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It’s better to

burn out O T Y A N A W A TH E D A F

In the hundred years since Victorian times, attitudes to sex and death have completely reversed. In those days death was much discussed and celebrated as a normal part of daily life while sex was virtually unmentionable. Now the reverse is true - sex is open for wide discussion while death has become the great taboo. Perhaps this is one of the

reasons why the way in which we leave this world is a subject that brings out intense emotion and often anger. And nothing seems to raise the debate to more fevered levels than the idea that each of us may choose the time and place of our death.

>> This is an informative publication on the topic suicide, and it also provides tips on suicide prevention. >>

Types of suicide >honour suicide >Copy cat suicide >Advocacy of suicide Gender & suicide >Suicide rates

Contents page

Suicide prevention >Understanding and preventing it >Common misconceptions about it >Warning signs >Do’s and Don’ts when talking to a suicidal person >Suicide in teens and the elderly TOP 10 Methods of suicide The Stigma of suicide

D E T S I S AS T L U C E D i C i L i FAM

d e c for


typ o suic

pes of cide



types of suicide



Honor suicide is a process whereby a person commits suicide to escape the shame of an immoral action, such as having had extramarital sexual relations. It is distinguished from regular suicide in that the subject is actively deciding to either privately or publicly kill themselves for the sake of restoring honor. Some honor suicides are a matter of personal choice and are devoid of any cultural context. For example, honor suicides have been committed by military figures when faced with defeat, such as Władysław Raginis and Hans Langsdorff. Japan has a long history of suicide in its culture. Seppuku is a type of ritual suicide that was practiced by samurai to avoid capture. During World War 2, both Banzai charges and Kamikaze attacks were suicidal types of attacks used against the enemy. Suicides in Japan are also often used to atone for wrongdoing.


Seppuku (“stomach-cuttingâ€?) is a form of Japanese ritual suicide by disembowelment. Seppuku was originally reserved only for samurai. Part of the samurai bushido honor code, seppuku was either used voluntarily by samurai to die with honor rather than fall into the hands of their enemies (and likely suffer torture), or as a form of capital punishment for samurai who had committed serious offenses, or performed for other reasons that had brought shame to them. The ceremonial disembowelment, which is usually part of a more elaborate ritual and performed in front of spectators, consists of plunging a short blade, traditionally a tantĹ?, into the abdomen and moving the blade from left to right in a slicing motion.

types of suicide



A copycat suicide is defined as an emulation of another suicide that the person attempting suicide knows about either from local knowledge or due to accounts or depictions of the original suicide on television and in other media.

The well-known suicide serves as a model, in the absence of protective factors, for the next suicide. This is referred to as suicide contagion. They occasionally spread through aschool system, through a community, or in terms of a celebrity suicide wave, nationally. This is called a suicide cluster. Suicide clusters are caused by the social learning of suicide related behaviors, or “copycat suicides�. Point clusters are clusters of suicides in both time and space, and have been linked to direct social learning from nearby individuals.Mass clusters are clusters of suicides in time but not space, and have been linked to the broadcasting of information concerning celebrity suicides via the mass media. Examples of celebrities whose suicides have inspired suicide clusters include Ruan Lingyu, the Japanese musicians Yukiko Okada and hide, Kurt Cobain and Marilyn Monroe, whose death was followed by an increase of 200 more suicides than average for that August month. Another famous case is the self-immolation of Mohamed Bouazizi, a Tunisian street vendor who set himself on fire on December 17, 2010, an act that was a catalyst for Tunisian Revolution and sparked Arab Spring, including several men who emulated Bouazizi’s act. To prevent this type of suicide, it is customary in some countries for the media to discourage suicide reports except in special cases.

types of suicide

William Francis Melchert-Dinkel (from Faribault, Minnesota, United States) is a former LPN (Licensed Practical Nurse) and convicted online predator. He was found guilty of encouraging people to commit suicide while he watched voyeuristically on a webcam. He allegedly told those contemplating suicide what methods worked best, that it was a decent choice to commit suicide, that they would be better in heaven, and/or falsely entered into suicide pacts with them, which he then abandoned. He is a married father of two.

