168-404: Suicide is the act of intentionally causing one's own death . Mental disorders , physical disorders , and substance abuse are common risk factors. Some suicides are impulsive acts driven by stress (such as from financial or academic difficulties ), relationship problems (such as breakups or divorces ), or harassment and bullying . Those who have previously attempted suicide are at
336-522: A coping mechanism to relieve emotional pain or discomfort or as an attempt to communicate distress. Studies of individuals with developmental disabilities (such as intellectual disability ) have shown self-harm being dependent on environmental factors such as obtaining attention or escape from demands. Some individuals may have dissociation harboring a desire to feel real or to fit into society's rules. The most common form of self-harm for adolescents, according to studies conducted in six countries,
504-428: A crime ." Some advocacy groups recommend using the terms took his/her own life , died by suicide , or killed him/herself instead of committed suicide . The Associated Press Stylebook recommends avoiding "committed suicide" except in direct quotes from authorities. The Guardian and Observer style guides deprecate the use of "committed", as does CNN . Opponents of commit argue that it implies that suicide
672-412: A postmortem examination or an obduction , is a medical procedure that consists of a thorough examination of a human corpse to determine the cause and manner of a person's death and to evaluate any disease or injury that may be present. It is usually performed by a specialized medical doctor called a pathologist . Autopsies are either performed for legal or medical purposes. A forensic autopsy
840-466: A self-punishment function, and modest evidence for anti-dissociation, interpersonal-influence, anti-suicide, sensation-seeking, and interpersonal boundaries functions. Self-harm can also occur in high-functioning individuals who have no underlying mental health diagnosis. The motivations for self-harm vary; some use it as a coping mechanism to provide temporary relief of intense feelings such as anxiety , depression , stress , emotional numbness , or
1008-426: A sense of failure . Self-harm is often associated with a history of trauma , including emotional and sexual abuse . There are a number of different methods that can be used to treat self-harm, which concentrate on either treating the underlying causes, or on treating the behavior itself. Other approaches involve avoidance techniques, which focus on keeping the individual occupied with other activities, or replacing
1176-721: A suicide pact . In extenuating situations where continuing to live would be intolerable, some people use suicide as a means of escape. Some inmates in Nazi concentration camps are known to have killed themselves during the Holocaust by deliberately touching the electrified fences. Suicide prevention is a term used for the collective efforts to reduce the incidence of suicide through preventive measures. Protective factors for suicide include support, and access to therapy. About 60% of people with suicidal thoughts do not seek help. Reasons for not doing so include low perceived need, and wanting to deal with
1344-430: A 2016 review characterized the evidence base as "greatly limited". There is no consensus as to the reason for this apparent phenomenon. As a coping mechanism, self-harm can become psychologically addictive because, to the self-harmer, it works; it enables them to deal with intense stress in the current moment. The patterns sometimes created by it, such as specific time intervals between acts of self-harm, can also create
1512-539: A 4% lifetime risk of suicide. Half of all people who die by suicide may have major depressive disorder ; having this or one of the other mood disorders such as bipolar disorder increases the risk of suicide 20-fold. Other conditions implicated include schizophrenia (14%), personality disorders (8%), obsessive–compulsive disorder , and post-traumatic stress disorder . Those with autism also attempt and consider suicide more frequently. Others estimate that about half of people who die by suicide could be diagnosed with
1680-410: A behavioral pattern that can result in a wanting or craving to fulfill thoughts of self-harm. Emotional pain activates the same regions of the brain as physical pain, so emotional stress can be a significantly intolerable state for some people. Some of this is environmental and some of this is due to physiological differences in responding. The autonomic nervous system is composed of two components:
1848-458: A broader range of circumstances, including wounds that result from organic brain syndromes , substance abuse , and autoeroticism . Different sources draw various distinctions between some of these terms. Some sources define self-harm more broadly than self-injury , such as to include drug overdose , eating disorders , and other acts that do not directly lead to visible injuries. Others explicitly exclude these. Some sources, particularly in
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#17328515738002016-776: A burden along with having an impulsive personality and/or less effective social problem-solving skills. Two studies have indicated that self-harm correlates more with pubertal phase , particularly the end of puberty (peaking around 15 for girls), rather than with age. Adolescents may be more vulnerable neurodevelopmentally in this time, and more vulnerable to social pressures, with depression, alcohol abuse, and sexual activity as independent contributing factors. Transgender adolescents are significantly more likely to engage in self-harm than their cisgender peers. This can be attributed to distress caused by gender dysphoria as well as increased likelihoods of experiencing bullying, abuse, and mental illness. The most distinctive characteristic of
2184-548: A coma. In the case of sleep, electroencephalograms (EEGs) are used to tell the difference. The category of "brain death" is seen as problematic by some scholars. For instance, Dr. Franklin Miller, a senior faculty member at the Department of Bioethics, National Institutes of Health, notes: "By the late 1990s... the equation of brain death with death of the human being was increasingly challenged by scholars, based on evidence regarding
2352-409: A concept of an afterlife that may hold the idea of judgment of good and bad deeds in one's life. There are also different customs for honoring the body, such as a funeral , cremation , or sky burial . After a death, an obituary may be posted in a newspaper, and the "survived by" kin and friends usually go through the grieving process . The concept of death is the key to human understanding of
2520-567: A decrease around Christmas, but an increase in rates during spring and summer, which might be related to exposure to sunshine. Another study found that the risk may be greater for males on their birthday. Genetics might influence rates of suicide. A family history of suicide, especially in the mother, affects children more than adolescents or adults. Adoption studies have shown that this is the case for biological relatives, but not adopted relatives. This makes familial risk factors unlikely to be due to imitation . Once mental disorders are accounted for,
2688-446: A definition of the moment of death is required, doctors and coroners usually turn to "brain death" or "biological death" to define a person as being dead; people are considered dead when the electrical activity in their brain ceases. It is presumed that an end of electrical activity indicates the end of consciousness . Suspension of consciousness must be permanent and not transient, as occurs during certain sleep stages, and especially
2856-691: A desire to deceive medical personnel in order to gain treatment and attention is more important in Münchausen's than in self-harm. Self-harm is frequently described as an experience of depersonalization or a dissociative state. Abuse during childhood is accepted as a primary social factor increasing the incidence of self-harm, as is bereavement , and troubled parental or partner relationships. Factors such as war, poverty, unemployment, and substance abuse may also contribute. Other predictors of self-harm and suicidal behavior include feelings of entrapment, defeat, lack of belonging, and perceiving oneself as
3024-472: A desire to obtain martyrdoms or are religiously motivated. Kamikaze missions were carried out as a duty to a higher cause or moral obligation. Murder–suicide is an act of homicide followed within a week by suicide of the person who carried out the act. Mass suicides are often performed under social pressure where members give up autonomy to a leader (see Notable cases below). Mass suicides can take place with as few as two people, often referred to as
3192-540: A focus of clinical attention". While NSSI is not a separate mental disorder, the DSM-5-TR adds a diagnostic code for the condition in-line with the ICD . The disorder is defined as intentional self-inflicted injury without the intent of dying by suicide. Criteria for NSSI include five or more days of self-inflicted harm over the course of one year without suicidal intent, and the individual must have been motivated by seeking relief from
3360-593: A higher risk for future attempts. Effective suicide prevention efforts include limiting access to methods of suicide such as firearms, drugs, and poisons; treating mental disorders and substance abuse; careful media reporting about suicide; improving economic conditions; and dialectical behaviour therapy (DBT). Although crisis hotlines , like 988 in North America and 13 11 14 in Australia , are common resources, their effectiveness has not been well studied. Suicide
3528-517: A lifetime prevalence of 11.4% for suicidal or non-suicidal self-harm (i.e. excluding self-poisoning) and 22.9% for non-suicidal self-injury (i.e. excluding suicidal acts), for an overall prevalence of 16.9%. The difference in SH and NSSI rates, compared to figures of 16.1% and 18.0% found in a 2012 review, may be attributable to differences in methodology among the studies analyzed. The World Health Organization estimates that, as of 2010, 880,000 deaths occur as
