Why Suicide?

An Electronic Mental Health Newsletter from Joel I. Kimmel, Ph.D., P.A. & Associates

Volume 9, Number 8
August means the end of summer for most of us in South Florida. Vacations are over and children have returned to school. We look forward to one more holiday, Labor Day, and the advent of Fall. We have lived through very fierce weather including scorching hot days as well as violent thunderstorms as has the rest of the country. All of us have learned to be flexible which may become the word most descriptive of this decade. We hope you had the opportunity to vacation and relax and have not given in to the fear and anger generated by countless news reports about the events in the world.

We have all been made conscious of the tragedy of suicide as manifested by the death of Robin Williams. This was a man whose comic genius and grasp on life made us laugh. Admired by many, we laughed with him through The Bird Cage and Mrs. Doubtfire. Yet who can forget his poignant roles in Good Will Hunting and Dead Poets Society? How could such a talented and giving individual kill himself?

This month’s E-letter focuses on understanding suicide. Our email of the month is about 21 Suggestions for Success and our Ask the Doc question is about changes in teen behavior. We hope you find the enclosed information helpful. As always, we appreciate your questions and comments are welcome.

Practice News

Divorced Women’s Support Group. An eight week support group for women who are divorced will begin on Thursday evening September 11, 2014 from 6:00 to 7:15 P.M. In response to a request both from patients and attorneys, we are beginning this educational and support group, facilitated by Dr. Terry Newell. Areas of focus will include, but are not limited to:

  • Co-parenting issues
  • Living life as a single parent
  • Dealing with depression
  • Navigating finances
  • Developing personal interests
  • Managing stress

For further information or if you are interested in joining this group, please contact Jillian at 954 755-2885.

Depression group. A weekly depression therapy group meets regularly in our office. This group is run by Dr. Jim Kaikobad and meets for one and one-half hours. The group is educational, supportive, and confidential and is limited to 8 people. If you are interested in attending, please contact Jillian at 954 755-2885.

Research Study. If you are overweight, you might consider participating in a research study. Our practice has been asked by Life Extension Institute to participate in conducting research assessing the effects of cognitive therapy, nutritional supplements, and medications on weight management in overweight individuals. Informal results continue to show success for those subjects who are in the study. For more information about the study, contact Jillian, at 954 755-2885.

Parent Education and Family Stabilization Course. Our practice is one of the few offices certified to provide the Parent Education and Family Stabilization Course. Sometimes referred to as the Divorce Class, it is required by the State of Florida for all parents divorcing or separating even if not legally married. We have provided this course many times and have designed it as a 4-hour, one-session presentation that focuses on ensuring that parents protect their children from the effects of divorce or separation by setting aside their differences and focusing on the children’s need for both parents in their lives. The course also provides information about divorce as loss, gives an overview of the Florida laws and statutes related to divorce and custody issues, and offers information on how children react to divorce based on their ages. The course is offered live on a flexible schedule, based on the availability of those attending the course. Please contact our Administrative Assistant, Jillian, at 954 755-2885 for additional information.

Handouts from previous E-Letters can be found on our website, www.KimmelPsychology.com. We invite you to read and download them if desired.


Our E-Letter this month focuses on Suicide which Phil Donohue has referred to as a permanent solution to a temporary problem. It is one of the most anxiety producing situations for therapists to hear a patient say that they are thinking of killing themselves. It is also very scary for families or friends to have a member threaten suicide. Being able to discern whether the statement is serious or an attempt to get attention or manipulate others is very difficult. Every suicidal statement should therefore be taken seriously as you just might save someone’s life.

Suicide is a serious mental health problem that does take a huge emotional toll. Often seen as a very selfish behavior, families and friends are left to deal with the aftermath of a loved one’s suicide. Common reactions include guilt, anger, shock, and sadness: guilt about not being able to stop or prevent it, anger at not being allowed to help, shock and disbelief that it occurred, and sadness about the loss of a loved one.

In 2010, over 38,000 Americans killed themselves making suicide the 10th leading cause of death. Often people commit suicide because they feel trapped with no other way to find relief from their hurt. It is a desperate attempt to escape a painful and unbearable life that is often accompanied by feelings of self-hate, hopelessness, and isolation. 90% of people who commit suicide have a treatable mental disorder that may have gone unrecognized. In 2011, the CDC reported that the highest suicide rate was among people 45 to 64 years of age followed by those 85 or older. The suicide rate among men was 4 times higher than among women.

