Promoting Hope, Preventing Suicide

Research and advice on preventing teen and adult suicide

What might Michael Jackson and Boston weather have in common?

Links between chronic pain and suicide risk

Where I live, in Boston, Massachusetts, it has been gloomy for what feels like forever. However tempted I might be to try to write about a link between crummy weather and suicide risk, I'd rather focus on something with a little bit of evidence behind it.

It turns out that this past month was not one for the record books - it was not colder or rainier than any of the other Boston Junes on record, despite our experience of it as so.

Meteorologist Eric Fisher, who works in Western Massachusetts, was quoted in an article as saying: "It just tells us that memories are short. It always seems worst when you are in it."

Fisher's statement couldn't have rang more true as far as suicide is concerned. When people are suicidal, life seems genuinely unbearable. Thus, I am always stunned when those who survive suicide attempts say that they realized that they wanted to live just as they thought they might actually die. (A most striking example can be found in this article).

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Our perceptions of our experiences are shaped in ways we sometimes can't even understand.

The experience of physical pain, like psychic pain, can also be chronic. A study published last year in the journal General Hospital Psychiatry found that people experiencing chronic pain may have an increased risk of suicide. Specifically, people who reported chronic pain other than arthritis, especially head pain and pain in multiple areas of the body were four times more likely to have attempted suicide than adults not suffering from chronic pain.

It's important to note that the majority of chronic pain sufferers will not become suicidal. But there's something about the ever-present nature of the pain that seems to contribute to suicidality.

There are a few implications for these findings. One, we treat chronic psychic pain sufferers with therapeutic support, support groups, and sometimes medication to ease that pain. Should chronic physical pain treatment have a similar prescription?

What do we know about how anti-depressants or other psychotropic medications might be able to help those who experience chronic pain? How does insurance help or hinder access to mental health care for people with chronic pain? Are doctors treating chronic pain patients asking the right questions about mental health? And, do mental health practitioners ask chronic pain sufferers the right questions about suicide?

Their experience of pain is just as real as the experience of psychic pain by those who are depressed or experiencing other mental illness. Can we learn from our successes in treating psychic pain as we learn how to help people with chronic pain? I, for one, would like to think that chronic pain sufferers who are suicidal, if offered a way out of their pain other than suicide, would take it.

Thanks to my friend and colleague Leah Horn for the great inspiration of her curious mind!

Copyright 2009 Elana Premack Sandler, All Rights Reserved

Elana Premack Sandler, L.C.S.W., M.P.H., is a public health social worker specializing in violence and injury prevention and adolescent health promotion.

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