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#17328515738003696-425: A living being can survive all calamities but eventually dies due to causes relating to old age. Conversely, premature death can refer to a death that occurs before old age arrives, for example, human death before a person reaches the age of 75. Animal and plant cells normally reproduce and function during the whole period of natural existence, but the aging process derives from the deterioration of cellular activity and
3864-408: A local cluster of cases. Most research does not distinguish between risk factors that lead to thinking about suicide and risk factors that lead to suicide attempts. Risks for suicide attempt, rather than just thoughts of suicide, include a high pain tolerance and a reduced fear of death . A 2002 review of about analyzing about 90 suicide related study concluded that the risk of suicide following
4032-462: A means of feeling something , even if the sensation is unpleasant and painful. Those who self-harm sometimes describe feelings of emptiness or numbness ( anhedonia ), and physical pain may be a relief from these feelings. Those who engage in self-harm face the contradictory reality of harming themselves while at the same time obtaining relief from this act. It may even be hard for some to actually initiate cutting, but they often do because they know
4200-471: A means of making up for failure or as a form of protest. Similarly, a ritual fast unto death, known as Vatakkiruttal ( Tamil : வடக்கிருத்தல் , Vaṭakkiruttal , 'fasting facing north'), was a Tamil ritual suicide in ancient India during the Sangam age . Suicide and attempted suicide, while previously illegal, are no longer so in most Western countries. It remains a criminal offense in some countries . In
4368-427: A meta-analysis that did not distinguish between suicidal and non-suicidal acts, self-harm is common among those with schizophrenia and is a significant predictor of suicide. There are parallels between self-harm and Münchausen syndrome , a psychiatric disorder in which individuals feign illness or trauma. There may be a common ground of inner distress culminating in self-directed harm in a Münchausen patient. However,
4536-473: A negative effect on problem-solving skills and memory, both of which are implicated in suicidality. According to a 2022 study, adverse childhood experiences maybe "associated with a two-fold higher odds" of anxiety disorders, depression and suicidality." Problem gambling is associated with increased suicidal ideation and attempts compared to the general population. Between 12 and 24% of pathological gamblers attempt suicide. The rate of suicide among their spouses
4704-729: A negative state, resolving an interpersonal difficulty, or achieving a positive state. A common belief regarding self-harm is that it is an attention-seeking behavior; however, in many cases, this is inaccurate. Many self-harmers are very self-conscious of their wounds and scars and feel guilty about their behavior, leading them to go to great lengths to conceal their behavior from others. They may offer alternative explanations for their injuries, or conceal their scars with clothing. Self-harm in such individuals may not be associated with suicidal or para-suicidal behavior. People who self-harm are not usually seeking to end their own life; it has been suggested instead that they are using self-harm as
4872-655: A non-fatal expression of an attenuated death wish and thus coined the term partial suicide . He began a classification system of six types: Pao (1969) differentiated between delicate (low lethality) and coarse (high lethality) self-mutilators who cut. The "delicate" cutters were young, multiple episodic of superficial cuts and generally had borderline personality disorder diagnosis. The "coarse" cutters were older and generally psychotic. Ross and McKay (1979) categorized self-mutilators into nine groups: cutting , biting , abrading , severing , inserting , burning , ingesting or inhaling , hitting , and constricting . After
5040-411: A number of medications (such as beta blockers and steroids ). A number of psychological factors increase the risk of suicide including: hopelessness, loss of pleasure in life , depression , anxiousness, agitation, rigid thinking, rumination , thought suppression , and poor coping skills. A poor ability to solve problems, the loss of abilities one used to have, and poor impulse control also play
5208-660: A personality disorder, and could potentially be used for those with other mental disorders who exhibit self-harming behavior. Diagnosis and treatment of the causes of self-harm is thought by many to be the best approach to treating self-harm. In adolescents multisystem therapy shows promise. According to the classification of Walsh and Rosen trichotillomania and nail biting represent class I and II self-mutilation behavior (see classification section in this article); for these conditions habit reversal training and decoupling have been found effective according to meta-analytic evidence. A meta-analysis found that psychological therapy
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5376-442: A personality disorder, with borderline personality disorder being the most common. About 5% of people with schizophrenia die of suicide. Eating disorders are another high risk condition. Around 22% to 50% of people with gender dysphoria have attempted suicide, however this greatly varies by region. Among approximately 80% of suicides, the individual has seen a physician within the year before their death, including 45% within
5544-502: A preventive effect, for instance fiction might normalize mental health problems and encourage help-seeking. Some environmental exposures, including air pollution , intense sunlight , sunlight duration , hot weather , and high altitude , are associated with suicide. There is a possible association between short-term PM 10 exposure and suicide. These factors might affect certain high-risk individuals more than others. The time of year may also affect suicide rates. There appears to be
5712-407: A previous attempt or self-harm is hundreds of time larger than in the general population. A more recent study estimated that individuals with a history of suicide attempts are approximately 25 times more likely to die by suicide compared to the general population. These findings makes a suicide attempt one of the strongest predictors of eventual completed attempt. Among the population that completed
5880-401: A previous miscarriage, and the use of abortion can increase the chances of having a miscarriage. An abortion may be performed for many reasons, such as pregnancy from rape , financial constraints of having a child, teenage pregnancy , and the lack of support from a significant other . There are two forms of abortion: a medical abortion and an in-clinic abortion or sometimes referred to as
6048-522: A prominent suffragette , used a stint in Holloway Prison during March 1909 to mutilate her body. Her plan was to carve 'Votes for Women' from her breast to her cheek, so that it would always be visible. But after completing the V on her breast and ribs she requested sterile dressings to avoid blood poisoning , and her plan was aborted by the authorities. She wrote of this in her memoir Prisons and Prisoners . Kikuyu girls cut each other's vulvas in
6216-576: A propensity for suicide. Cannabis , however, does not appear to independently increase the risk. Non-suicidal self-harm is common with 18% of people engaging in self-harm over the course of their life. Acts of self-harm are not usually suicide attempts and most who self-harm are not at high risk of suicide. Some who self-harm, however, do still end their life by suicide, and risk for self-harm and suicide may overlap. Individuals who have been identified as self-harming after being admitted to hospital are 68% ( 38 – 105% ) more likely to die by suicide. There
6384-424: A psychiatric disturbance caused by side effects, such as disinhibition , or withdrawal symptoms. Countries that have higher rates of alcohol use and a greater density of bars generally also have higher rates of suicide. About 2.2–3.4% of those who have been treated for alcoholism at some point in their life die by suicide. Alcoholics who attempt suicide are usually male, older, and have tried to take their own lives in
6552-556: A result of self-harm (including suicides). About 10% of admissions to medical wards in the UK are as a result of self-harm, the majority of which are drug overdoses . However, studies based only on hospital admissions may hide the larger group of self-harmers who do not need or seek hospital treatment for their injuries, instead treating themselves. Many adolescents who present to general hospitals with deliberate self-harm report previous episodes for which they did not receive medical attention. In
6720-494: A result self-harm may be an indicator of depression and/or other psychological problems. As of 2021 , there is little or no evidence that antidepressants , mood stabilizers , or dietary supplements reduce repetition of self-harm. In limited research into antipsychotics , one small trial of flupentixol found a possible reduction in repetition, while one small trial of fluphenazine found no difference between low and ultra-low doses. As of 2012 , no clinical trials have evaluated
6888-425: A role in depression ( major depressive disorder ), and interventions in these areas may be an effective add-on to conventional methods. Vitamin B 2 , B 6 and B 12 deficiency may cause depression in females. Risk of depression may be reduced with a healthy diet "high in fruits, vegetables, nuts, and legumes; moderate amounts of poultry, eggs, and dairy products; and only occasional red meat". A balanced diet and
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7056-499: A role. In older adults, the perception of being a burden to others is important. Those who have never married are also at greater risk. Recent life stresses , such as a loss of a family member or friend or the loss of a job, might be a contributing factor. Certain personality factors, especially high levels of neuroticism and introvertedness , have been associated with suicide. This might lead to people who are isolated and sensitive to distress to be more likely to attempt suicide. On
