When feeling sad and lonely, knowing that others have similar problems and finding a friend to talk to are good coping strategies. People with a traumatic brain injury are frequently susceptible, so healthcare providers are looking for the medical reasons behind the elevated risks. Some background information is offered here to help people with TBI and their loved ones understand the status of current research and recognize the signs that make suicide so seductive to those who are feeling depressed and also coping with TBI.
The reader may find in it the relief that talking to someone would give. But if not, he or she should seek out a friend or get professional help.
Why are TBI Sufferers Suicidal?
According to a paper on TBI and associated psychiatric disorders, the authors say this subject provides a fertile field for research. There is a high incidence of TBI and low level of scientific evidence concerning the relationship between them. While doctors, patients, and caregivers frequently observe the relationship between TBI and depression and suicidal ideation, the damage to the brain that causes this relationship is not understood.
What is Known about TBI and Suicide?
An Australian paper outlines the current status of the relationship between persons with TBI and suicide. It notes several recent studies that report an elevated risk of death by suicide, suicide attempts, and suicide ideation among people with TBI. People with severe TBI are four times more likely to commit suicide compared with the general population and that people with mild injuries also have an elevated risk of suicide.
The authors advise practitioners to take the chronic, or life-long and habitual, tendency toward suicide among people with TBI into account.
Knowledge is Power for Persons with TBI and their Caregivers
The state of medical knowledge suggests that TBI sufferers and their caregivers should take into account that that an elevated risk of suicide has been observed, even though the elements of the injury that cause this to be the case are not well understood. The knowledge that points to a medical cause can help reduce overwhelming feelings of self-blame and hopelessness and help one gain control over the seductive urge to commit self harm.
In addition, the medical literature points to the fact that persons with TBI are prone to suicide attempts involving self-poisoning. Persons with TBI and their caregivers can restrain themselves or their loved one by keeping small amounts of medications on hand.
Suggested Reasons for TBI-related Suicide
One explanation is that a pre-injury situation (psychiatric or other illness, misuse of drugs or alcohol, aggressive personality) or a non-injury event (from the death of someone close or rejection by a friend or in a work situation) plays a more significant role than the brain damage alone. In particular, pre-injury substance abuse issues have been observed to increase the risk of suicide. Also, when pre-injury stress and substance abuse occur together, the risk is greatly increased.
However, depression and anxiety are widely observed after TBI, with major depression occurring in more than one-quarter of cases. So the case for pre-injury tendencies should not be overly stressed.
Rather, the more important reason for treatment for depression is the TBI. The observed correlation between post-TBI depression and suicide, suicide attempts, and suicide ideation point to the medical nature of the relationship, even when sometimes complicated by pre-injury states.
Perspective of the Person with TBI
A person with TBI suffers from a loss of self worth and feelings that life is no longer worth living. This situation develops as the person with TBI recognizes the changes in the cognitive and physical self and becomes discouraged. Life’s trials, embarrassments, and little things pile up to change the way the person with TBI feels about him- or herself. He or she may act impulsively when presented with the alternative not to live.
Friends and family often piece this together after the fact. Survivors blame themselves and think that if only one interaction with the person with TBI had been different, things might not have ended in suicide.
Suicide Following Recovery from Brain Injury by Dr. William F. Frey (for the The Perspectives Network) gets inside the emotion. “Life is precious,” he says, “but those who survive a TBI understand this differently than others that escape injury or death. The cost for the ‘fate better than death’ is often a loss of the pre-injury self. What is gained is simply another chance to be someone else that can struggle with the trials of life. It is not surprising that fatigue occurs over time and that this new self needs a great deal of nurturing to keep up to the task and not fall prey to the seductiveness of nonexistence.”
Sara E. Lewis - Sara E. Lewis is a writer and publications consultant. As a freelancer, she writes and produces marketing materials and especially enjoys ...
