Suicide and Mental Disorder: Causes, History, and Treatment
This paper examines the psychopathology of suicide from multiple perspectives. Beginning with a historical backdrop, it traces how societal attitudes toward suicide have shifted over centuries, from honor and glory in some ancient cultures to stigmatization in Western Christianity and, eventually, to modern clinical understanding. The paper surveys biological, psychodynamic, and socio-cultural explanations for suicidal behavior, including findings on serotonin, personality traits, and Durkheim's integration theory. Age-related patterns, early life trauma, and cultural variations are also addressed. Evidence-based treatment approaches—cognitive therapy, dialectical behavior therapy, and mentalization-based treatment—are reviewed alongside key prevention strategies. The paper concludes with a discussion of religious perspectives and directions for future research.
- Introduction: Defining suicide, its scope, and DSM classification
- Historical Perspective: How societies have viewed suicide across centuries
- Causes of Suicide: Biological, psychodynamic, and socio-cultural explanations
- Other Contributing Factors: Age, personality traits, and early life trauma
- Treatment Approaches and Prevention Strategies: CBT, DBT, mentalization, and prevention interventions
- Cross-Cultural and Religious Perspectives: Cultural variation and biblical views on suicide
- Future Research Directions: Gaps in knowledge and priorities for future study
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What makes this paper effective
- The paper synthesizes multiple explanatory frameworks—biological, psychodynamic, and socio-cultural—providing a genuinely multi-perspective account of a complex phenomenon rather than reducing it to a single cause.
- It integrates historical context with contemporary clinical evidence, helping readers understand how shifting cultural attitudes have shaped both the definition of suicide and the treatment of those affected by it.
- The treatment section moves beyond description to evaluate specific, empirically supported therapies (Cognitive Therapy, DBT, mentalization-based treatment), grounding the paper in practical clinical relevance.
Key academic technique demonstrated
The paper demonstrates effective use of a multi-framework organizational strategy: each explanatory perspective (biological, psychodynamic, socio-cultural) is given its own subsection, allowing the reader to evaluate them independently before the paper synthesizes their implications. This structure is particularly well-suited to complex psychological topics where no single explanation is sufficient.
Structure breakdown
The paper opens with definitional grounding using the DSM-5, then moves chronologically through history before turning to causal analysis. A dedicated section on contributing factors (age, personality, early life) adds empirical depth. Treatment and prevention strategies are treated as a distinct unit, followed by cross-cultural and religious perspectives that broaden the scope. The paper closes with a forward-looking discussion of research gaps, giving it a complete arc from definition through implication.
Introduction
Globally, suicide is one of the major causes of death. As many as 36,000 people commit suicide in the United States annually, and estimates suggest that 1 million individuals commit suicide in the rest of the world. While the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not classify suicide as a mental disorder, practitioners recognize the correlation between psychological dysfunction and suicide, particularly with respect to perturbed orientation toward life, emotional confusion, and poor coping skills in ordinary circumstances (Comer, 2013).
The precise definition of a suicide attempt is that it is an action which the individual has initiated with at least a partial goal of ending their own life. This act may or may not result in medical consequences and/or injury. Factors that impact the actual result of a suicide attempt include: low intentionality and/or ambivalence, chance intervention during the attempted act, incomplete knowledge about the chosen method, and poor planning (American Psychiatric Association, 2013).
The DSM-5 states that suicidal behavior includes at least one suicide attempt by the individual. An attempt made at suicide, even if the person changed their mind or there was a timely intervention, is considered suicidal behavior. Some suicide attempts involve the use of poison and/or medications; the individual may begin taking these substances but then be stopped by another person, or may choose to stop themselves. However, should an individual not actually initiate suicidal behavior—whether due to self-restraint or intervention—it is recommended that this person not be diagnosed as suicidal (American Psychiatric Association, 2013).