7224-402: A surgical abortion. A medical abortion involves taking a pill that will terminate the pregnancy no more than 11 weeks past the last period , and an in-clinic abortion involves a medical procedure using suction to empty the uterus; this is possible after 12 weeks, but it may be more difficult to find an operating doctor who will go through with the procedure. Senescence refers to a scenario when
7392-441: A vegetative state or coma, in that the former situation describes a state that is beyond recovery. EEGs can detect spurious electrical impulses, while certain drugs, hypoglycemia , hypoxia , or hypothermia can suppress or even stop brain activity temporarily; because of this, hospitals have protocols for determining brain death involving EEGs at widely separated intervals under defined conditions. People maintaining that only
7560-429: A very different ancestral environment may be maladaptive in the current one. Trauma is a risk factor for suicidality in both children and adults. Some may take their own lives to escape bullying or prejudice . A history of childhood sexual abuse and time spent in foster care are also risk factors. Sexual abuse is believed to contribute to approximately 20% of the overall risk. Significant adversity early in life has
7728-456: Is aging , followed by cardiovascular disease , which is a disease that affects the heart or blood vessels . As of 2022, an estimated total of almost 110 billion humans have died, or roughly 94% of all humans to have ever lived. A substudy of gerontology known as biogerontology seeks to eliminate death by natural aging in humans, often through the application of natural processes found in certain organisms. However, as humans do not have
7896-408: Is a finite supply presented at birth. Later, Goldstone proposed the concept of production or income of adaptation energy which may be stored (up to a limit) as a capital reserve of adaptation. In recent works, adaptation energy is considered an internal coordinate on the "dominant path" in the model of adaptation. It is demonstrated that oscillations of well-being appear when the reserve of adaptability
8064-417: Is a positive statistical correlation between self-harm and physical, sexual, and emotional abuse. Self-harm may become a means of managing and controlling pain , in contrast to the pain experienced earlier in the person's life over which they had no control (e.g., through abuse). Assessment of motives in a medical setting is usually based on precursors to the incident, circumstances, and information from
8232-709: Is a well-established treatment for self-injurious behavior in youth and is probably useful for decreasing the risk of non-suicidal self-injury. Several other treatments including integrated CBT (I-CBT), attachment-based family therapy (ABFT), resourceful adolescent parent program (RAP-P), intensive interpersonal psychotherapy for adolescents (IPT-A-IN), mentalization-based treatment for adolescents (MBT-A), and integrated family therapy are probably efficacious. Cognitive behavioral therapy may also be used to assist those with Axis I diagnoses, such as depression, schizophrenia , and bipolar disorder . Dialectical behavior therapy (DBT) can be successful for those individuals exhibiting
8400-427: Is almost exhausted. In 2012, suicide overtook car crashes as the leading cause of human injury deaths in the U.S., followed by poisoning, falls, and murder. Accidents and disasters, from nuclear disasters to structural collapses , also claim lives. One of the deadliest incidents of all time is the 1975 Banqiao Dam Failure , with varying estimates, up to 240,000 dead. Other incidents with high death tolls are
8568-488: Is also a factor, with heightened relative poverty compared to those around a person increasing suicide risk. Over 200,000 farmers in India have died by suicide since 1997, partly due to issues of debt. In China, suicide is three times as likely in rural regions as urban ones, partly, it is believed, due to financial difficulties in this area of the country. Being religious may reduce one's risk of suicide while beliefs that suicide
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#17328515738008736-477: Is an association between suicidality and physical health problems such as chronic pain, traumatic brain injury, cancer, chronic fatigue syndrome , kidney failure (requiring hemodialysis ), HIV , and systemic lupus erythematosus . The diagnosis of cancer approximately doubles the subsequent frequency of suicide. The prevalence of increased suicidality persisted after adjusting for depressive illness and alcohol abuse. Among people with more than one medical condition
8904-399: Is an elder ending his or her life to leave greater amounts of food for the younger people in the community. Suicide in some Inuit cultures has been seen as an act of respect, courage, or wisdom. A suicide attack is a political or religious action where an attacker carries out violence against others which they understand will result in their own death. Some suicide bombers are motivated by
9072-494: Is an irreversible process where someone loses their existence as a person. Historically, attempts to define the exact moment of a human's death have been subjective or imprecise. Death was defined as the cessation of heartbeat (cardiac arrest) and breathing , but the development of CPR and prompt defibrillation have rendered that definition inadequate because breathing and heartbeat can sometimes be restarted. This type of death where circulatory and respiratory arrest happens
9240-671: Is by definition non-suicidal, it may still be life-threatening. People who do self-harm are more likely to die by suicide, and self-harm is found in 40–60% of suicides. Still, only a minority of those who self-harm are suicidal. The desire to self-harm is a common symptom of some personality disorders . People with other mental disorders may also self-harm, including those with depression , anxiety disorders , substance abuse , mood disorders , eating disorders , post-traumatic stress disorder , schizophrenia , dissociative disorders , psychotic disorders , as well as gender dysphoria or dysmorphia . Studies also provide strong support for
9408-501: Is carried out when the cause of death may be a criminal matter, while a clinical or academic autopsy is performed to find the medical cause of death and is used in cases of unknown or uncertain death, or for research purposes. Autopsies can be further classified into cases where external examination suffices, and those where the body is dissected and an internal examination is conducted. Permission from next of kin may be required for internal autopsy in some cases. Once an internal autopsy
9576-438: Is complete the body is generally reconstituted by sewing it back together. A necropsy, which is not always a medical procedure, was a term previously used to describe an unregulated postmortem examination. In modern times, this term is more commonly associated with the corpses of animals. Death before birth can happen in several ways: stillbirth , when the fetus dies before or during the delivery process; miscarriage , when
9744-520: Is criminal, sinful , or morally wrong. There is no known unifying underlying pathophysiology for suicide; it is believed to result from an interplay of behavioral, socio-economic and psychological factors. Low levels of brain-derived neurotrophic factor (BDNF) are both directly associated with suicide and indirectly associated through its role in major depression, post-traumatic stress disorder, schizophrenia and obsessive–compulsive disorder . Post-mortem studies have found reduced levels of BDNF in
9912-883: Is determined by the rate of aging for a species inherent in its genes . A recognized method of extending maximum lifespan is calorie restriction . Theoretically, the extension of the maximum lifespan can be achieved by reducing the rate of aging damage, by periodic replacement of damaged tissues , molecular repair , or rejuvenation of deteriorated cells and tissues. A United States poll found religious and irreligious people, as well as men and women and people of different economic classes, have similar rates of support for life extension, while Africans and Hispanics have higher rates of support than white people. 38% said they would desire to have their aging process cured. Researchers of life extension can be known as "biomedical gerontologists ." They try to understand aging, and develop treatments to reverse aging processes, or at least slow them for
10080-423: Is effective in reducing self-harm. The proportion of the adolescents who self-harmed over the follow-up period was lower in the intervention groups (28%) than in controls (33%). Psychological therapies with the largest effect sizes were dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), and mentalization-based therapy (MBT). In individuals with developmental disabilities, occurrence of self-harm
10248-405: Is generally applied to whole organisms; the equivalent for individual components of an organism, such as cells or tissues , is necrosis . Something that is not considered an organism, such as a virus , can be physically destroyed but is not said to die , as a virus is not considered alive in the first place. As of the early 21st century, 56 million people die per year. The most common reason
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#173285157380010416-553: Is generally thought that self-harm rates increase over the course of adolescence, although this has not been studied thoroughly. The earliest reported incidents of self-harm are in children between 5 and 7 years old. In addition there appears to be an increased risk of self-harm in college students than among the general population. In a study of undergraduate students in the US, 9.8% of the students surveyed indicated that they had purposefully cut or burned themselves on at least one occasion in
