September is Suicide Prevention/Awareness Month. 

According to the American Foundation for Suicide Prevention, suicide is the 10th leading cause of death in the USA. In 2018, 48,344 Americans died by suicide, and there were 1.4 million suicide attempts. Suicide is a public health concern. 

There are on average 132 suicides per day. 

There can be a variety of risk factors for suicide, and may or may not include preexisting mental illness. Psychosocial and life stressors such as relationships, physical health, substance use and toxic behaviors, financial and housing problems, may all be contributory.

Between 1999 and 2016, suicide rates increased across all states. It remains to be seen how the current pandemic will exacerbate this public health issue. 

However, on the individual level, we can be aware of the signs of declining mental health and suicide. 

Potential Signs of Depression/Suicide

A few signs of depression, which can be closely related to or a precursor for suicide:

• (S-I-G-E-C-A-P-S)

  
  

• Sleep ⠀

  • Are you sleeping more or less than usual? Are you having difficulty with quality sleep or staying asleep?

• Interest

  • Are you feeling uninterested in your normal activities (anhedonia)? Are you feeling withdrawn or socially isolated?

• Guilt⠀

  • Are you feeling guilty or worthless?⠀Feeling hopeless?

• Energy⠀

  • Are you feeling sluggish or low energy? Or vacillate between the two?

• Concentration⠀

  • Are you having difficulty focusing on tasks?

• Appetite⠀

  • Are you having either increased or decreased appetite, or weight changes?⠀

• Psychomotor⠀

  • Do you notice that you are agitated or moving slower than usual?⠀

• Suicidal⠀

  • Any thoughts of hurting yourself or others?⠀

Other warning signs for suicide could include:

• feeling hopeless

• rage or anger

• substance use

• mood changes/swings

• social withdrawal

• feeling like a burden

• talking about or making plans for suicide

Physician Suicide

An estimated 300-400 physicians die by suicide every year (JAMA, 2003).

The current pandemic has worsened feelings of depression, hopelessness, and anxiety in the medical community.

A few alarming (pre-covid) statistics from the ACGME:

“Twenty-eight percent of residents experience a major depressive episode during training versus 7–8 percent of similarly aged individuals in the U.S. general population.”

“In one study, 23 percent of interns had suicidal thoughts.”

“Physicians who took their lives were less likely to be receiving mental health treatment compared with nonphysicians who took their lives even though depression was found to be a significant risk factor at approximately the same rate in both groups.”

Almost every physician I know has been directly or indirectly affected by physician anxiety, depression, and/or physician suicide. Over the past 7 years, two physicians I knew personally took their own life. Several others who I did not know personally but knew of, also took their lives.

Many physicians struggle with mental health on a daily basis. You would not know it from the outside; doctors are masters of disguise.

Mental illness needs to be destigmatized (in and outside the medical community), and there is never shame in seeking treatment.

Preventing Suicide 

Check in with yourself, and make self-care a daily priority. Exercise daily, eat a balanced diet. 

If you feel you need help, feel no shame whatsoever in telling someone.

If someone appears to be acting differently or having a rough time, reach out. Never dismiss any hint that they might be intending to hurt themselves. Don’t be judgemental. Follow up with them.

Find a battle buddy. This is someone who can check up on your emotional well being. Having a battle buddy has shown to increase morale and decrease stress.

If you or anyone you know is struggling with anxiety, depression, or having harmful/negative thoughts, please reach out to @crisistextline (text 741741) or the national suicide prevention hotline (800.273.8255).