A past suicide attempt is the best predictor of a future attempt, says psychiatrist and director of the Ottawa Psychopharmacology Clinic Dr. David Bakish. In addition, he says, "the risk of suicide is higher in someone who has a family history of suicide. Suicidologists from the 1900s on recognized that there was a familial tendency."
Bakish, who previously taught at the University of Ottawa and worked at the Royal Ottawa Hospital, notes that when profiling patients in the emergency room, "we would look at those with that weight towards suicide very carefully before discharging them. And in my clinical practice now, we treat patients who have had a previous suicide attempt and have someone in the family who had a suicide attempt much more aggressively."
Gene screening indicates that people with "suicidal ideation seem to have a bigger number of a specific serotonin receptors. So there definitely seems to be a linkage with serotonin."He adds that the genetic connection becomes more complex with time.
For example, he says, negative events in childhood could change serotonin sensitivity and could result in an individual being prone to overreact in some situations, "sometimes by a cry for help through suicidal gestures."
"There are many other reasons for suicidal thoughts," says Bakish. "You can have the person who is perfectly well, then blows the family fortune and jumps out of a window. There is also a whole body of literature on drugs that may or may not induce suicide."
However, the biggest problem of all, he says, is that "people don't see depression as an illness. They see it as a failure of their psyche and are embarrassed because there is a stigma and people - particularly males - come for help too late. People should accept that depression is an illness, that treatment and medication can help and that suicidal ideation is a danger sign."Almost all suicides are preventable, he says. "The easiest way to decrease the suicide rate is to get the patients who have depression treated."