10584-544: Is hard to obtain. Epigenetics , the study of changes in genetic expression in response to environmental factors which do not alter the underlying DNA , is also believed to play a role in determining suicide risk. Factors that affect the risk of suicide include mental disorders, drug misuse, psychological states , cultural, family and social situations, genetics, experiences of trauma or loss, and nihilism . Mental disorders and substance misuse frequently co-exist. Other risk factors include having previously attempted suicide,
10752-455: Is known as the "Werther effect", named after the protagonist in Goethe 's The Sorrows of Young Werther who killed himself and then was emulated by many admirers of the book. This risk is greater in adolescents who may romanticize death. It appears that while news media has a significant effect, that of the entertainment media is equivocal. It is unclear if searching for information about suicide on
10920-478: Is known as the circulatory definition of death (CDD). Proponents of the CDD believe this definition is reasonable because a person with permanent loss of circulatory and respiratory function should be considered dead. Critics of this definition state that while cessation of these functions may be permanent, it does not mean the situation is irreversible because if CPR is applied fast enough, the person could be revived. Thus,
11088-539: Is largely inconclusive. Substance misuse, dependence and withdrawal are associated with self-harm. Benzodiazepine dependence as well as benzodiazepine withdrawal is associated with self-harming behavior in young people. Alcohol is a major risk factor for self-harm. A study which analyzed self-harm presentations to emergency rooms in Northern Ireland found that alcohol was a major contributing factor and involved in 63.8% of self-harm presentations. A 2009 study in
11256-568: Is little evidence to support or refute their effectiveness. Preventing childhood trauma provides an opportunity for suicide prevention. The World Suicide Prevention Day is observed annually on 10 September with the support of the International Association for Suicide Prevention and the World Health Organization . About 50% of people who die of suicide have a mood disorder such as major depression. Sleep and diet may play
11424-406: Is more of a process than a single event. It implies a slow shift from one spiritual state to another. Other definitions for death focus on the character of cessation of organismic functioning and human death, which refers to irreversible loss of personhood. More specifically, death occurs when a living entity experiences irreversible cessation of all functioning. As it pertains to human life, death
11592-672: Is most commonly regarded as direct injury of one's own skin tissues , commonly with suicidal intention. Other terms such as cutting , self-injury , and self-mutilation have been used for any self-harming behavior regardless of suicidal intent. Common forms of self-harm include damaging the skin with a sharp object or scratching with the fingernails, hitting , or burning . The exact bounds of self-harm are imprecise, but generally exclude tissue damage that occurs as an unintended side-effect of eating disorders or substance abuse , as well as more societally acceptable body modification such as tattoos and piercings . Although self-harm
11760-608: Is noble may increase it. This has been attributed to the negative stance many religions take against suicide and to the greater connectedness religion may give. Muslims , among religious people, appear to have a lower rate of suicide; however, the data supporting this is not strong. There does not appear to be a difference in rates of attempted suicide. Young women in the Middle East may have higher rates. Certain occupations carry an elevated risk of self-harm and suicide, such as military careers. Research in several countries has found that
11928-669: Is now seen as a process, more than an event: conditions once considered indicative of death are now reversible. Where in the process, a dividing line is drawn between life and death depends on factors beyond the presence or absence of vital signs . In general, clinical death is neither necessary nor sufficient for a determination of legal death . A patient with working heart and lungs determined to be brain dead can be pronounced legally dead without clinical death occurring. Life extension refers to an increase in maximum or average lifespan , especially in humans, by slowing or reversing aging processes through anti-aging measures. Aging
12096-412: Is often demonstrated to be related to its effects on the environment, such as obtaining attention or desired materials or escaping demands. As developmentally disabled individuals often have communication or social deficits, self-harm may be their way of obtaining these things which they are otherwise unable to obtain in a socially appropriate way (such as by asking). One approach for treating self-harm thus
12264-462: Is partly related to the availability of effective means. Views on suicide have been influenced by broad existential themes such as religion, honor, and the meaning of life. The Abrahamic religions traditionally consider suicide as an offense towards God due to belief in the sanctity of life . During the samurai era in Japan, a form of suicide known as seppuku ( 腹切り , harakiri ) was respected as
12432-560: Is performed intentionally and usually without suicidal intent. The adjective "deliberate" is sometimes used, although this has become less common, as some view it as presumptuous or judgmental. Less common or more dated terms include parasuicidal behavior , self-mutilation , self-destructive behavior , self-inflicted violence , self-injurious behavior , and self-abuse . Others use the phrase self-soothing as intentionally positive terminology to counter more negative associations. Self-inflicted wound or self-inflicted injury refers to
12600-501: Is something humans share with cetaceans called the mammalian diving reflex . As medical technologies advance, ideas about when death occurs may have to be reevaluated in light of the ability to restore a person to vitality after longer periods of apparent death (as happened when CPR and defibrillation showed that cessation of heartbeat is inadequate as a decisive indicator of death). The lack of electrical brain activity may not be enough to consider someone scientifically dead. Therefore,
12768-435: Is stabbing or cutting the skin with a sharp object. For adults ages 60 and over, self- poisoning (including intentional drug overdose ) is by far the most common form. Other self-harm methods include burning , head-banging, biting, scratching, hitting, preventing wounds from healing, self-embedding of objects, and hair-pulling. The locations of self-harm are often areas of the body that are easily hidden and concealed from
12936-414: Is the 10th leading cause of death worldwide, accounting for approximately 1.5% of total deaths. In a given year, this is roughly 12 per 100,000 people. Though suicides resulted in 828,000 deaths globally in 2015, an increase from 712,000 deaths in 1990, the age-standardized death rate decreased by 23.3%. By gender , suicide rates are generally higher among men than women, ranging from 1.5 times higher in
13104-402: Is the end of life ; the irreversible cessation of all biological functions that sustain a living organism . The remains of a former organism normally begin to decompose shortly after death. Death eventually and inevitably occurs in all organisms. Some organisms, such as Turritopsis dohrnii , are biologically immortal ; however, they can still die from means other than aging . Death
13272-483: Is the most common cause of death worldwide. Aging is seen as inevitable, so according to Aubrey de Grey little is spent on research into anti-aging therapies, a phenomenon known as pro-aging trance . The average lifespan is determined by vulnerability to accidents and age or lifestyle-related afflictions such as cancer or cardiovascular disease . Extension of lifespan can be achieved by good diet , exercise, and avoidance of hazards such as smoking . Maximum lifespan
13440-440: Is the reasoned taking of one's own life. However, some consider suicide as never being rational. Euthanasia and assisted suicide are accepted practices in a number of countries among those who have a poor quality of life without the possibility of getting better. They are supported by the legal arguments for a right to die . The act of taking one's life for the benefit of others is known as altruistic suicide . An example of this
13608-441: Is three times greater than that of the general population. Other factors that increase the risk in problem gamblers include concomitant mental illness, alcohol, and drug misuse. Infection by the parasite Toxoplasma gondii , more commonly known as toxoplasmosis , has been linked with suicide risk. One explanation states that this is caused by altered neurotransmitter activity due to the immunological response. Rational suicide
13776-413: Is to teach an alternative, appropriate response which obtains the same result as the self-harm. Generating alternative behaviors that the person can engage in instead of self-harm is one successful behavioral method that is employed to avoid self-harm. Techniques, aimed at keeping busy, may include journaling, taking a walk, participating in sports or exercise or being around friends when the person has
13944-463: Is viewed as problematic by some scholars, there are proponents of it that believe this definition of death is the most reasonable for distinguishing life from death. The reasoning behind the support for this definition is that brain death has a set of criteria that is reliable and reproducible. Also, the brain is crucial in determining our identity or who we are as human beings. The distinction should be made that "brain death" cannot be equated with one in
14112-572: The 1931 China floods , which killed an estimated 4 million people, although estimates widely vary; the 1887 Yellow River flood , which killed an estimated 2 million people in China; and the 1970 Bhola cyclone , which killed as many as 500,000 people in Pakistan. If naturally occurring famines are considered natural disasters, the Chinese famine of 1906–1907 , which killed 15–20 million people, can be considered
