Thursday, March 25, 2010

Eating Disorders and Suicide

This is not a pleasant subject, but one that deserves attention. I attended a presentation at the IAEDP Conference a couple of weeks ago about suicide. There were some interesting facts that I wanted to share.
In the United States alone, there are 790,000 suicide attempts made each year out of the general population, with 31,655 cases of completed suicides, as they are referred to. Approximately half of those who commit suicide met with a clinician in the weeks prior to taking their lives. What does this mean?
Often a person who is struggling with thoughts of suicide (suicidal ideation) will not reveal this to anyone, nor will they ask for help. Also, many times, the people who attempt suicide, have no intention of dying, but are truly expressing their distress about certain things in their lives, or their lives in general. Then there are those who talk about wanting to die, threaten, and may even make an attempt, but their intention is likely to gain attention, and they may not have knowledge or skills to get it in a positive way. Anyone who fits into any of these groups needs help, regardless of the level of real danger involved.
Surprisingly enough, suicide rates are higher for those with eating disorders or substance abuse issues than for those with Major Depressive Disorder. This is thought to be a result of closer monitoring for suicidal ideation among those with MDD than for patients who present with an ED or substance abuse issues. It was also noted that persons suffering from eating disorders are likely to use a much more violent method to take their life. This is thought to be related to the common element of low self-esteem, even self-hatred, experienced by many people with eating disorders.
A study conducted by Sullivan (1995) on mortality among eating disorder patients showed that out of 3006 patients, there were 178 deaths. 54% of those deaths were due to eating disorder complications, 27% were due to suicide, and 19% were from unknown/other causes.
One source, Pompili et al, refutes the belief that starvation is the primary cause of death among those suffering from anorexia, stating that in fact, suicide is the major cause of death.
There is no way that a treatment professional can predict that a person will choose to take their life, but an important tool for prevention is to perform a thorough suicide assessment on every psychiatric patient.
Many times, a patient with an eating disorder will present with a comorbid diagnosis.
With Anorexia nervosa (Restricting type), examples of comorbid conditions may include:
Personality Disorder-22%
-Avoidant-19%
-Borderline-11%
-Dependent-11%
For Anorexia nervosa (Binge Eating/Purging Type):
-Borderline-25%
-Avoidant/Dependent-15%
-Histrionic-10%
And with Bulimia nervosa:
-Borderline-28%
-Dependent, Histrionic, Avoidant-20%
In summary, I will share my own experience of losing a very dear friend to suicide. In addition to suffering for many years from an eating disorder, she suffered greatly from deep depression that seemingly could not be controlled. Her suicide was a great shock to all those who knew her.
Please, no one, ever take a person's despair or threat to self-harm lightly. Listen, offer support, and always call necessary emergency personnel if you ever suspect anyone is in danger.
Eating disorders are treatable. Full recovery is absolutely possible. NEVER give up!!
Without apology....♥

1 comment:

  1. sensitive, scary topic.
    during my very first appointment with a therapist, this topic was discussed extensively. i sense that she understands that eating issues and suicide can go hand in hand. scary to talk about; but what a safe feeling to have that topic, as well as many other painfully difficult topics, just thrown out there as if they are anticipated parts to the equation and are solvable.
    thank you for the attention you are giving to the many connected aspects of disordered eating.

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