The most frequently cited risk factor for suicide is having a mental disorder such as depression, bipolar disorder, substance abuse, schizophrenia, PTSD, an eating disorder and some personality disorders. Depression and bipolar disorder are the most common risk factors followed by substance abuse, especially of prescription medications. Other risk factors can include hopelessness, helplessness, isolation, anxiety, impulsiveness, loss of a job, loss of one’s health, loss of a loved one, and being involved in abusive relationships. It becomes a lethal situation if several of these risk factors occur at the same time. The greatest predictor of suicide is a history of previous attempts.

Warning signs of suicidal behavior include:

  • Talking about wanting to kill themselves/wishing that they were dead
  • Giving away important possessions
  • Discussing a specific suicide plan
  • Saying goodbyes to others
  • Looking for a means to kill themselves including purchasing firearms or knives
    or hoarding medications
  • Talking about having no reason to live or feeling like a burden to others
  • Isolating oneself and withdrawing from friends and family
  • Losing interest in any activities and unable to feel any pleasure
  • Feelings of being trapped and needing to escape
  • Feeling humiliated and abused
  • Feeling hopelessness or helplessness
  • Putting one’s affairs in order
  • So what can you do? The most important thing you can do when you think someone may be suicidal is to take it seriously. 50% to 75% of people who attempt suicide tell someone about their intentions. Don’t wait to see what happens. Talk to them and tell them that you are concerned about them. It is better to overreact than not at all. Do not argue or lecture them on why suicide is wrong or try to guilt them into not doing it. Do not promise to keep it a secret. Be empathetic and encourage them to tell you their thoughts. Try to determine whether they have a plan, a time frame, means, and the intention to do it. Never leave the suicidal person alone. Call 911 or take them to the emergency room. Try to remove all lethal objects, weapons, and pills. Call or have them call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for guidance. Continue to offer caring and support after you have gotten them to a hospital or mental health professional. Medication, therapy, and support can be very effective in ending suicidal thoughts and behaviors.

    We offer the following information on Why Suicide:

    “Suicide is a permanent solution to a temporary problem” -Phil Donohue


    • Suicide is defined as the act of intentionally causing one’s own death
    • Between 800,000 to 1,000,000 people commit suicide around the world each year
    • It is the 10th leading cause of death; men are 3 to 4 times more likely to kill themselves than women
    • About 25-40 percent of those who completed suicide had contact with a mental health professional in the prior year
    • Suicide is a desperate attempt to escape a painful and unbearable life that is often accompanied by feelings of self-hate, hopelessness, and isolation
    • A suicidal person often sees no other way of finding relief except to commit suicide
    • Although existential theories such as the meaning of life, religion, and honor have influenced suicide, most suicides are committed out of despair and mental illness
    • Mental disorders that have a high correlation with suicide are depression, bipolar disorder, schizophrenia, PTSD, some personality disorders, and eating disorders
    • Depression and bipolar disorder are the most common risk factors for completed suicide followed by substance abuse, especially of prescription medications
    • Risk factors also include hopelessness, anxiousness, loss of pleasure, inability to problem solve, loss of family or close friend, poor impulse control, perception of being a burden to others, being bullied, loss of a job, isolation, abusive relationships and poverty
    • The greatest predictor for completing suicide is a history of previous attempts
    • The Werther effect or suicide contagion/copycat suicide is often enhanced by the media
    • In 56 countries, hanging was the most common form of suicide followed by drug overdose, using firearms and drinking pesticides
    • Most people who commit suicide do not want to die but to stop hurting
    • Suicide warning signs include talking about killing oneself, talking a lot about death and dying, giving possessions away, looking for things that could be used such as guns, knives, and pills, isolating oneself, having feelings of helplessness and hopelessness, saying goodbyes, putting one’s affairs in order, and expressing a sense of being trapped
    • The economic costs of suicides in the United States is estimated to be $34 billion annually, mostly due to lost wages and work productivity
    • Once the suicidal person is in treatment, medication and therapy can be quite helpful in ending suicidal thoughts and behaviors


    • Take any suicidal talk or behavior seriously; better to overreact than not at all
    • Do not argue or lecture why suicide is wrong and do not promise to keep it a secret
    • Talk to the suicidal person and try to evaluate the immediacy of the danger by asking whether they have a plan, a time frame, means and an intention to do it
    • Offer help and support; be empathetic and encourage them to talk to you
    • Never leave the suicidal person alone; call 911 or take them to an emergency room
    • Remove all lethal objects, weapons, and pills
    • Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for guidance
    • If you are plagued by suicidal thoughts or urges, seek professional help and do not be alone, talk to someone, call the Suicide Hotline, and/or go to the emergency room

    We Can Help!