14280-514: The Day of Ashura , the commemoration of the martyrdom of Imam Hussein, with a ritual of self-flagellation , using chains and swords. Dueling scars such as those acquired through academic fencing at certain traditional German universities are an early example of scarification in European society. Sometimes, students who did not fence would scar themselves with razors in imitation. Constance Lytton ,
14448-513: The Wanggongchang explosion (when a gunpowder factory ended up with 20,000 deaths), a collapse of a wall of Circus Maximus that killed 13,000 people, and the Chernobyl disaster that killed between 95 and 4,000 people. Natural disasters kill around 45,000 people annually, although this number can vary to millions to thousands on a per-decade basis. Some of the deadliest natural disasters are
14616-666: The developing world to 3.5 times higher in the developed world ; in the Western world , non-fatal suicide attempts are more common among young people and women. Suicide is generally most common among those over the age of 70; however, in certain countries, those aged between 15 and 30 are at the highest risk. Europe had the highest rates of suicide by region in 2015. There are an estimated 10 to 20 million non-fatal attempted suicides every year. Non-fatal suicide attempts may lead to injury and long-term disabilities. The most commonly adopted method of suicide varies from country to country and
14784-485: The embryo dies before independent survival; and abortion , the artificial termination of the pregnancy. Stillbirth and miscarriage can happen for various reasons, while abortion is carried out purposely. Stillbirth can happen right before or after the delivery of a fetus. It can result from defects of the fetus or risk factors present in the mother. Reductions of these factors, caesarean sections when risks are present, and early detection of birth defects have lowered
14952-441: The hippocampus and prefrontal cortex , in those with and without psychiatric conditions. Serotonin , a brain neurotransmitter , is believed to be low in those who die by suicide. This is partly based on evidence of increased levels of 5-HT2A receptors found after death. Other evidence includes reduced levels of a breakdown product of serotonin, 5-hydroxyindoleacetic acid , in the cerebral spinal fluid . However, direct evidence
15120-454: The neo-cortex of the brain is necessary for consciousness sometimes argue that only electrical activity should be considered when defining death. Eventually, the criterion for death may be the permanent and irreversible loss of cognitive function, as evidenced by the death of the cerebral cortex . All hope of recovering human thought and personality is then gone, given current and foreseeable medical technology. Even by whole-brain criteria,
15288-426: The personality and identity are irretrievably lost, so therefore, the person should be considered entirely dead. Brain death is sometimes used as a legal definition of death. For all organisms with a brain, death can instead be focused on this organ. The cause of death is usually considered important and an autopsy can be done. There are many causes, from accidents to diseases. Many cultures and religions have
15456-754: The sympathetic nervous system controls arousal and physical activation (e.g., the fight-or-flight response ) and the parasympathetic nervous system controls physical processes that are automatic (e.g., saliva production). The sympathetic nervous system innervates (e.g., is physically connected to and regulates) many parts of the body involved in stress responses. Studies of adolescents have shown that adolescents who self-injure have greater physiological reactivity (e.g., skin conductance) to stress than adolescents who do not self-injure. Several forms of psychosocial treatments can be used in self-harm including dialectical behavior therapy . Psychiatric and personality disorders are common in individuals who self-harm and as
15624-526: The withdrawal phase . Those who used inhalants are also at significant risk with around 20% attempting suicide at some point and more than 65% considering it. Smoking cigarettes is associated with risk of suicide. There is little evidence as to why this association exists; however, it has been hypothesized that those who are predisposed to smoking are also predisposed to suicide, that smoking causes health problems which subsequently make people want to end their life, and that smoking affects brain chemistry causing
15792-474: The 1950s as a symbol of defiance, in the context of the campaign against female genital mutilation in colonial Kenya . The movement came to be known as Ngaitana ("I will circumcise myself"), because to avoid naming their friends, the girls said they had cut themselves. Historian Lynn Thomas described the episode as significant in the history of FGM because it made clear that its victims were also its perpetrators. Karl Menninger considered self-mutilation as
15960-575: The 1970s the focus of self-harm shifted from Freudian psycho-sexual drives of the patients. Walsh and Rosen (1988) created four categories numbered by Roman numerals I–IV, defining Self-mutilation as rows II, III and IV. Favazza and Rosenthal (1993) reviewed hundreds of studies and divided self-mutilation into two categories: culturally sanctioned self-mutilation and deviant self-mutilation . Favazza also created two subcategories of sanctioned self-mutilations; rituals and practices . The rituals are mutilations repeated generationally and "reflect
16128-406: The 20th and 21st centuries, suicide has been used on rare occasions as a form of protest ; it has also been committed while or after murdering others , a tactic that has been used both militarily and by terrorists . Suicide is often seen as a major catastrophe, causing significant grief to the deceased's relatives, friends and community members, and it is viewed negatively almost everywhere around
16296-453: The 20th century and could kill 1 billion people worldwide in the 21st century, a World Health Organization report warned. Many leading developed world causes of death can be postponed by diet and physical activity , but the accelerating incidence of disease with age still imposes limits on human longevity . The evolutionary cause of aging is, at best, only beginning to be understood. It has been suggested that direct intervention in
16464-510: The 20th-century psychiatrist Karl Menninger is often credited with the initial clinical characterization of self-harm, self-harm is not a new phenomenon. There is frequent reference in 19th-century clinical literature and asylum records which make a clear clinical distinction between self-harm with and without suicidal intent. This differentiation may have been important to both safeguard the reputations of asylums against accusations of medical neglect and to protect patients and their families from
16632-636: The Internet relates to the risk of suicide. The opposite of the Werther effect is the proposed "Papageno effect", in which coverage of effective coping mechanisms may have a protective effect. The term is based upon a character in Mozart 's opera The Magic Flute —fearing the loss of a loved one, he had planned to kill himself until his friends helped him out. As a consequence, fictional portrayals of suicide, showing alternative consequences or negative consequences, might have
16800-688: The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research in 1980. They concluded that this approach to defining death sufficed in reaching a uniform definition nationwide. A multitude of reasons was presented to support this definition, including uniformity of standards in law for establishing death, consumption of a family's fiscal resources for artificial life support, and legal establishment for equating brain death with death to proceed with organ donation . Aside from
16968-474: The United Kingdom, define deliberate self-harm or self-harm in general to include suicidal acts. (This article principally discusses non-suicidal acts of self-inflicted skin damage or self-poisoning.) The inconsistent definitions used for self-harm have made research more difficult. Nonsuicidal self-injury (NSSI) has been listed in section 2 of the DSM-5-TR under the category "other conditions that may be
17136-533: The United Nations Special Reporter on the Right to Food, 2000 – Mar 2008, mortality due to malnutrition accounted for 58% of the total mortality rate in 2006. Ziegler says worldwide, approximately 62 million people died from all causes and of those deaths, more than 36 million died of hunger or diseases due to deficiencies in micronutrients . Tobacco smoking killed 100 million people worldwide in
17304-460: The United States up to 4% of adults self-harm with approximately 1% of the population engaging in chronic or severe self-harm. The onset of self-harm tends to occur around puberty , although scholarship is divided as to whether this is usually before puberty or later in adolescence. Meta-analyses have not supported some studies' conclusion that self-harm rates are increasing among adolescents. It
17472-444: The act of self-harm with safer methods that do not lead to permanent damage. Self-harm tends to begin in adolescence . Self-harm in childhood is relatively rare, but the rate has been increasing since the 1980s. Self-harm can also occur in the elderly population. The risk of serious injury and suicide is higher in older people who self-harm. Captive animals , such as birds and monkeys, are also known to harm themselves. Although
17640-404: The aging process may now be the most effective intervention against major causes of death. Selye proposed a unified non-specific approach to many causes of death. He demonstrated that stress decreases the adaptability of an organism and proposed to describe adaptability as a special resource, adaptation energy . The animal dies when this resource is exhausted. Selye assumed that adaptability
17808-444: The arguments for and against the CDD boil down to defining the actual words "permanent" and "irreversible," which further complicates the challenge of defining death. Furthermore, events causally linked to death in the past no longer kill in all circumstances; without a functioning heart or lungs, life can sometimes be sustained with a combination of life support devices, organ transplants , and artificial pacemakers . Today, where
