More urban myth than actual reality, the holiday season does not have the highest incidence for suicide. Though suicide is the most preventable kind of death with an average of 3,000 people dying by suicide each day – November and December actually have the lowest rates of suicide. The highest rate of death by suicide occurs in the spring[i].
The movie, It’s a Wonderful Life tends to get a lot of airplay during this holiday time. And while the main character, George Bailey, contemplates dying by suicide at Christmas, his story is more off-trend than on. What George Bailey realizes by the end of the movie is the meaningfulness of social connection, family and love. And it’s those elements, according to research, that help discourage many depressed people from suicide at this time of year[ii]. The increased emotional and social support during holiday time temporarily dims the feelings of despair and anguish for many depressed children and adults. However, it’s important for health care professionals and the general public to note that while a “depressive calm” may linger through the winter, it may lead to an “energized despair” come spring[iii].
The pattern of spring being a heightened risk for suicide has been long known. It was first observed in 1897 by the sociologist, Emile Durkheim[iv], who described suicides in Europe reaching “its maximum during the fine season, when nature is most smiling and the temperature milder.” There are many contemporary studies linking a climate-suicide dynamic. For example, data points to Vitamin D[v], melatonin[vi], warmer temperatures[vii], abundant sunshine[viii], inflammation, allergens and viruses[ix] that can jump-start an energized despair.
Even Gabennesch’s Broken Promise Effect[x], the psychological theory where despair gives way from reality not meeting raised expectations, follows this climate paradigm. As winter thaws into spring, there is the hope for renewal that if not delivered can set into motion agitation and despair.
5 Tips for Depression Support
What’s most important this holiday time of year is for health professionals and the general public to understand depression, suicidality and offer support.
- Identify those at-risk: People at-risk for depression are children and adults who may have endured a significant loss or illness; have a history of physical, sexual or emotional abuse; experience alcohol or drug abuse; are socially isolated or have been through a traumatic event, financial hardship and/or school failure. A family history of mood disorders raises the statistics for being at-risk for depression.
- Know suicide warning signs Though death by suicide peaks in spring, there will be some who die by suicide this holiday season. Keep in mind the warning signs of suicidality which include: getting affairs in order, giving away items, increased alcohol and drug use, no hope for the future, preoccupation with death, previous suicide attempt, saying goodbye, seeking out lethal means, self-destructive behavior, sudden sense of calm, talking about suicide, withdrawing from others.
- Pave the way for support: Health professionals, media and concerned family/friends should create an open and stigma-free forum to discuss the topic of depression during the holidays and the risk of death by suicide. Family, friends and co-workers are encouraged to check in on those who are depressed, lonely, ill, elderly, shut-in or disabled on a consistent and regular basis. It can be a most significant lifeline.
- Outreach: Health professionals and media should approach holiday depression and suicide interventions with science, not sensationalism. Reporting facts, debunking stigma and publicizing resources like the National Alliance on Mental Illness Hotline (800) 950-NAMI (6264); the National Suicide Prevention Lifeline at 800-273-TALK or 800 SUICIDE, should be a main goal.
- Have a safety plan at-the-ready. Health professionals and family members should create a safety plan if depression devolves into suicidal thinking. This includes knowing which mental health professionals to call; which hospitals, if necessary, to use; which family members and friends to ask for assistance; having medication or treatment files ready to share, and knowing exactly how this process will unfold.
Suicide is a significant risk for anyone with a mental illness, but is exponentially higher for children and adults with depression[xi]. Though suicide is the most preventable kind of death, more than a million people die by suicide each year–more than all the deaths caused by accidents, wars, and homicides, around the world, combined. It’s time for us to lower this statistic with greater detection, diagnosis, intervention and compassionate understanding.
[ii] Ajdacic-Gross V.; Bopp M. et. al. (2010). Seasonality in suicide – A review and search of new concepts for explaining the heterogeneous phenomena. Social Sciences Medicine, 71:657-666.
[iii] Sher, L. (2004). Weather, climate, and suicidality. Acta Psychiatrica Scandinavica, 109:319.
[iv] Durkheim, E. (1897). Le Suicide: Etude de sociologie. Paris: Alcan.
[v] Tariq, M.M. et. al (2011). Vitamin D: A potential role in reducing suicide risk? International Journal of Medical Health, 23(3):157-165.
[vi] Havaki-Kontaxi, B.J. et. al (2010). Seasonality, suicidality and melatonin. Psychiatrike, 21(4):324-331.
[vii] Preti, A., Lentini, G., and Maugeri, M. (2007). Global warming possibly linked to an enhanced risk of suicide: Data from Italy, 1974-2003. Journal of Affective Disorders, 102:19-25.
[viii] Thorson, J. A., and Kasworm, C. (1984). Sunshine and suicide: Possible influences of climate on behavior. Death Education 8:125-136.
[ix] Okusaga, O. et. al (2011). Association of seropositivity for influenza and coronaviruses with history of mood disorders and suicide attempts. Journal of Affective Disorders, 130(1-2):220-225.
[x] Gabennesch, H. (1988). When promises fail: A theory of temporal fluctuations in suicide. Social Forces, 67:129-145.
[xi] Serani, D. (2011). Living with Depression. Lanham: Rowman & Littlefield.