Hidden Suicide Danger

In the Viewpoints column in the October 17 issue, Dr. Al Herzog’s discussion of recognizing suicide signs in our patients provided valuable guidelines. There is too often one danger that may be hidden—it presents in the seemingly recovered patient and may be from any of several causes.

In patients with severe depression, thinking is more or less frozen. With improvement, especially from medication, the patient’s thought processes clear, and the idea of suicide offers a solution to problems. The patient is calmer, and the physician is misled. The improvement in thinking can enable the patient to plan his or her suicide without the family’s or caretaker’s recognition.

This danger is present whether treatment includes ECT or antidepressant medications (which are wrongly blamed). We can’t always recognize these cases, but treatment of symptoms only without genuine knowledge of patients and their problems makes it impossible.