17976-439: The array of biological functioning displayed by patients correctly diagnosed as having this condition who were maintained on mechanical ventilation for substantial periods of time. These patients maintained the ability to sustain circulation and respiration, control temperature, excrete wastes, heal wounds, fight infections and, most dramatically, to gestate fetuses (in the case of pregnant "brain-dead" women)." While "brain death"
18144-501: The brain must have completely ceased. However, in other jurisdictions, some follow the brainstem version of brain death. Afterward, a death certificate is issued in most jurisdictions, either by a doctor or by an administrative office, upon presentation of a doctor's declaration of death. There are many anecdotal references to people being declared dead by physicians and then "coming back to life," sometimes days later in their coffin or when embalming procedures are about to begin. From
18312-471: The concept of information-theoretic death has been suggested as a better means of defining when true death occurs, though the concept has few practical applications outside the field of cryonics . The leading cause of human death in developing countries is infectious disease . The leading causes in developed countries are atherosclerosis ( heart disease and stroke), cancer, and other diseases related to obesity and aging . By an extremely wide margin,
18480-470: The consumption of lots of water is essential for mental health. Consuming oily fish may also help as they contain omega-3 fats. Consuming too much refined carbohydrates (e.g., snack foods) may increase the risk of depression symptoms. The mechanism on how diet improves or worsens mental health is still not fully understood. Blood glucose levels alterations, inflammation , or effects on the gut microbiome have been suggested. Death Death
18648-539: The deadliest natural disaster in recorded history. In animals, predation can be a common cause of death. Livestock have a 6% death rate from predation. However, younger animals are more susceptible to predation. For example, 50% of young foxes die to birds , bobcats , coyotes , and other foxes as well. Young bear cubs in the Yellowstone National Park only have a 40% chance to survive to adulthood from other bears and predators. An autopsy, also known as
18816-479: The determination of brain death can be complicated. At present, in most places, the more conservative definition of death (irreversible cessation of electrical activity in the whole brain, as opposed to just in the neo-cortex) has been adopted. One example is the Uniform Determination Of Death Act in the United States. In the past, the adoption of this whole-brain definition was a conclusion of
18984-427: The effective methods is to educate journalists on how to report suicide news in a manner that might reduce that possibility of imitation and encourage those at risk to seek for help. When journalists follow certain reporting guidelines the risk of suicides can be decreased. Getting buy-in from the media industry, however, can be difficult, especially in the long term. This trigger of suicide contagion or copycat suicide
19152-449: The effects of pharmacotherapy on adolescents who self-harm. Emergency departments are often the first point of contact with healthcare for people who self-harm. As such they are crucial in supporting them and can play a role in preventing suicide. At the same time, according to a study conducted in England, people who self-harm often experience that they do not receive meaningful care at
19320-496: The emergency department. Both people who self-harm and staff in the study highlighted the failure of the healthcare system to support, the lack of specialist care. People who self-harm in the study often felt shame or being judged due to their condition, and said that being listened to and validated gave them hope. At the same time staff experienced frustration from being powerless to help and were afraid of being blamed if someone died by suicide. There are also difficulties in meeting
19488-437: The estimated heritability rate is 36% for suicidal ideation and 17% for suicide attempts. An evolutionary explanation for suicide is that it may improve inclusive fitness . This may occur if the person dying by suicide cannot have more children and takes resources away from relatives by staying alive. An objection to this explanation is that deaths by healthy adolescents likely do not increase inclusive fitness. Adaptation to
19656-620: The extent of this association, which is significant both at the cross-sectional ( odds ratio = 1.569, 95% confidence interval [1.167-2.108]) and longitudinal (odds ratio = 2.569, 95% confidence interval [2.207-3.256]) levels, and highlighting the role of the chronic use of the substance, and the presence of depressive symptoms or of mental disorders as factors that might increase the risk of self-injury among cannabis users. Self-injury may result in serious injury and scarring. While non-suicidal self-injury by definition lacks suicidal intent, it may nonetheless result in accidental death. While
19824-444: The female rate of self-harm exceeded that of the males, with the highest rate among females in the 13–24 age group and the highest rate among males in the 12–34 age group. However, this discrepancy has been known to vary significantly depending upon population and methodological criteria, consistent with wide-ranging uncertainties in gathering and interpreting data regarding rates of self-harm in general. Such problems have sometimes been
19992-439: The figure to be closer to 800. In cases of electric shock , cardiopulmonary resuscitation (CPR) for an hour or longer can allow stunned nerves to recover, allowing an apparently dead person to survive. People found unconscious under icy water may survive if their faces are kept continuously cold until they arrive at an emergency room . This "diving response," in which metabolic activity and oxygen requirements are minimal,
20160-434: The flaws in this approach is that there are many organisms that are alive but probably not conscious. Another problem is in defining consciousness, which has many different definitions given by modern scientists, psychologists and philosophers. Additionally, many religious traditions, including Abrahamic and Dharmic traditions, hold that death does not (or may not) entail the end of consciousness. In certain cultures, death
20328-481: The focus of criticism in the context of broader psychosocial interpretation. For example, feminist author Barbara Brickman has speculated that reported gender differences in rates of self-harm are due to deliberate socially biased methodological and sampling errors, directly blaming medical discourse for pathologising the female. This gender discrepancy is often distorted in specific populations where rates of self-harm are inordinately high, which may have implications on
20496-514: The frequency was particularly high. In Japan, health problems are listed as the primary justification for suicide. Sleep disturbances, such as insomnia and sleep apnea , are risk factors for depression and suicide. In some instances, the sleep disturbances may be a risk factor independent of depression. A number of other medical conditions may present with symptoms similar to mood disorders, including hypothyroidism , Alzheimer's , brain tumors , systemic lupus erythematosus, and adverse effects from
20664-406: The heartbeat ceased, a status still known as clinical death . However, the development of cardiopulmonary resuscitation (CPR) meant that such a state was no longer strictly irreversible. Brain death was then considered a more fitting option, but several definitions exist for this. Some people believe that all brain functions must cease. Others believe that even if the brainstem is still alive,
20832-416: The improvement of health and maintenance of youthfulness. Those who use life extension findings and apply them to themselves are called "life extensionists" or "longevists." The primary life extension strategy currently is to apply anti-aging methods to attempt to live long enough to benefit from a cure for aging. Self-harm Self-harm refers to intentional behaviors that cause harm to oneself. This
21000-475: The issue of support of or dispute against brain death, there is another inherent problem in this categorical definition: the variability of its application in medical practice. In 1995, the American Academy of Neurology (AAN) established the criteria that became the medical standard for diagnosing neurologic death. At that time, three clinical features had to be satisfied to determine "irreversible cessation" of
21168-487: The jellyfish Turritopsis dohrnii , the hydra , and the planarian . Unnatural causes of death include suicide and predation . Of all causes, roughly 150,000 people die around the world each day. Of these, two-thirds die directly or indirectly due to senescence, but in industrialized countries – such as the United States, the United Kingdom, and Germany – the rate approaches 90% (i.e., nearly nine out of ten of all deaths are related to senescence). Physiological death
21336-476: The largest unifying cause of death in the developed world is biological aging, leading to various complications known as aging-associated diseases . These conditions cause loss of homeostasis , leading to cardiac arrest, causing loss of oxygen and nutrient supply, causing irreversible deterioration of the brain and other tissues . Of the roughly 150,000 people who die each day across the globe, about two thirds die of age-related causes. In industrialized nations,
21504-601: The legal or religious consequences of a suicide attempt. In 1896, the American ophthalmologists George Gould and Walter Pyle categorized self-mutilation cases into three groups: those resulting from "temporary insanity from hallucinations or melancholia; with suicidal intent; and in a religious frenzy or emotion". Self-harm was, and in some cases continues to be, a ritual practice in many cultures and religions. The Maya priesthood performed auto- sacrifice by cutting and piercing their bodies in order to draw blood. A reference to
