In 2016 alone, nearly 45,000 lives were lost to suicide in the United States. Worldwide, close to 800,000 people die by suicide annually. That’s one death roughly every 40 seconds. Honest conversations about suicide are important year-round. September is National Suicide Prevention Awareness Month, a time to come together and share resources that bring awareness to this often-stigmatized topic. This month, American Addiction Centers would like to highlight the connection between mental health disorders, suicide, and another stigmatized illness: addiction.
Addiction and mental health disorders often go hand-in-hand, and both can contribute to suicidality. Unfortunately, this link is often ignored. Mental health and addiction are rarely treated together, an approach that is dangerously ineffective.
Substance use can create mental highs and lows that can worsen suicidal thoughts. They also lower inhibitions and impulse control, increasing the risk of suicide. In fact, more than 1 in 3 people who die from suicide do so under the influence of alcohol. Meanwhile, opiates are present in 20% of suicide deaths in the U.S.
It’s time to shed light on mental health disorders, addiction, and their relationship to suicide. If we want people to ask for help and access the resources they need, we must begin by dismantling stigma and shame.
About National Suicide Prevention Awareness Month
Each September, National Suicide Prevention Awareness Month provides a time for people to offer collective strength and passion around the difficult topic of suicide. It’s a dedicated time to share resources, stories, and honest conversation.
Studies by the Center for Disease Control and Prevention show that suicide rates are continuously rising. Many factors can contribute to suicide, and there is no single answer to address this challenging topic. However, we know what we can do to help. We can share resources and information, advocate for prevention strategies, and connect people with the support and services they need.
We can also continue to talk about suicide, mental health, and addiction openly and honestly. Silence around these issues reduces awareness of life-saving resources, and it prevents people from asking for help.
Mental health disorders, suicidal thoughts, and addiction can affect anyone. When people decide not to speak up or seek treatment, suicide can often be the end result. Choosing conversation and compassion, not shame and stigma, saves lives.
Why is there a link between mental health disorders and addiction?
According to the National Institute on Drug Abuse (NIDA), people with diagnosed mental health conditions (including anxiety, depression, and bipolar disorder) are about twice as likely as those without mental health conditions to become addicted to drugs or alcohol. Similarly, long-term use of drugs or alcohol can trigger mental health disorders.
Why? Several factors contribute to this link. For instance, people who experiment with substances early in life risk damaging their brains, which are still developing. Later in life, this may result in substance abuse and/or mental health disorders. Additionally, genetics and environmental triggers, like chronic stress and trauma, play a significant role in both disorders.
Perhaps most significantly, people who struggle with mental health disorders often attempt to self-medicate with drugs or alcohol. Substances can provide temporary relief, but substance abuse leads to difficulties with relationships, careers, finances, health, and more, ultimately making matters worse.
A study published by the National Institute of Health shows that alcohol lowers serotonin levels, worsening depression. The “comedown” from stimulants such as cocaine can also increase depression and anxiety.
This creates a vicious cycle, as people turn more frequently to the temporary relief they get from substances. Over time, they need more of the substance to achieve even momentary relief, and the cycle continues.
Mental health disorders, addiction, and suicide
While depression and mood disorders are the leading risk factor for suicide, addiction is a close second. And as explained above, these two causes are often closely related. For individuals with co-occurring mental health and substance abuse disorders, suicidal thoughts or behaviors are among the typical signs.
Even when mental illness is not involved, substance abuse greatly increases the risk of suicide. Individuals diagnosed with alcohol dependence have a suicide risk that is 10 times greater than that of the general population. People who inject drugs are about 14 times more likely to commit suicide than the general population.
One reason is the disinhibition and impaired judgement that occurs when an individual is intoxicated. Additionally, substance use can increase depression and aggression, constrict cognition, and motivate people to carry out suicidal action. For example, people may believe that substances will reduce or eliminate the pain of suicide. They are also likelier to have access to lethal substances.
The severe consequences of addiction, like jail time, divorce, bankruptcy, and losing custody of children, may also contribute to suicide. The same is true of the shame that is often associated with addiction, which can cripple an individual’s self-esteem and support system.
