or other crucial aspects of daily functioning. And finally, the symptoms must not be a direct result of substance abuse or another medical condition.
The DSM-5 symptoms that mental health professionals look for when diagnosing a major depressive disorder include the following, as reported by the client or objectively observed by others:
* Depressed mood most of the day, nearly every day. For instance, feeling sad, empty, or hopeless.
* Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
* Significant weight loss when not dieting or unintended weight gain; or a decrease or increase in appetite nearly every day.
* Sleep problems: Insomnia or hypersomnia nearly every day.
* Psychomotor agitation or retardation: a slowing down of thought and a reduction of physical movement.
* Fatigue or loss of energy nearly every day.
* Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
* Diminished ability to think or concentrate, or indecisiveness, nearly every day.
* Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a detailed plan for committing suicide.
What Causes Depression?
There are several ideas about what causes depression. The cause of a depressive disorder can vary a lot among different people. And for some people, it’s a combination of various factors/events that may cause depression. Some individuals may become depressed for no apparent reason.
The possible causes of depression or contributing factors include: 5
- Traumatic childhood experiences
- Difficult life events
- Other mental health problems
- Physical health problems
- Genetic predisposition via parents
- Medication, recreational drugs, and alcohol use
- Lifestyle: improper sleep, diet, and exercise
Is depression caused by low levels of serotonin and other neurotransmitters? 6 This question many people ask and may be a source of confusion. While depression may sometimes be correlated with chemical imbalances in the brain, the theory that such imbalances cause it has recently been challenged. 7
How Common is Suicide?
Both suicidal ideation—i.e., thinking about, visualizing, planning, or contemplating suicide—or actually attempting suicide is one of the symptoms of a major depressive disorder. But how common is suicide itself?
In the U.S., suicide is a major public health concern. In 2020, suicide was the 12th leading cause of death overall in the United States—claiming the lives of over 45,900 people. 8
The U.S. Centers for Disease Control and Prevention have reported that: 9
* According to a 2022 survey, suicide was the second-leading cause of death for teens and young adults ages 10-34. Suicide was the second leading cause of death among individuals between the ages of 10-14 and 25-34; the third leading cause of death among individuals between the ages of 15-24; and the fourth leading cause of death among individuals between the ages of 35 and 44.
* According to a 2020 survey, 25.5% of adults aged 18-24 seriously considered suicide in the past month. This is a higher percentage than any other adult age group.
* According to a 2021 survey, the suicide rate for people 13-30 years old has steadily increased from 2010 to 2018 (showing a decrease in 2019). This rate is higher among males of all racial/ethnic groups, particularly American Indian males.
Warning Signs of Suicidal Behavior
Suicide is complicated and tragic—but is also often preventable.10 Knowing the warning signs of suicidal feelings, thoughts, and behaviors can help save a person’s life.
Some of the signs and symptoms indicating that a person may be at risk of attempting suicide include: 11
- Talking about feeling empty or hopeless or having no reason to live
- Talking about feeling trapped or feeling that there are no solutions
- Changes in eating and sleep patterns
- Loss of interest in usual activities: work, school, community, hobbies
- Withdrawing from friends and family members, physically and emotionally
- Increased alcohol or drug use
- Not caring about personal appearance
- Unnecessary risk-taking such as driving very fast
- Fixation on death and dying or having feelings of wanting to die
- Physical complaints connected to emotional distress, such as stomachaches, headaches, or extreme fatigue
- Feelings of boredom or trouble concentrating
- Lack of response to praise or numbness to affection
- Demonstrating an active plan or intention to commit suicide. For instance, saying, “I want to kill myself,” or “I’m going to commit suicide.” Or giving hints such as “I won’t be a problem much longer,” or “If anything happens to me, I want you to know ….”
- Writing one or more suicide notes
- Looking for specific ways to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun
- Giving away favorite possessions or throwing away important belongings
- Becoming suddenly cheerful after a long period of depression
- Saying goodbye to friends and family
- Putting affairs in order, such as making a will
Noticing such signs or symptoms in oneself or a loved one means that immediate professional help is required.
How are Depression and Suicide Linked?
Since depression can vary in its intensity, mental health professionals categorize it (via the criteria listed in the DSM-5) into three types: mild, moderate, or severe. When a depressive disorder is moderate or severe, it can potentially lead to self-harm, thoughts of suicide, or suicide attempts.
What experts have discovered and is essential to understand is that: 12
* The vast majority of people who suffer from depression do not attempt or die by suicide. Being diagnosed with a depressive disorder doesn’t automatically mean that one is or will become suicidal.
* However, depression is linked to a greater risk of suicide. And about 60% of people who lose their lives to suicide have had a mood disorder such as depression or bipolar disorder.
Risk Factors for Suicide
One of the main risk factors for suicide is depression (or another mood disorder). But there are other risk factors as well—other circumstances that may predispose a person to contemplate or carry out suicide:
A more comprehensive list of risk factors for suicide includes:
- Other mental disorders
- A substance use disorder
- A history of previous suicide attempts
- Family history of a mental illness or substance use
- Family history of suicide
- Having chronic pain
- History of family violence, such as physical or sexual abuse
- Access to firearms or life-threatening drugs in the home
- Having recently been released from prison/jail
- Exposure to others’ suicidal behavior, e.g., family members, peers, or celebrities
- Prolonged stress or an overwhelming personal crisis, such as relationship problems, financial difficulties, bullying, or the death of a loved one
- People who face harassment or discrimination (refugees, migrants, indigenous people, LGBTQ people, and prisoners) are at a higher risk of suicide
Most people who have depression or other suicide risk factors will not attempt suicide. However, it is difficult to tell who will act on suicidal thoughts, so it’s essential to pay attention to and take the warning signs of suicidal behavior seriously.
