Suicidal Young Adults Research Articles

Suicidal ideation and young adults

SIR: The article by Patrick J. Meehan, M.D., and associates ( 1 ) brings up an important issue, namely, the high prevalence of suicidal thoughts in a normal population. Of 694 college freshmen/women in the sample, 54% had ever considered suicide, 10% had attempted it, and 3% sought help as a result of such attempts. Data presented but not discussed (table 1 of Dr. Meehan and associates’ article) show that 62% of women, compared with 44% of men, had ever considered suicide. Almost the same proportion of men (43%) and women (49%) had thought of specific ways to take their own lives. Another recent study corroborates these findings among high school students: 33% had thought of suicide, and 4.5% reported an attempt in the previous year (2). When half or more of a sizable, typical cohort exhibits a phenomenon associated with psychiatric morbidity and montality, how are we to view it? Not, I submit, by striving to eradicate suicidal thoughts per se, although a reduction in their prevalence might be a good thing. Instead, we might view the phenomenon as fairly typical of a stressful transition. Although a sign of pain, suicidal ideation may indicate health as much as illness. The refusal of suicide suggests a commitment, an engagement with life which is stronger than passive acquiescence. In the psychiatric history, I have come to regard episodes of suicidal ideation with concern, but not qualms, in most cases. It may be no more, and no less, than a pause at the mirror of philosophy: Is this life worth living? Even Albert Camus, who called it “the one truly serious philosophical problem,” remarked that suicide is rarely committed through reflection (3). The literature of autobiography abounds with instances of suicidal ideation followed by an affirmation oflife. Mark Twain wrote about putting a gun to his head at the age of 30: “Many times I have been sorry I did not succeed, but I was never ashamed of having tried” (4). A generation later in Freud’s Vienna, Otto Rank, at age 20, went through a similar crisis and wrote: “Afterwards there grew in me the greatest lust for life and courage towards death” (5). WilliamJames confronted suicide at 28, and wrote at 54, “I take it that no man is educated who has never dallied with the thought of suicide” (6). Many similar examples could be cited, i.e., Arthur Rubinstein, Graham Greene, Karen Homey . . . . Is the episode a sign or harbinger of pathology? I submit that we do not know and should be slow to assume so. Many young people today-close to half-have suicidal thoughts at least once. Epidemiological study may shed light on the psychiatric and social significance of the phenomenon. Meanwhile, we should be cautious about putting suicidal ideation on a single continuum of disease and death. The phenomenon may have as much on more to do with affirmation of life and immunity to actual suicide. It may be a part of normal, healthy adult development.