Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Hopelessness & Suicide

A key element in suicidal behavior is the feeling of helplessness, which arises from prolonged periods of extreme stress or emotional upset. This includes abuse, poverty, terrible living conditions, neglect, poor health, injury, or the perception of permanent disability. It is the absence of hope for improvement that can and does precipitate depression and suicidal thoughts for some injured workers.

Statistically, 90% of the people who commit suicide have a mental or substance abuse disorder (or both), and more than half are seriously or clinically depressed. Although most depressed people are not suicidal, most suicidal people are depressed.

Twenty to twenty-five percent of suicidal individuals are intoxicated. Alcohol does not a cause of suicide. However, alcohol lowers self-control and increases impulsive behavior. Not surprisingly, someone with a mental disorder who also drinks is at increased risk of suicide.

Hopelessness in conjunction with a mental disorder such as depression is a dangerous warning sign that always needs to be taken seriously. For the hopeless individual, sometimes death by suicide is seen as an improvement over living with unrelieved illness or pain.

People often express hopelessness in statements that they make, such as the following:

_ Things will never get better.
_ There are no solutions to my problems.
_ I will never be happy again.
_ I will never get over what happened.
_ I don’t see things ever improving.
_ There is no point in trying anymore.
_ I just want to give up.
_ I feel so hopeless.
_ There is no hope for me.
_ What do I have to look forward to?
_ The future is empty for me.
_ I only see things getting worse in the future.
_ Everything is going downhill.
_ I will never get back to the way I was.
_ It’s too late for me.
_ There is nothing that I can do to make things better.

Levels of hopelessness can be quickly assessed by using a device called the “Beck Hopelessness Scale” – from research by Beck et al., and further measured and corroborated by more in-depth evaluation.

Anyone expressing feelings of hopelessness who may be suffering from depression or a similar disorder needs to be evaluated. Effective treatment can eliminate or substantially reduce feelings of hopelessness. Indeed, depression is highly treatable, and the vast majority of people who receive treatment get better.

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