Does Suicidal Ideation Have a Negative Impact on Depression?
Any kind of suicidal ideation—having thoughts of taking one’s own life—is, for mental health professionals, typically associated with significant clinical depression. In other words, clinicians are often inclined not to consider suicidal ideation as a symptom of major depression. 14
However, as mentioned above, most people who have been diagnosed with depression do not die by suicide. And many of these individuals never even experience suicidal ideation (thoughts of suicide)—even when faced with intensely challenging circumstances or in the depth of a severe depressive episode.
The bottom line is that suicide is complex, and its relationship with clinical depression is not straightforward. Not everyone who experiences suicidal ideation is clinically depressed, and the specific effects of suicidal ideation on the mind of a person with a depressive disorder cannot be predicted with any kind of certainty.
Do People Suffering from Depression Have a Higher Chance of Attempting Suicide?
Although a majority of people who are diagnosed with depression do not die by suicide, having major depression does increase suicide risk compared to people without depression. 14 The risk of death by suicide may, at least in part, be related to the severity of the depression. In particular:
* New data on depression that has followed people over long periods of time suggests that about 2% of people who have been treated for depression in an outpatient setting will die by suicide.
* Among people who have ever been treated for depression in an inpatient hospital setting, the rate of death by suicide is twice as high (4%).
* People treated for depression as inpatients following suicide ideation or suicide attempts are about three times as likely to die by suicide (6%) as those who were only treated as outpatients.
* There are also dramatic gender differences in the lifetime risk of suicide among people suffering from depression: While about 7% of men with a lifetime history of depression will die by suicide, only 1% of women with a lifetime history of depression will die by suicide.
* Younger people who kill themselves often have a substance abuse disorder in addition to being depressed.
Learn More About Depression & Suicide at Brain Therapy TMS
It’s important to understand that suicide is not a typical healthy response to stressful circumstances. Suicidal thoughts or actions are a sign of extreme mental-emotional distress and should not be ignored. If warning signs and symptoms of suicide appear for oneself or a loved one, it’s vital to get immediate help.
The good news is that depression is treatable, and suicide can be averted. With professional support and creating a safe environment within which to heal, it’s possible to feel better and create a truly satisfying life.
Brain Therapy TMS provides transcranial magnetic stimulation (TMS) in San Diego, California—utilizing the latest technology to resolve mental and neuropathic disorders without medication. Their highly trained staff treat a variety of physical ailments as well as mental health disorders—including depression—with cutting-edge TMS treatment.
What Is Transcranial Magnetic Stimulation (TMS)?
TMS is a proven breakthrough therapy that heals specific areas of the brain that are impaired by brain cell dysfunction. TMS treatment significantly improves mood, energy, function, focus, and general well-being.
TMS can be a crucial component of successful depression treatment. Approximately 50% to 60% of people who have failed to benefit from depression medications experience a positive response to TMS. One-third of those who responded positively even saw complete remission of their symptoms!
TMS is a treatment modality without any negative side effects associated with prescription antidepressants. Studies also suggest that TMS may dramatically help people with treatment-resistant depression.
Each client at Brain Therapy TMS receives a highly individualized, customized treatment plan. The TMS team continues to modify that plan through the course of treatment if their battery of tests and evaluations indicates a more effective protocol for the client.
Also, data from treatment results indicate that TMS Therapy is most effective when paired with traditional psychotherapy (talk therapy). To ensure this highest success rate, TMS offers psychotherapy for all TMS patients.
References & Resources
- Major Depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/major-depression
- Depression: Key Facts. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/depression
- Suicide. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/suicide
- Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 9, DSM-IV to DSM-5 Major Depressive Episode/Disorder Comparison. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t5/
- Causes of Depression. Mind.org UK. https://www.mind.org.uk/information-support/types-of-mental-health-problems/depression/causes/
- Analysis: Depression is probably not caused by a chemical imbalance in the brain – new study. (July 20, 2022). UCL News. https://www.ucl.ac.uk/news/2022/jul/analysis-depression-probably-not-caused-chemical-imbalance-brain-new-study#:~:text=For%20three%20decades%2C%20people%20have,evidence%20does%20not%20support%20it .
- Moncrieff, J., Cooper, R.E., Stockmann, T. et al. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry (2022). https://www.nature.com/articles/s41380-022-01661-0
- Suicide Prevention. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/suicide-prevention
- Mental Health and Suicide Statistics. The JED Foundation.https://jedfoundation.org/mental-health-and-suicide-statistics/#:~:text=NCHA%2C%202021).-,Suicide%20Rates,suicide%20in%20the%20past%20month.
- Suicide Prevention. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/suicide-prevention
- Depression and Suicide. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/depression-and-suicide
- What Is the Connection Between Depression and Suicide? The JED Foundation. https://jedfoundation.org/resource/what-is-the-connection-between-depression-and-suicide/
- Pompili M. Critical appraisal of major depression with suicidal ideation. Ann Gen Psychiatry. 2019 May 31;18:7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543655/
- Does Depression Increase the Risk for Suicide? U.S. Department of Health and Human Services. https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-depression-increase-risk-of-suicide/index.html