Widespread myths can prevent you from knowing who’s at risk…

The instinct to live is hardwired in us. That’s why suicidal tendencies can be so difficult—even impossible—to grasp for people who have never felt a desire to die. The more we do know, however, the better able we are to reach out to people who are at risk of dying by suicide. To better understand suicide, it’s important to know the truth behind several long-standing myths…

MYTH: Suicide is an act of anger or revenge. Only 10% to 12% of suicides contain an element of anger or revenge. Unfortunately, these tend to draw media attention, painting all suicides with the same brush. In truth, the tendency to die by suicide can most often be attributed to two simultaneously occurring beliefs—the sense that one is a burden…and that one doesn’t belong. People considering suicide often think of themselves as a liability for their families, along the lines of They’d be better off without me. When accompanied by a lack of belongingness—a sense of loneliness and social alienation—the result can be lethal.

MYTH: Suicide is an easy escape, one that cowards use. Suicide is very difficult to accomplish—only one death occurs for every 20 attempts. Combat soldiers and policemen, who require physical fearlessness in their work, for example, are at high suicide risk. When they experience feelings of alienation and being a burden, their bravery can turn deadly. Physicians and dentists, in particular, are also at high risk—they are so exposed to pain and injury every day that they can become inured to the natural human aversion to taking one’s own life.

MYTH: People often die by suicide on a whim. When standing on top of a roof, many people experience a fleeting thought along the lines of What if I jumped? When driving a car around a sharp bend, a similar thought might occur—What if I drove off the road? It can feel like you had a sudden whim to end it all—but that’s not what’s happening.

That impulse is called the high-place phenomenon. It’s considered to be an instinctual safety signal that causes one to pay greater attention and take precautions—for example, to back up from the rooftop. Moments later, though, your slower perceptual system kicks in and misattributes the safety signal as a kind of a death wish. It’s nothing of the sort. Our studies have shown that the high-place phenomenon is, in fact, an urge to live, not die. By contrast, taking one’s own life is usually preceded by detailed planning and resolve.

MYTH: Unless you’re depressed, you’re not at risk for suicide. While depression is a significant risk factor for suicide, it is not the only one. Mental disorders such as anorexia nervosa, schizophrenia and borderline personality disorder increase suicide risk. Additional risk factors include stressful life events (such as a death, divorce or job loss), access to firearms and historical factors, including a family history of suicide, previous attempts and childhood abuse. More than one in 10 suicides are related to chronic or terminal illness.

MYTH: Most people who die by suicide leave a note. Seventy-five percent of people who kill themselves don’t leave a note or other message for loved ones. Unfortunately, that helps fuel the incorrect notion that the act was impulsive.

To understand why notes are so rare, remember that people who are considering suicide are typically in a state of misery and isolation, which makes it very hard to communicate. Those who do leave notes tend to provide factual instructions about day-to-day matters rather than an emotional missive.

MYTH: Suicidal behavior peaks around the end-of-year holidays.  In fact, suicides tend to occur in the spring. That’s true around the world. Why? The explanation that I favor comes back to the idea that suicide requires a great deal of resolve and focus. In the spring, all living things—human, animal, even plant—become more energetic. For most people that’s a good thing, but a small percentage experience symptoms such as agitation, edginess and trouble sleeping. This clinical state of overarousal, combined with alienation and burdensomeness, is correlated with higher rates of suicides during the spring.

MYTH: There are more suicides in big cities than in rural areas. Not true. People who live in rural counties are 70% more likely to die by suicide than those who live in big, metropolitan areas. The reason may be that rural residents hold more physical occupations, which often go hand-in-hand with a higher level of everyday fearlessness. Another factor may be that they live far from their neighbors, resulting in social isolation. The lack of easy access to doctors and other medical professionals may also contribute.

MYTH: If people want to die by suicide, we can’t stop them. A landmark study found that 94% of people who were restrained from jumping off the Golden Gate Bridge in San Francisco were still alive decades later or had died from natural causes. This was true even though they had high-risk characteristics that suggest a determined mind-set—most were men (who are at greater risk than women)…had chosen a highly lethal method (jumping from a high structure)…and were rarely referred to mental health treatment after being restrained (unfortunate but not uncommon). Yet nearly all of them chose to keep on living. This suggests that intervention can save lives.

If you or a loved one is considering suicide or shows suicidal tendencies, there is help available! The suicide hot line 800-273-TALK is a great resource—callers speak with a trained crisis worker who listens to their problems and then provides information on mental health services in the caller’s area.

Another good option: Reaching out to a primary care physician who can prescribe medication and/or recommend a mental health professional.