James Donaldson on Mental Health – Understanding the suicide risk in schizophrenia

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Schizophrenia suicide rates are among the highest of any mental illness, but suicide prevention strategies can make a difference.

Schizophrenia is a severe and chronic mental health condition that affects how a person thinks, feels, and behaves. Among its many challenges, one of the most concerning is the significantly increased risk of suicide.

Research indicates that individuals with schizophrenia are far more likely to attempt or die by suicide than the larger population. According to a 2019 review, about 1 in 10 people with schizophrenia die by suicide, with up to 5 in 10 attempting suicide at least once in their lifetime.

The reasons for this high suicide risk are complex, often involving many factors of schizophrenia, such as:

  • delusions
  • hallucinations
  • social isolation
  • depression
  • impaired judgment

Many individuals with schizophrenia have issues with the stigma of the condition, difficulty maintaining relationships, and barriers to accessing consistent treatment.

Despite these challenges, early intervention, comprehensive treatment, and strong support systems can significantly reduce the risk of suicide in individuals with schizophrenia.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Are people with schizophrenia at greater risk of suicide?

Individuals with schizophrenia face a much higher risk of suicide than the larger population. Studies show that people with schizophrenia are more than 20 times more likely to die by suicide than the larger population.

The suicide risk in schizophrenia stems from multiple factors, including:

  • Depression: Many individuals with schizophrenia experience co-occurring depression, increasing their risk.
  • Awareness of illness: Those with more insight into their condition may feel distressed about their future or issues with stigma.
  • Social isolation: Difficulty maintaining relationships or securing employment can lead to loneliness and despair.
  • Command hallucinations: Some people with schizophrenia experience voices telling them to harm themselves.
  • Lack of treatment adherence: Many individuals stop taking medication, leading to worsening symptoms and impulsive behaviors.
  • Substance misuse: Drugs and alcohol increase impulsivity and worsen schizophrenia symptoms, further raising suicide risk.

What is schizophrenia?

Schizophrenia is a severe mental health disorder involving disruptions in thought processes, perception, emotions, and behavior. It affects about 1%Trusted Source of the global population. It typically develops in late adolescence or early adulthood.

Common symptoms include:

  • Hallucinations: hearing voices or seeing things that are not there
  • Delusions: false beliefs that are firmly held despite contrary evidence
  • Disorganized thinking and speech: difficulty following conversations or expressing thoughts coherently
  • Social withdrawal: avoidance of relationships and a decline in personal hygiene
  • Emotional blunting: reduced facial expressions and difficulty experiencing pleasure

Learn more about schizophrenia.

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Outlook

The long-term outlook for individuals with schizophrenia varies widely. It depends on age of onset, symptom severity, and access to treatment.

Factors that can impair a person’s outlook with schizophrenia include Trusted Source:

  • early onset in childhood or adolescence
  • thinking difficulties
  • issues with social functioning before diagnosis
  • substance use

In contrast, those who develop schizophrenia later in life or live in countries with strong mental health support systems tend to have a better outlook.

However, suicide remains the leading cause Trusted Source of early death in schizophrenia, with most individuals experiencing at least one episode of suicidal thoughts.

On average, individuals with schizophrenia have a life expectancy that is about 15 years shorter Trusted Source than the larger population due to lifestyle factors such as substance use, including smoking, and diet.

Despite these challenges, early intervention with medication, therapy, and social support can improve stability and quality of life.

Signs

Recognizing the warning signs of suicide is crucial. Individuals with schizophrenia may exhibit:

  • Increased withdrawal: The person may avoid social interactions more than usual.
  • Hopelessness or worthlessness: The person may express thoughts such as “I cannot go on” or “I am a burden.”
  • Speak about death: They may mention or fixate on suicide or dying.
  • Have sudden calmness: A previously distressed person may appear at peace if they have decided to end their life.
  • Self-harm: They may engage in behaviors such as cutting, burning, or harming themselves.
  • Give away possessions: The person may unexpectedly give away important belongings.
  • Refuse medication: They may stop antipsychotic or antidepressant treatments.

Learn more about suicide ideation.

When to contact a doctor

Seeking medical help is essential when someone with schizophrenia displays:

  • severe paranoia or delusions
  • uncontrolled hallucinations, especially if they involve self-harm
  • signs of extreme depression
  • suicidal thoughts or a suicide attempt
  • sudden worsening of symptoms after stopping medication

Call emergency services such as 911 or a crisis hotline for urgent assistance if there is immediate danger.

Causes 

The exact cause of schizophrenia Trusted Source remains unclear but may involve:

  • Genetics: A family history of schizophrenia increases risk.
  • Brain chemistry: Dopamine and glutamate imbalances link to schizophrenia symptoms.
  • Environmental factors: Prenatal complications, early childhood trauma, and substance use can contribute to the condition.

In terms of suicide risk, certain factors increase the suicide risk rate in people with schizophrenia, including Trusted Source:

  • younger age
  • being male
  • living alone
  • having a recent diagnosis
  • having a history of prior suicide attempts
  • having higher education levels or occupational status before diagnosis
  • stopping treatment or lacking a support system

Treatment

Managing schizophrenia and reducing suicide risk requires a holistic approach. While antipsychotic medications help manage symptoms, therapy is crucial for emotional regulation and coping strategies.

Medication

Antipsychotic medications can help manage hallucinations, delusions, and disordered thinking. Options include:

Clozapine is the only antipsychotic drug proven to reduce suicide risk in schizophrenia.

Clinicians may prescribe antidepressants if coexisting depression is present.

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Therapy and psychosocial support

Cognitive behavioral therapy (CBT) can help individuals manage delusions, hallucinations, and emotional distress.

Dialectical behavior therapy (DBT) can be beneficial for suicidal thoughts and emotional regulation.

Family therapy can also improve support networks and medication adherence.

Crisis intervention and hospitalization

A person may require hospitalization if they are at immediate risk of harming themselves. Crisis hotlines and psychiatric emergency services provide urgent care.

Lifestyle and social support

Stable housing and employment can reduce stress and isolation. Healthy routines such as regular exercise and sleep regulation improve mental stability. Avoiding drugs and alcohol can help prevent symptoms from worsening.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.
  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson’s latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Link for 40 Habits Signup
bit.ly/40HabitsofMentalHealth

If you’d like to follow and receive my daily blog in to your inbox, just click on it with Follow It. Here’s the link https://follow.it/james-donaldson-s-standing-above-the-crowd-s-blog-a-view-from-above-on-things-that-make-the-world-go-round?action=followPub

Schizophrenia support

Finding the right support system is critical for managing schizophrenia and preventing suicide. Resources include:

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Summary

People with schizophrenia face a significantly higher risk of suicide, with up to 1 in 10 people with schizophrenia dying by suicide and up to 5 in 10 attempting it.

The combination of delusions, hallucinations, depression, and social isolation makes suicide prevention crucial. Recognizing warning signs, ensuring proper treatment, and providing strong emotional support can significantly reduce suicide risk.

With the proper medical care, therapy, and community support, individuals with schizophrenia can lead typical lives while managing their condition effectively.

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