Advocacy of


types of suicide


He allegedly met his victims in internet suicide chat rooms, where he posed as a depressed woman in her 20s. Investigators say he told them he encouraged dozens of people to kill themselves, contacting more than 100 people. According to the police, Melchert-Dinkel, admitted to using a number of e-mail addresses to persuade five people to kill themselves. He allegedly admitted using two e-mail addresses, andli_, and the alias Cami D, to advise, encourage and create suicide pacts, typically by hanging, with persons on the internet for four to five years.


Melchert-Dinkel was convicted on March 15, 2011, in a criminal complaint filed in Rice County, Minnesota. He was charged under a rarely used state law with advising, encouraging, or assisting Kajouji and Drybrough in taking their own lives using internet correspondence. He was ordered to stay off the internet while his criminal case is pending. While counseling to commit suicide is illegal, laws in North America and Britain have not previously been successfully used to prosecute anyone for promoting suicide over the internet. He was found guilty of aiding a suicide under Minnesota law, which provides penalties for anyone who “intentionally advises, encourages, or assists another in taking the other’s own life�, punishment can be up to 15 years in prison and a fine of up to $30,000. He was sentenced on May 4, 2011, to 360 days in jail.

gender & suicide The relationship between gender and suicide has been extensively researched by Western sociologists, given that males die much more often by means of suicide than do females, although reported suicide attempts are 3 times more common among females than males. American males between the ages of 20 and 24 have a suicide rate that is seven times higher than that of women.

GENDER & suicide




Female Poisoning


Some medical professionals believe this stems from the fact that males are more likely to end their lives through effective violent means (guns, knives, hanging, etc.), while females primarily use less violent methods such as overdosing on medications. The incidence of completed suicide is vastly higher among males than females among all age groups in most of the world. In the United States, the ratio varies between 3:1 to 10:1. Some ascribe the disparity to inherent differences in male/ female psychology.

Greater social stigma against male depression and a lack of social networks of support and help with depression are often identified as key reasons for men’s disprportionately higher level of suicides, since suicide as a “cry for help� is not seen by men as an equally viable option.






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Suicides per 50 000 Males Suicides per 50 000 Females

GENDER & suicide

Typically males die from suicide three to four times more often as females, and not unusually five or more times as often. Campaign Against Living Miserably is a charity in the UK that attempts to highlight this issue for public discussion. Excess male mortality from suicide is also evident from data from non-Western countries. In 1979-81, out of 74 countries with a non-zero suicide rate, two reported equal rates for the sexes (Seychelles andKenya), three reported female rates exceeding male rates (Papua New Guinea, Macau, and French Guiana), while the remaining 69 countries had male suicide rates greater than female suicide rates.The contrast is even greater today, with WHO statistics

showing China as the only country where the suicide rate of female matches or exceeds that of males.

In most countries, most committed suicides are made by men, but in China women are 40% more likely to commit suicide. It has been found that suicide makes up for about 30% of deaths of women living in rural China. Traditional gender roles in China hold women responsible for keeping the family happy and intact. Suicide for women in China is shown in literature to be an acceptable way to avoid disgrace that

may be brought to themselves or their families. One explanation for increased suicide in women in China is that pesticides are easily accessible and tend to be used in many suicide attempts made by women. Another explanations is that women are still seen as subservient to men due to Chinese gender roles. Thirdly, difficult living conditions and strict views on marriage and family values cause women high stress which is a risk factor for suicidal behavior. The rate of nonlethal suicidal behavior is 40 to 60 percent higher in women as it is in men. This is due to the fact that more women are depressed than men, and also that depression is correlated with suicide attempts.


suic i d prev e enti on

A suicidal person may not ask for help, but that doesn’t mean that help isn’t wanted. Most people who commit suicide don’t want to die— they just want to stop hurting. Suicide prevention starts with recognizing the warning signs and taking them seriously. If you think a friend or family member is considering suicide, you might be afraid to bring up the subject. But talking openly about suicidal thoughts and feelings can save a life.


