Bipolar Disorders

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The suicide rates among ethnic groups in
the United States vary widely. In 2002,
more teenagers and young adults died
from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia and influenza, and chronic lung disease
combined (National Center for Health Statistics, 2004).
Suicides per 100,000 population
FIGURE 1 2 .4
Suicide Rates by Gender
and Ethnicity
Chapter 12 Psychological Disorders
25
20
15
10
5
American
Indians
European
Americans
Asian
Americans
Hispanic
Americans
African
Americans
Men
Women
Source: Centers for Disease Control and Prevention (2002d).
Surveys indicate that, sometime during the previous year, about 3 percent of all
adults and as many as 10 percent of college students have thought about committing
suicide (Brener, Hassan, & Barrios, 1999; Kessler, Berglund, Borges, et al., 2005). Predicting who will actually do so is difficult, but the results of hundreds of research studies provide some guidance. In the United States, at least, suicide is most likely among
European American males, especially those older than forty-five, single or divorced, and
living alone. The risk of suicide is also heightened among people diagnosed with a
mood disorder, anxiety disorder, or schizophrenia (Boardman & Healy, 2001; Khan et al.,
2002; Rihmer, 2001). Among the elderly, suicide is most common in males who suffer
depression over health problems (e.g., Brown, Bongar, & Cleary, 2004). The risk is
higher, too, in people who have made a specific plan, given away possessions, and are
impulsive (Centers for Disease Control and Prevention, 2004; Corruble, Damy, &
Guelfi, 1999). A previous suicide attempt may not always be a good predictor of eventual suicide, because such attempts may have been help-seeking gestures, not failed
efforts to die (Nock & Kessler, 2006). In fact, although about 10 percent of unsuccessful
attempters try again and succeed, most people who commit suicide had made no prior
attempts (Clark & Fawcett, 1992).
It is often said that people who talk about suicide will never try it. This is a myth
(Shneidman, 1987). Those who say they are thinking of suicide are much more likely
than other people to try suicide. In fact, most suicides are preceded by some kind of
warning, whether direct (“I think I’m going to kill myself ”) or vague (“Sometimes I
wonder if life is worth living”). Although not everyone who threatens suicide follows
through, if you suspect that someone you know is thinking about suicide, encourage
the person to contact a mental health professional or a crisis hotline. If the danger is
immediate, make the contact yourself, and ask for advice about how to respond. Many
suicide attempts—including those triggered by other suicides in the same town or
school—can be prevented by social support and other forms of help for people at high
risk (Centers for Disease Control and Prevention, 2004; Mann et al., 2005). For more
information, visit suicide-related web sites, such as that of the American Association of
Suicidology (www.suicidology.org).
Bipolar Disorders
bipolar disorder A condition in which
a person alternates between the two
emotional extremes of depression and
mania.
mania An elated, active emotional
state.
The alternating appearance of two emotional extremes, or poles, characterizes bipolar
disorder. We have already described one emotional pole: depression. The other is
mania, which is an agitated, usually elated, emotional state. During periods of mania,
people tend to be overly optimistic, boundlessly energetic, certain of having extraordinary powers and abilities, and bursting with all sorts of ideas. They are irritated by