21672-490: The life-time risk of self-injury is ~1:7 for women and ~1:25 for men. Aggregated research has found no difference in the prevalence of self-harm between men and women. This contrasts with previous studies, which suggested that up to four times as many females as males have direct experience of self-harm, which many had argued was rather the result of data collection biases. The WHO /EURO Multicentre Study of Suicide, established in 1989, demonstrated that, for each age group,
21840-431: The means to apply this to themselves, they have to use other ways to reach the maximum lifespan for a human, often through lifestyle changes, such as calorie reduction , dieting , and exercise . The idea of lifespan extension is considered and studied as a way for people to live longer. Determining when a person has definitively died has proven difficult. Initially, death was defined as occurring when breathing and
22008-438: The means to the end. Euthanasia , more specifically voluntary euthanasia , is where another person takes a more active role in bringing about a person's death. Suicidal ideation is thoughts of ending one's life but not taking any active efforts to do so. It may or may not involve exact planning or intent. Suicidality is defined as "the risk of suicide, usually indicated by suicidal ideation or intent, especially as evident in
22176-528: The mid-18th century onwards, there was an upsurge in the public's fear of being mistakenly buried alive and much debate about the uncertainty of the signs of death. Various suggestions were made to test for signs of life before burial, ranging from pouring vinegar and pepper into the corpse's mouth to applying red hot pokers to the feet or into the rectum . Writing in 1895, the physician J.C. Ouseley claimed that as many as 2,700 people were buried prematurely each year in England and Wales, although some estimates peg
22344-453: The mind from feelings that are causing anguish. This may be achieved by tricking the mind into believing that the present suffering being felt is caused by the self-harm instead of the issues they were facing previously: the physical pain therefore acts as a distraction from the original emotional pain. To complement this theory, one can consider the need to "stop" feeling emotional pain and mental agitation. Alternatively, self-harm may be
22512-466: The moment when life ends. Determining when death has occurred is difficult, as cessation of life functions is often not simultaneous across organ systems. Such determination, therefore, requires drawing precise conceptual boundaries between life and death. This is difficult due to there being little consensus on how to define life. It is possible to define life in terms of consciousness. When consciousness ceases, an organism can be said to have died. One of
22680-459: The most impact. For example, about 15–40% of people leave a suicide note , and media are discouraged from reporting the contents of that message. When detailed descriptions of how to kill oneself by a specific means are portrayed, this method of suicide can be imitated in vulnerable people. This phenomenon has been observed in several cases after press coverage. In a bid to reduce the adverse effect of media portrayals concerning suicide report, one of
22848-627: The motivations for self harm vary, the most commonly endorsed reason for self harm given by adolescents is "to get relief from a terrible state of mind". Young people with a history of repeated episodes of self harm are more likely to self-harm into adulthood, and are at higher risk of suicide. In older adults, influenced by a combination of interconnected individual, societal, and healthcare factors, including financial and interpersonal problems and comorbid physical conditions and pain, with increased loneliness, perceived burdensomeness of ageing, and loss of control reported as particular motivations. There
23016-482: The need of patients that self-harm in mental healthcare. Studies have shown that staff found the care for people who self-harm emotionally challenging and they experienced an overwhelming responsibility in preventing the patients from self-harming and the care focuses mainly on maintaining the safety for the patients, for example by removing dangerous items or physical restraint, even if it is believed to be ineffective. Dialectical behavior therapy for adolescents (DBT-A)
23184-430: The normal verb in scholarly research and journalism for the act of suicide was commit , and argued for destigmatizing terminology related to suicide; in 2011, they published an article calling for changing the language used around suicide entitled "Suicide and language: Why we shouldn't use the 'C' word". The American Psychological Association lists "committed suicide" as a term to avoid because it " frame [s] suicide as
23352-488: The other hand, optimism has been shown to have a protective effect. Other psychological risk factors include having few reasons for living and feeling trapped in a stressful situation. Changes to the stress response system in the brain might be altered during suicidal states. Specifically, changes in the polyamine system and hypothalamic–pituitary–adrenal axis . Social isolation and the lack of social support has been associated with an increased risk of suicide. Poverty
23520-447: The other hand, believe that the rule does not uphold the best interests of the donors and that the rule does not effectively promote organ donation. Signs of death or strong indications that a warm-blooded animal is no longer alive are: The stages that follow after death are: The death of a person has legal consequences that may vary between jurisdictions. Most countries follow the whole-brain death criteria, where all functions of
23688-704: The past, may also be effective. Some have proposed reducing access to alcohol as a preventive strategy (such as reducing the number of bars). In young adults who have recently thought about suicide, cognitive behavioral therapy appears to improve outcomes. School-based programs that increase mental health literacy and train staff have shown mixed results on suicide rates. Economic development through its ability to reduce poverty may be able to decrease suicide rates. Efforts to increase social connection , especially in elderly males, may be effective. In people who have attempted suicide, following up on them might prevent repeat attempts. Although crisis hotlines are common, there
23856-416: The past. Between 3 and 35% of deaths among those who use heroin are due to suicide (approximately fourteenfold greater than those who do not use). In adolescents who misuse alcohol, neurological and psychological dysfunctions may contribute to the increased risk of suicide. The misuse of cocaine and methamphetamine has a high correlation with suicide. In those who use cocaine, the risk is greatest during
24024-461: The past. When the definition of self-harm was expanded to include head-banging, scratching oneself, and hitting oneself along with cutting and burning, 32% of the sample said they had done this. In Ireland, a study found that instances of hospital-treated self-harm were much higher in city and urban districts, than in rural settings. The CASE (Child & Adolescent Self-harm in Europe) study suggests that
24192-713: The patient. However, limited studies show that professional assessments tend to suggest more manipulative or punitive motives than personal assessments. A UK Office for National Statistics study reported only two motives: "to draw attention" and "because of anger". For some people, harming themselves can be a means of drawing attention to the need for help and to ask for assistance in an indirect way. It may also be an attempt to affect others and to manipulate them in some way emotionally. However, those with chronic, repetitive self-harm often do not want attention and hide their scars carefully. Many people who self-harm state that it allows them to "go away" or dissociate , separating
24360-420: The phenomenon. There are many scientific approaches and various interpretations of the concept. Additionally, the advent of life-sustaining therapy and the numerous criteria for defining death from both a medical and legal standpoint have made it difficult to create a single unifying definition. One of the challenges in defining death is in distinguishing it from life. As a point in time, death seems to refer to
24528-525: The presence of a well-elaborated suicidal plan." In a murder–suicide (or homicide–suicide), the individual aims at taking the lives of others at the same time. A special case of this is extended suicide, where the murder is motivated by seeing the murdered persons as an extension of their self. Suicide in which the reason is that the person feels that they are not part of society is known as egoistic suicide . The Centre for Suicide Prevention in Canada found that
24696-645: The priests of Baal "cutting themselves with blades until blood flowed" can be found in the Hebrew Bible. However, in Judaism, such self-harm is forbidden under Mosaic law . It occurred in ancient Canaanite mourning rituals, as described in the Ras Shamra tablets. Self-harm is practised in Hinduism by the ascetics known as sadhu s. In Catholicism , it is known as mortification of the flesh . Some branches of Islam mark
24864-620: The prior month. Approximately 25–40% of those who died by suicide had contact with mental health services in the prior year. Antidepressants of the SSRI class appear to increase the frequency of suicide among children and young persons. An unwillingness to get help for mental health problems also increases the risk. Substance misuse is the second most common risk factor for suicide after major depression and bipolar disorder. Both chronic substance misuse as well as acute intoxication are associated. When combined with personal grief, such as bereavement ,
25032-592: The problem alone. Despite these high rates, there are few established treatments available for suicidal behavior. Reducing access to certain methods , such as access to firearms or toxins such as opioids and pesticides, can reduce risk of suicide by that method. Reducing access to easily-accessible methods of suicide may make impulsive attempts less likely to succeed. Other measures include reducing access to charcoal (for burning) and adding barriers on bridges and subway platforms. Treatment of drug and alcohol addiction, depression, and those who have attempted suicide in