UNDERSTANDING AND PREVENTING SUICIDE The World Health Organization estimates that approximately 1 million people die each year from suicide. What drives so many individuals to take their own lives? To those not in the grips of suicidal depressionand despair, it’s difficult to understand what drives so many individuals to take their own lives. But a suicidal person is in so much pain that he or she can see no other option.

Suicide is a desperate attempt to escape suffering that has become unbearable. Blinded by feelings of self-loathing, hopelessness, and isolation, a suicidal person can’t see any way of finding relief except through death. But despite their desire for the pain to stop, most suicidal people are deeply conflicted about ending their own lives. They wish there was an alternative to committing suicide, but they just can’t see one.

“If a person is determined to kill him/herself, nothing is going to stop them.” Even the most severely depressed person has mixed feelings about death, wavering until the very last moment between wanting to live and wanting to die. Most suicidal people do not want death; they want the pain to stop. The impulse to end it all, however overpowering, does not last forever.

“Anyone who tries to kill him/herself must be crazy.” Most suicidal people are not psychotic or insane. They must be upset, grief-stricken, depressed or despairing, but extreme distress and emotional pain are not necessarily signs of mental illness.

“Talking about suicide may give someone the idea.” You don’t give a suicidal person morbid ideas by talking about suicide. The opposite is true — bringing up the subject of suicide and discussing it openly is one of the most helpful things you can do.



WARNING SIGNS OF SUICIDE Most suicidal individuals give warning signs or signals of their intentions. The best way to prevent suicide is to recognize these warning signs and know how to respond if you spot them. If you believe that a friend or family member is suicidal, you can play a role in suicide prevention by pointing out the alternatives, showing that you care, and getting a doctor or psychologist involved. Major warning signs for suicide include talking about killing or harming oneself,

talking or writing a lot about death or dying, and seeking out things that could be used in a suicide attempt, such as weapons and drugs. These signals are even more dangerous if the person has a mood disorder such as depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide. A more subtle but equally dangerous warning sign of suicide is hopelessness. Studies have found that hopelessness is

a strong predictor of suicide. People who feel hopeless may talk about "unbearable" feelings, predict a bleak future, and state that they have nothing to look forward to. Other warning signs that point to a suicidal mind frame include dramatic mood swings or sudden personality changes, such as going from outgoing to withdrawn or well-behaved to rebellious. A suicidal person may also lose interest in day-to-day activities, neglect his or her appearance, and show big changes in eating or sleeping habits.

Talking about suicide

Self Seeking destructive out lethal behaviour means

Any talk about suicide, dying, or self-harm, such as "I wish I hadn't been born," "If I see you again...," and "I'd be better off dead."

Increased alcohol or drug use, reckless driving, unsafe sex. Taking unnecessary risks as if they have a "death wish."

Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt.

Preoccupation with death

Self hatred

Withdrawing from others

Unusual focus on death, dying, or violence. Writing poems or stories about death.

Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden ("Everyone would be better off without me").

Withdrawing from friends and family. Increasing social isolation. Desire to be left alone.

Getting affairs in order

No hope for the future

Sudden sense of calm

Making out a will. Giving away prized possessions. Making arrangements for family members. Saying goodbye Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won't be seen again.

Feelings of helplessness, hopelessness, and being trapped("There's no way out"). Belief that things will never get better or change.

A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to commit suicide.


Do’s and Don’ts When talking to a suicidal person

Be yourself

Be sympathetic

Offer hope

Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it.

non-judgmental, patient, calm, accepting. Your friend or family member is doing the right thing by talking about his/her feelings.

Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important to you.



