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Panic Attacks – A Huge Red Flag for a Suicide Attempt
I have said before (controversially) that people to attempt or commit suicide do not want to die. It’s very clear to me that people who are suicidal are looking for a way out of pain, not a way towards death, per se. People who attempt suicide or die of suicide are people in excruciating amounts of pain that they need to remedy.
But in spite of the fact that no one wants to die, people do die. According to the Centers for Disease Control, over 38,000 of them did in 2010. And we suck at stopping suicide attempts. While I can tell you all sorts of things that are associated with suicide attempts and I can tell you, generally, who will attempt/commit suicide, on an individual level, it’s almost impossible for us to tell.
Feeling Takes Over for Reason in a Suicide Attempt
Igor Galynker, MD, has some insight on that:
“Even the most planned suicidal act is an urge and an effect of emotional action as opposed to a thought and rational action . . . When people feel like they are trapped and that no options exist . . . they start panicking and as a result develop distorted cognitions and impaired judgment, which leads to the suicidal act.”
In other words, people who are suicidal aren’t thinking as much as they’re feeling, and I don’t know how much experience you have of dealing with a purely feeling person, but they are awfully hard to reason with (because reason takes thinking).
Panic Attacks Can Lead to Suicide Attempts
And the point Arline Kaplan makes in the article, Panic Attacks and Suicide is that these extremely strong emotions lead to a panic attack, which leads to a suicide attempt. In fact, according to a study I wrote about a couple of years ago, severe anxiety was linked to 92 percent of suicide attempts and panic attacks were linked with 80 percent of suicide attempts (these two match and beat out depression as far as warning signs go.)
Another study found that the specific panic attack symptoms of fear of dying, fear of losing control and fear of going insane were more strongly associated with risk of suicide attempt than were other panic attack symptoms. Panic attacks with a fear of dying were found to increase the risk of a suicide attempt seven-fold in another study.
What Does This Mean for Patients?
Unfortunately, one of the most disturbing things about suicide is that patients do reach out for help, but few of them actually mention suicide when they do it. More than half of people who attempt suicide seek medical care in the month before an attempt but only 5 mention suicidal thoughts at the time.
So this means that doctors need to probe more when a person presents with a panic attack and mood disorder together. A panic attack, for example, may feel like a heart attack and so it’s common for a doctor to simply reassure the patient that he is not having a heart attack and that the feeling of anxiety will go away. But, if the person with the panic attack also has an affective disorder like depression or bipolar disorder, that simply is not enough. The doctor needs to ask about how the patient is feeling, whether he is currently depressed and what his panic feels like to him.
Galynker says he considers hospitalizing depressed patients who are in a crisis, have attempted before, and are suffering from a fear of death.
But what does it mean for all of us with doctors who don’t know to take such a symptom seriously? Well, we need to take it seriously in ourselves and others. The feelings of suicide can come on very quickly and if you spot in yourself a fear of dying associated with a panic attack, and you have bipolar disorder or depression, then it’s time to call 9-1-1 and tell them you are feeling suicidal. You don’t want to get to the place where your feelings have taken over for your brain; because then you won’t be able to make that call.
While it would be great if this information could be used by all doctors to protect us, if nothing else we can use this information to protect ourselves.