People who attempt to quit using substances without help may experience severe withdrawal symptoms, and even death. Such withdrawal symptoms include extreme worry and depression, which can increase the risk of suicide, especially for those who use substances to self-medicate mental illness.
What can we do about it?
For people suffering from both mental illness and a substance abuse disorder, integrated treatment is essential. Treating one disorder without treating the other ultimately treats neither. For example, ignoring the underlying causes of an addiction (such as depression or bipolar disorder), nearly guarantees relapse in the future.
It’s also important for medical professionals to understand that addiction is often connected to suicide. Risk assessments, safety plans, and suicide prevention should play a role in the treatment of addiction. Suicidality is not separate from the addictive experience.
The Substance Abuse and Mental Health Services Administration advocates for programs that teach life skills, emotional regulation, and problem-solving in schools and communities. These programs provide social supports that can prevent both substance abuse and suicide.
On the individual level, we can get informed about mental illness, addiction, and suicide. We can offer compassion, rather than judgement, to people who struggle with these disorders.
The following is a list of suicide warning signs, along with resources for both mental health and addiction.
Warning signs of suicide include:
- Suicidal ideation (comments or thoughts about suicide)
- Substance use, especially increasing substance use
- Withdrawal from friends, family, and previously enjoyed activities
- Aggressive, impulsive, or reckless behavior
- Mood swings
If you notice these signs, don’t be afraid to ask tough questions like, “Do you have a plan for how you would kill yourself?” Remove access to weapons or other means, and ask direct questions, like, “Can I help you call your psychiatrist?”
Don’t negate the person’s feelings by saying, for example, “Your life isn’t bad!” Instead, listen patiently and offer empathy. Express concern and support, and avoid debating whether suicide is right or wrong.
If you notice the following suicidal behaviors, call 911 or seek immediate help from a health provider:
- Buying a weapon, collecting and saving pills
- Saying goodbye to loved ones
- Giving away possessions
- Paying off debts, organizing personal papers, or otherwise tying up loose ends
Shying away from uncomfortable conversations or not taking suicidal comments seriously can have devastating outcomes. Suicidal thoughts are a symptom, and just like any other, they can be treated. With support and access to resources, there is hope.
Mental Health Resources
The following resources can help you or someone you know who is experiencing difficult or suicidal thoughts:
- Call The National Suicide Prevention Lifeline: 800-273-TALK (8255).
- Call SAMHSA’s National Helpline: 1-800-662-HELP (4357) for information and referrals related to mental and/or substance use disorders.
- Download Navigating a Mental Health Crisis: A National Alliance on Mental Illness (NAMI) Resource Guide for Those Experiencing a Mental Health Emergency.
- Text NAMI to 741-741 to be connected to a trained crisis counselor on the Crisis Text Line.
- Read/watch Being Prepared for a Crisis.
- If you or someone you know is in an emergency, call 911.
If you or a loved one is struggling with addiction, these resources can help:
- Visit org to access tools and resources for recovery from alcoholism, or call the helpline: 866-985-0524.
- Visit the National Institute on Alcohol Abuse and Alcoholism’s
- Read NIDA’s guide, Seeking Drug Abuse Treatment: Know What to Ask.
- Call the American Addiction Centers helpline: 888-444-7613.
American Addiction Centers recognize addiction as a disease. We treat individuals struggling with drug addiction, alcohol addiction, and mental health/behavioral health issues.
We take a big picture, whole person approach to addiction treatment. That includes treating co-occurring mental health disorders, customizing treatment, and developing an effective aftercare plan. If you or a loved one needs treatment and support, we’re here for you.
For the rest of September, and for all the months that follow, let’s keep talking about mental health, addiction, and suicide.
For people struggling with mental illness, addiction, or suicidal thoughts, there is hope. Resources and treatment are available, and suicide is not the answer. Join us in sharing stories, offering resources, and providing empathy and encouragement. With support rather than shame, people can find the courage to seek help and healing.