Offer ways

Avoid saying things like: “You have so much to live for,” “Your suicide will hurt your family,” or “Look on the bright side.”


to fix their

Refuse to be sworn to secrecy. A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe. If you promise to keep your discussions secret, you may have to break your word.

problems or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your friend or loved one.

Listen Let the suicidal person unload despair, ventilate anger. No matter how negative the conversation seems, the fact that it exists is a positive sign.

Blame yourself You can’t “fix” someone’s depression. Your loved one’s happiness, or lack thereof, is not your responsibility.

Suicide in Teens Teenage suicide is a serious and growing problem. The teenage years can be emotionally turbulent and stressful. Teenagers face pressures to succeed and fit in. They may struggle with selfesteem issues, selfdoubt, and feelings of alienation. For some, this leads to suicide. Depression is also a major risk factor for teen suicide.

Other risk factors for teenage suicide include: -Childhood abuse -Recent traumatic event -Lack of a support network -Availability of a gun -Hostile social or school environment -Exposure to other teen suicides

Suicide warning signs in teens Additional warning signs that a teen may be considering suicide: -Change in eating and sleeping habits -Withdrawal from friends, family, and regular activities -Violent or rebellious behavior, running away -Drug and alcohol use -Unusual neglect of personal appearance -Persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork -Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc. -Not tolerating praise or rewards

Suicide in teens

The highest suicide rates of any age group occur among persons aged 65 years and older. One contributing factor is depression in the elderly that is undiagnosed and untreated.

Other risk factors for suicide in the elderly include: -Recent death of a loved one -Physical illness, disability, or pain -Isolation and loneliness -Major life changes, such as retirement -Loss of independence -Loss of sense of purpose

Suicide warning signs in older adults Additional warning signs that an elderly person may be contemplating suicide: -Reading material about death and suicide -Disruption of sleep patterns -Increased alcohol or prescription drug use -Failure to take care of self or follow medical orders -Stockpiling medications -Sudden interest in firearms -Social withdrawal or elaborate good-byes -Rush to complete or revise a will




METHODS of SUICIDE The unfortunate and depressing issue of suicide has become a staggering piece of harsh reality in today’s world. In the US, ranking 46th in the world of rates per capita, we experience 11,000 self-inflicted deaths per year, and the UK: 7,000. This has become a serious issue

for many countries whether the factors be family issues, health issues, money problems, or relationship failures. The ways in which people decide to shuffle this mortal coil are numerous and varying. Ten of the most often seen are as follows.

#10 drowning How it’s Done: Driving or even walking into a large body or water or perishing in a slightly-filled bathtub.

#09 electric shock How it’s Done: Jamming a utensil in a wall outlet, dunking an appliance in an occupied bathtub.

Results from Failure: Oxygen deprivation Results from Failure: can cause severe and Deep burns from 500permanent brain damage. 1000 volts, ventricular fibrillation at 110220 volts, and severe neurological damage.

#08 #07 exsanguaination jumping How it’s Done: Using a sharp implement such as razors or knifes to rapidly harm one’s self yet pass on relatively slowly, is to slit the wrists or the carotid, radial, ulnar, or femoral artery. Contrary to popular belief, the effective method for this is not to cross the wrist, but to draw the blade up the forearm. Results from Failure: Extreme loss of blood causing the heart to dramatically slow eventually depriving the brain of oxygen. Also, most often, deep scars and tissue damage.

How it’s Done: Leaping off a building or a cliff over jagged rocks, or bridges. Results from Failure: Shattered femurs from impacting with water up to severe bodily harm from impacting with any solid surface.


#06 suffocation How it’s Done: Asphyxiate yourself with a plastic bag over your head. Inhaling nitrogen or helium directly. Results from Failure: Turning back at the last minute can result in long-lasting permanent brain damage.

#05 carbon monoxide inhalation How it’s Done: Locking yourself in a car/ closed garage with the engine running and going to sleep. Results from Failure: CO molecules irreversibly attach themselves to human hemoglobin and the result is often fatal even if one backs out.