25200-624: The proportion is much higher, approaching 90%. With improved medical capability, dying has become a condition to be managed . In developing nations , inferior sanitary conditions and lack of access to modern medical technology make death from infectious diseases more common than in developed countries . One such disease is tuberculosis , a bacterial disease that killed 1.8 million people in 2015. In 2004, malaria caused about 2.7 million deaths annually. The AIDS death toll in Africa may reach 90–100 million by 2025. According to Jean Ziegler ,
25368-432: The rare genetic condition Lesch–Nyhan syndrome is uncontrollable self-harm and self-mutilation, and may include biting (particularly of the skin , nails , and lips) and head-banging. Genetics may contribute to the risk of developing other psychological conditions, such as anxiety or depression, which could in turn lead to self-harming behavior. However, the link between genetics and self-harm in otherwise healthy patients
25536-595: The rate of stillbirth. However, 1% of births in the United States end in a stillbirth. A miscarriage is defined by the World Health Organization as, "The expulsion or extraction from its mother of an embryo or fetus weighing 500g or less." Miscarriage is one of the most frequent problems in pregnancy, and is reported in around 12–15% of all clinical pregnancies ; however, by including pregnancy losses during menstruation , it could be up to 17–22% of all pregnancies. There are many risk-factors involved in miscarriage; consumption of caffeine , tobacco , alcohol , drugs, having
25704-554: The rate of suicide among former armed forces personnel in particular, and young veterans especially, is markedly higher than that found in the general population. War veterans have a higher risk of suicide due in part to higher rates of mental illness, such as post-traumatic stress disorder , and physical health problems related to war. The media, including the Internet, plays an important role. Certain depictions of suicide may increase its occurrence, with high-volume, prominent, repetitive coverage glorifying or romanticizing suicide having
25872-568: The ready availability of a means to take one's life, a family history of suicide, or the presence of traumatic brain injury . For example, suicide rates have been found to be greater in households with firearms than those without them. Socio-economic problems such as unemployment, poverty, homelessness, and discrimination may trigger suicidal thoughts. Suicide might be rarer in societies with high social cohesion and moral objections against suicide. Genetics appears to account for between 38% and 55% of suicidal behaviors. Suicides may also occur as
26040-525: The relation between cannabis use and deliberate self-harm (DSH) in Norway and England found that, in general, cannabis use may not be a specific risk factor for DSH in young adolescents. Smoking has also been associated with both non-suicidal self injury and suicide attempts in adolescents, although the nature of the relationship is unclear. A 2021 meta-analysis on literature concerning the association between cannabis use and self-injurious behaviors has defined
26208-629: The relief that will follow. For some self-harmers this relief is primarily psychological while for others this feeling of relief comes from the beta endorphins released in the brain. Endorphins are endogenous opioids that are released in response to physical injury, acting as natural painkillers and inducing pleasant feelings, and in response to self-harm would act to reduce tension and emotional distress. Many people do not feel physical pain when self-harming. Studies of clinical and non-clinical populations suggest that people who engage in self-harm have higher pain thresholds and tolerance in general, although
26376-461: The risk is further increased. Substance misuse is also associated with mental health disorders. Most people are under the influence of sedative-hypnotic drugs (such as alcohol or benzodiazepines) when they die by suicide, with alcoholism present in between 15% and 61% of cases. Use of prescribed benzodiazepines is associated with an increased rate of suicide and attempted suicide. The pro-suicidal effects of benzodiazepines are suspected to be due to
26544-722: The ruination of regular functioning. The aptitude of cells for gradual deterioration and mortality means that cells are naturally sentenced to stable and long-term loss of living capacities, even despite continuing metabolic reactions and viability. In the United Kingdom, for example, nine out of ten of all the deaths that occur daily relates to senescence, while around the world, it accounts for two-thirds of 150,000 deaths that take place daily. Almost all animals who survive external hazards to their biological functioning eventually die from biological aging , known in life sciences as "senescence." Some organisms experience negligible senescence , even exhibiting biological immortality . These include
26712-433: The rule: there must be an official declaration of death in a person before starting organ procurement, or that organ procurement cannot result in the death of the donor. A great deal of controversy has surrounded the definition of death and the dead donor rule. Advocates of the rule believe that the rule is legitimate in protecting organ donors while also countering any moral or legal objection to organ procurement. Critics, on
26880-469: The second year have the highest risk of completed attempt. It is estimated that 1% die by suicide within a year of the first attempt It is estimated that about 90% of suicide survivors will not die of suicide. Mental illness is present at the time of suicide 27% to more than 90% of the time. Of those who have been hospitalized for suicidal behavior, the lifetime risk of suicide is 8.6%. Comparatively, non-suicidal people hospitalized for affective disorders have
27048-978: The sight of others. Neither the DSM-IV-TR nor the ICD-10 provide diagnostic criteria for self-harm. It is often seen as only a symptom of an underlying disorder, though many people who self-harm would like this to be addressed. Although some people who self-harm do not have any form of recognized mental disorder, self-harm often co-occurs with psychiatric conditions. Self-harm is for example associated with eating disorders, autism spectrum disorders , borderline personality disorder , dissociative disorders , bipolar disorder , depression , phobias , and conduct disorders . As many as 70% of individuals with borderline personality disorder engage in self-harm. An estimated 30% of individuals with autism spectrum disorders engage in self-harm at some point, including eye-poking, skin-picking , hand-biting, and head-banging. According to
27216-510: The significance and interpretation of psychosocial factors other than gender. A study in 2003 found an extremely high prevalence of self-harm among 428 homeless and runaway youths (aged 16–19) with 72% of males and 66% of females reporting a history of self-harm. However, in 2008, a study of young people and self-harm saw the gender gap widen in the opposite direction, with 32% of young females, and 22% of young males admitting to self-harm. Studies also indicate that males who self-harm may also be at
27384-498: The suicide attempt, it is estimated that between 25% (after one year) to 40% tried to commit suicide before. The likelihood of completion of the subsequent attempt depends on the means used, the age of the person and their gender. Other risk factors such as substance use and mental health impact likelihood of completed attempt after an attempt. High suicidal intent during previous attempts is another strong predictor. Time passing since an attempt also plays critical role. The first and
27552-414: The total brain, including coma with clear etiology, cessation of breathing, and lack of brainstem reflexes. These criteria were updated again, most recently in 2010, but substantial discrepancies remain across hospitals and medical specialties. The problem of defining death is especially imperative as it pertains to the dead donor rule , which could be understood as one of the following interpretations of
27720-417: The traditions, symbolism, and beliefs of a society" (p. 226). Practices are historically transient and cosmetic such as piercing of earlobes, nose, eyebrows as well as male circumcision while deviant self-mutilation is equivalent to self-harm. Self-harm (SH), self-injury (SI), nonsuicidal self-injury (NSSI) and self-injurious behavior (SIB) are different terms to describe tissue damage that
27888-409: The urge to harm themselves. The removal of objects used for self-harm from easy reach is also helpful for resisting self-harming urges. The provision of a card that allows the person to make emergency contact with counselling services should the urge to self-harm arise may also help prevent the act of self-harm. Some providers may recommend harm-reduction techniques such as snapping of a rubber band on
28056-459: The world; however, assisted suicide is legal in many countries and increasing in numbers. Suicide, derived from Latin suicidium , is "the act of taking one's own life". Attempted suicide , or non-fatal suicidal behavior, amounts to self-injury with at least some desire to end one's life that does not result in death. Assisted suicide occurs when one individual helps another bring about their own death indirectly by providing either advice or
28224-534: The wrist, but there is no consensus as to the efficacy of this approach. It is difficult to gain an accurate picture of incidence and prevalence of self-harm. Even with sufficient monitoring resources, self-harm is usually unreported, with instances taking place in private and wounds being treated by the self-harming individual. Recorded figures can be based on three sources: psychiatric samples, hospital admissions and general population surveys. A 2015 meta-analysis of reported self-harm among 600,000 adolescents found
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