    Call us at (954) 755-2885 or email us at drkimmel@kimmelpsychology.com

    Joel I. Kimmel, Ph.D., P.A. and Associates 5571 N. University Drive, Suite 101 Coral Springs, Florida 33067

    As always, we would like to welcome new readers to our e-Letter. We hope that you find it informational and enjoyable. We invite you to share this e-Letter with others. If you have received this from a fellow reader, please send us your email address to include you on our list.

    Ask the Doc

    SW writes: My 17 year old son just came back from a teen tour and will be going back to high school next week. He has been spending his time hanging out with old friends and some new ones. His behavior has changed since he is with these new kids. My husband thinks he is drinking and smoking pot. He stays out late and doesn’t really talk to us. I am afraid we are losing him. What should we do?

      Dr. Jim Kaikobad answers: If you truly have a good relationship with your son, you are not going to lose him. However, you are facing some challenges.

      First, remember your son is a teenager and a male. This is a developmental age where boys are generally curious, adventurous, and rebellious. They find their identities by aligning with “cool peers”. They generally engage in risk taking behaviors and learn by “trial and error”. Your son’s aloofness may be just a part of his search for identity by separating from parents and adults. Or he may indeed be drinking and smoking pot. Both of these behaviors, though scary and unacceptable to parents, have almost become a rite of passage for American teens.

      Secondly, our society has changed significantly where except for the age restriction, alcohol, tobacco, and now marijuana is legal in some locations. The media including television and especially the movies have glorified these behaviors. Teens are inventive and can get any of these products, even if underage. Fake IDs are easy to come by.

      Lastly you cannot be with your son 24 hours a day and police him as such. Your best options are to keep a warm, loving, and close relationship with him. Here are some suggestions:

    • Do not pull rank or authority as most teens rebel. As much as you think you can, you cannot control him.
    • Whenever possible educate him and plant a seed about the consequences of risky behaviors.
    • Be realistic, talk openly without exaggeration and drama.
    • Let the value of your relationship act as a deterrent from engaging in dangerous behaviors.
    • Most importantly, keep the lines of communication open at all times. He will rebel and make mistakes but he knows he can come to you when he errs.
    • Be there with understanding, patience, and forgiveness. His respect for you and the relationship may act as a deterrent when he is about to exercise poor judgment.
    • Keep an unobtrusive monitoring eye on him.
    • You will not prevent his inevitable developmental journey, but you can at least mitigate his mistakes from becoming blunders. Good luck. No one said parenting was easy, especially today.

    Email of the Month

    We would like to thank Sheila M. for the following email:

    21 Suggestions for Success

    1.Marry the right person. This one decision will determine 90% of your happiness or misery.
    2.Work at something you enjoy and that’s worthy of your time and talent.
    3.Give people more than they expect and do it cheerfully.
    4.Become the most positive and enthusiastic person you know.
    5.Be forgiving of yourself and others.
    6.Be generous.
    7.Have a grateful heart.
    8.Persistence, persistence, persistence.
    9.Discipline yourself to save money on even the most modest salary.
    10.Treat everyone you meet like you want to be treated.
    11.Commit yourself to constant improvement.
    12.Commit yourself to quality.
    13.Understand that happiness is not based on possession, power, prestige, but on relationships with people you love and respect.
    14.Be loyal.
    15.Be honest.
    16.Be a self-starter.
    17.Be decisive even if it means you’ll sometimes be wrong.
    18.Stop blaming others. Take responsibility for every area of your life.
    19.Be bold and courageous. When you look back on your life, you’ll regret the things you didn’t do more than the ones you did.
    20.Take good care of those you love.
    21.Don’t do anything that wouldn’t make your mom proud.

    Please continue to send us your comments, questions, and favorite emails for our e-Letter.

    Till September…

    The information provided in this electronic newsletter is not a substitute for professional treatment. It is the opinions of the writers and is provided solely for educational purposes. For mental health care, seek a qualified professional.

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    If you find this information interesting or helpful, please forward this e-Letter to your contacts and friends.

    Copyright © 2014 by Joel I. Kimmel, Ph.D., P.A. and Associates.