#04 poisoning

#03 hanging

How it’s Done: Locking yourself in a car/ closed garage with the engine running and going to sleep.

How it’s Done: acquire a length of rope and construct yourself a noose. Once built, wrap one end securely around something high: a rafter or a ceiling fan, and leap, head fastened within the loop, from a chair. Or, if you’re short of rope, anything strong enough to support your weight from your neck can be employed.

Results from Failure: CO molecules irreversibly attach themselves to human hemoglobin and the result is often fatal even if one backs out.

Results from Failure: Brain damage from lack of oxygen, Often, failure to actually break your own neck may only yield strangulation and you can be saved, but damaged. Also, permanent rope burns or implement scarring can occur.

#02 drug/ alochol overdose How it’s Done: Within your medicine cabinet lies the answer to your extermination: prescription and overthe-counter meds. A huge mouthful can do you right in. Or, to speed along the process, couple your target pills with a few swigs of alcohol. Many of our favorite musicians have chosen this route. Even alcohol alone, in extreme excess can kill you. Results from Failure: Severe to permanent organ failure if successful removal isn’t achieved, as well as impaired judgment. Often, clinical assistance is necessary if attempt is repeated.


#01 gun shot How it’s Done: One of the most often achieved forms of suicide is by gun shot. Generally a head shot is desired since its results are 99 percent effective, however a chest shot can be equally as devastating. Results from Failure: Sometimes the blast isn’t enough to kill. In this case, severe to permanent bodily damage can occur as well as blood loss, organ and tissue damage, and brain damage.

THE STIGMA OF SUICIDE Suicide is one of the few remaining taboos in today’s society. We struggle to understand how someone can take their own life. Since childhood, people have been taught that those who are suicidal or who have completed a suicide are shameful, sinful, weak, selfish, and in some cases, some people believe suicide is a permanent solution to a temporary problem. As of yet, there appears to be no scientific studies that can confirm that suicidal people have any of these qualities. What we do know is suicide has become not only a national concern but a worldwide concern and social stigma of suicide plays a vital role. According to data from World Health Organization (WHO),

almost one million people commit suicide per year in the world that is one suicide every 40 seconds. 60% of suicides are committed in Asia. The number of young people committing suicide and the reasons for suicide are multiplying by the day across the world. Debts, illnesses, broken relationships, failure in exams, substance abuse, war and the list goes on. Mental health professionals agree that a suicide is a cry for help that went unattended. A recent study has reported that children who had lost a sibling or a parent to suicide and returning to the school environment have been subjected to harsh treatment by both teachers and fellow students. Responses ranged

from that of a teacher informing a student that her father would be going to hell because “suicide is a sin,” to students ostracizing a student who lost her sibling by saying “stay away from her, she has suicide germs.'' (Davis, C. & Hinger; Assessing the needs of the survivors of suicide) The stigma of suicide remains big enough to discourage people, especially the elderly, from talking about their suicidal thoughts. Some people feel that they might be labeled as weak, lacking faith, coming from bad families if they were to share about their suicidal thoughts. This stigma can be a major obstacle to people getting help. It may also prevent us from speaking openly and freely about the problem and discussing what we can do, and can lead to misunderstandings and intolerance which are barriers to change.

Any approach to prevent suicide should include the removal of blame and stigmatizing. Many people that have taken their own lives have suffered from long term mental illness. They have been treated for years and years with little to no results. Some mental health issues are not temporary problems but long term problems that require a lifetime of medication and specialized help. It is information such as this that could help remove the stigma of suicide. This stigma can make it more difficult for people who feel suicidal or who have lost someone to suicide. There is a great need to change public attitudes, and increase awareness and understanding about suicide as a major public health problem that is largely preventable.


Local Helplines 1800-221-4444 >>Samaritans of Singapore 1800-353-5800

>>Care Corner Mandarin Counselling Centre: 1800-2744-788 >>Tinkle Friend

Tan Yue Li 2012

it's better to burn out than to fade away  

informative on suicide, and suicide prevention

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