Mood Disorders and Suicide 235
period when disclosing their homosexuality to immediate family members (Igartua,
Gill, & Montoro, 2003).
Despite such risks, most people who are depressed or have thoughts of sui-cide do not actually try to kill themselves. Even when in the blackest suicidal de-
spair, specifi c factors can lessen the risk of a suicide attempt: receiving support from
family and friends, holding religious or cultural beliefs that discourage suicide, and
getting prompt and appropriate treatment for any depression or substance abuse.
Additional protective factors are listed in Table 6.12.
Understanding Suicide
Adding risk factors and subtracting protective factors does not sum up to a defi ni-
tive probability that a given individual will attempt or complete suicide. Rather, the
presence or absence of such factors may create feedback loops over years, the effects
of which may or may not culminate in suicide. To understand why some people
commit suicide, we now turn to examine relevant neurological, psychological, and
social factors and their feedback loops.
Table 6.12 • Risk and Protective Factors for Suicide
Risk Factors- Mental disorder associated with suicidal behavior (depression, schizophrenia, substance
abuse, or personality disorder) - Feeling hopeless
- Being male (in the United States)
- Prior suicidal behavior (suicide threats, suicide attempts)
- Specifi c behaviors that suggest suicide planning (giving away possessions, saying goodbye
to friends, talking about death or suicide, talking about specifi c plans to commit suicide,
rehearsing a suicidal act, and/or accumulating medications) - Family history of suicidal behavior
- Chronic impulsivity or aggression and low stress tolerance
- Poor coping and problem-solving skills
- Poor judgment and rigid, distorted thinking
- Major life stressors (physical or sexual assault, threats against life, diagnosis of serious medi-
cal problem, dissolution of a signifi cant relationship, or sexual identity issues) - Breakdown of support systems or social isolation
- Changes in mental status (acute deterioration in mental functioning, onset of major mental
illness, extreme anxiety, paranoia, or severe depression) - Unsatisfying relationship history (never married, separated, divorced, or lack of signifi cant
relationships) - Poor work history (spotty work history or chronic unemployment)
- Childhood abuse
- History of violent behavior
Protective Factors- Being married (or having a signifi cant relationship)
- Employed or involved in a structured program (educational or vocational training program)
- Presence of a support system (family, friends, church, and/or social clubs)
- Having children who are under 18 years of age
- Constructive use of leisure time (enjoyable activities)
- General purpose for living
- Involved in mental health treatment
- Effective problem-solving skills
Source: Adapted from Sánchez, 2001, Appendix A.