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Suicide

Parkland, PTSD, and Suicide

Science can help us understand the connections between trauma and suicide.

 Pixabay
Source: Pixabay

In the past few weeks, we tragically lost two Parkland mass shooting survivors—Sidney Aiello and Calvin Desir—to suicide. Around the same time, Jeremy Richman, whose daughter was killed in the Newtown mass shooting, died by suicide too.

These heart-wrenching losses have prompted public discussion about connections between suicide and trauma.

What is PTSD?

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) defines trauma as exposure to actual or threatened death, serious injury, or sexual violence that is experienced: 1) directly, 2) by witnessing it happen to someone else, 3) by hearing about a close family member or friend experiencing it, and/or 4) repeated or extreme exposure to trauma details through one’s work (e.g., as a first responder).

The symptoms include re-experiencing the trauma (e.g., via nightmares and flashbacks), avoidance of reminders of the trauma, changes in beliefs and feelings (e.g., distancing yourself from loved ones due to mistrust, negative mood changes), and hyperarousal (e.g., always feeling “on guard”). For someone to be diagnosed with PTSD, these symptoms must last at least four weeks, cause substantial distress, and/or interfere with daily functioning.

Most people who experience trauma will not develop PTSD, but they do have a higher likelihood of developing other mental health problems (e.g., substance use, anxiety, depression).

Is there a link between PTSD and suicide?

In a nationally representative U.S. sample, 32% of people with lifetime PTSD diagnoses reported experiencing suicidal thoughts (compared to 6-14% of the general population). Meanwhile, 14% of people with PTSD reported a suicide attempt (compared to 2-9% of the general population). Suicidal thoughts and attempts were highest among people who had experienced multiple traumas. Some of the highest rates were associated with childhood physical abuse by a parent/caretaker and with sexual violence. A similar pattern emerged in a large Danish study, where people with PTSD were at heightened risk for suicide deaths.

Why is there a link between PTSD and suicide?

Research points to a variety of factors, including:

1) Survivor Guilt: When people feel bad or wrong for living through a trauma that others didn’t, they may blame themselves or feel they deserve to die too.

2) Emotion Regulation Difficulties: When people struggle to find healthy, effective ways to cope with their emotions, they may view suicide as the only escape from their pain.

3) Cognitive Inflexibility: When people have a hard time seeing their problems from other perspectives, they may have difficulty thinking of alternatives to suicide.

What reduces suicide risk among people with PTSD?

1) Community Support: Following the shooting at Marjory Stoneman Douglas High School, local mental health professionals started a group called Professionals United for Parkland to meet the community’s needs. This type of local organizing can be crucial for connecting trauma survivors with appropriately tailored mental health care.

2) Research-Supported Treatments: The National Center for PTSD has information and suggestions for coping with trauma following mass violence. They highlight research-supported PTSD treatments, including prolonged exposure, cognitive processing therapy, and eye movement desensitization and reprocessing therapy. These treatments target survivor guilt, emotion regulation difficulties, and cognitive inflexibility.

3) Safety and Crisis Planning: Check in with trauma survivors to see if they’re having suicidal thoughts. Listen to them in a nonjudgmental, compassionate manner. The American Association of Suicidology has several useful suggestions for talking to someone about suicide. These include showing that you care about their well-being and that you want them to be safe. Restricting access to lethal means (e.g., guns, pills) during high-risk periods can save lives. Creating a crisis plan that includes social support, pleasant and soothing activity options, and emergency contact information can also be helpful during suicidal crises.

Trauma can have devastating effects on people. Trauma-informed mental health care instills hope and saves lives.

LinkedIn Image Credit: Yupa Watchanakit/Shutterstock

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