The headline this week about Pastor Rick Warren’s 27 year old son committing suicide brings the tragedy of suicide as well as the connection between guns and suicide to our attention. The Warren family, like the grieving families of Newtown have tried to use their anguish to advocate for social change concerning guns as well as mental illness. Matthew Warren’s story sounds particularly heart rending as the family reports that he received extensive treatment, had a supportive loving family and still succumbed to the misery that depression inflicts on those suffering from it. He committed suicide with an unregistered gun he bought on the internet.

SUICIDE AND IMPULSIVE ACTION

As I wrote in my previous blog on Guns and Mental Health, two thirds of gun related deaths in this country are due to suicide. The number was 19,392 in 2010, the most recent year for which we have statistics. It is widely reported that more women attempt suicide but more men complete suicide because they are more likely to use the most lethal weapon, a gun. While it is true that some suicides are meticulously planned, most occur impulsively and the risk of death goes up greatly when there is a gun in the home. The current controversy about background checks can address this issue as people with certain types of mental health histories could be denied the right to purchase a gun. Pastor Warren did report that his son bought an unregistered gun on the internet. Adding another layer of difficulty in obtaining a gun could preserve many lives that are lost to suicide. A history of hospitalization for a suicide attempt or severe depression should be one of the indicators for review before the lawful purchase of a firearm.

Many people who suffer from depression also have anxiety disorders. High anxiety causes impulsivity. Others have Bipolar Disorder which can lead to severe episodes of depression but is also highly associated with impulsivity. There are many who have attempted suicide who did so in a moment of acute panic or distress that subsides in a matter of hours or days. For years, I consulted in the emergency room of a general hospital where I was frequently called in after someone made a suicide attempt, usually by drug overdose. One of the first questions I usually asked the patient was , “are you sorry you are still alive.” Almost always the patients said no and wanted help. The attempt often occurred impulsively after an upsetting event or conversation. This seems particularly common among teenagers who are more impulsive than adults in general. An argument with a friend, a nasty remark on Facebook, a screaming match with a parent may lead a teenager to take a suicidal action. When there is a gun in the house the ability to act on the impulse in a way that ensures death rises enormously.

DEPRESSION AND SUICIDAL FEELINGS

Depression, like many other common disorders waxes and wanes in severity. Even with the best of treatment and effort, depression can swing out of control, leaving the sufferer more prone to suicidal feelings and impulses. In the depths of despair, people tend to forget that they ever feel okay; that they will not always suffer. The decision to end the current suffering can lead to a solution with absolute finality when a gun is available to the person with depression.  Without a gun, treatment can attempt to alleviate the symptoms and the chance for recovery exists. There are many studies that show that states with the highest rate of gun ownership have the highest rates of gun suicide. Depression is a serious, life threatening illness that can cause suicidal thoughts, even in the absence of observable problems in the persons life. There are people with terrible depression who have never seriously contemplated suicide. Suicidal thoughts are a symptom, not necessarily a result of depression. Removing guns from the equation, by reducing ease of access during times of impulsive suicidal feelings can save lives.