Historical Perspective
In 1642, Sir Thomas Browne first used the word suicide in his book Religio Medici. The word derives from the Latin sui and cida, meaning "one who kills oneself." While suicidal numbers are high at present, the act itself appears to have been recorded throughout history. Prior to the introduction of the word "suicide," other terms in use included self-destruction, self-killing, and self-murder. Beck and colleagues defined suicide as the willful self-infliction of a life-threatening act (Pooja & Kochar, n.d.).
Historically, the societal view of suicide has varied with culture. For example, the traditions of feudal Japan held suicide to be an honorable act by which a family or clan could be protected from dishonor brought about by one family member's actions. Many in the ancient Roman Empire viewed suicide as an act of glory and a demonstration of superior wisdom. In earlier historical periods, the deliberate choice of death before becoming enfeebled was sometimes understood as "dying with dignity" (Barnes, 2010). Prior to the 1600s, when the term "suicide" entered common use, the act was often considered merely a different form of death.
An early stigmatization of suicide as an unforgivable sin came from Saint Augustine. Much of Western Christianity adopted his view, classifying suicide as a sinful act equivalent to murder and therefore a direct violation of one of the Ten Commandments. Accordingly, individuals who committed suicide were not permitted a church burial. In some cases, societal and moral disapproval was expressed by dragging the bodies of those who had committed suicide through town, both to impress the wrongness of the act upon the community and, possibly, to punish and humiliate the family of the individual (Barnes, 2010).
While there were often penalties and disgrace for the families of those who committed suicide, the classification of an individual as mentally disturbed began, during the 1800s, to shift the societal view of the act. Social status and family reputation were significant priorities of that era, and having a suicide in the family was considered disgraceful. The stigma attached to mental illness contributed to the development of a strong taboo against suicide in Western culture. In contrast, suicide is today discussed far more openly, and disgrace is not necessarily concomitant with the sorrow of losing a loved one to suicide. The view of the individual who has committed suicide has shifted from "sinner" to "victim" (Barnes, 2010).
Causes of Suicide
Different perspectives on the causes of suicide emerge from the biological, psychodynamic, and socio-cultural frameworks.
Analysis of the families, close relatives, and parents of individuals who commit suicide has shown higher rates of suicide within these groups. These data suggest the possibility of biological and/or genetic factors contributing to suicidal ideation. Twin studies also support this finding (Comer, 2013).
Over the last thirty years, there has been increasing laboratory and clinical research into suicide. Studies of the neurotransmitter serotonin, for example, have shown that individuals with low serotonin levels exhibit impulsive behavior and aggressive activity. For individuals diagnosed with clinical depression, aggressive tendencies may be partly a consequence of low serotonin activity. Such individuals may therefore be at particular risk of acting on suicidal thoughts (Comer, 2013).
Psychodynamic theory suggests that suicidal behavior derives from unresolved anger toward other people, as well as from depressed mental states in which the individual redirects external anger inward. One theory proposes that individuals "introject" the persona of a lost loved one—whether that loss was real, as in a death, or emotional, as in a dysfunctional relationship. This introjection involves an unconscious incorporation of the other person into the self-identity, along with feelings toward oneself that mirror those previously held toward the other person. These feelings can include anger toward the other person, now experienced as self-hatred. That anger can then manifest as extreme self-directed hostility and significant depression, with suicide as its most extreme expression.
Durkheim's analysis (as cited in Comer, 2013) focuses on the integration of the individual into societal groups, including the community, the family, and religious institutions. This perspective suggests that lack of integration is more often a factor in suicidal ideation, while more closely integrated individuals have an inherently decreased risk of suicide. The socio-cultural perspective identifies at least three categories of suicidal individual: altruistic, anomic, and egoistic.
Altruistic suicides include individuals who are apparently well integrated into society and who consider the sacrifice of their lives a contribution to the well-being of others. Anomic suicides—based on the concept of anomie, meaning a lack of normal ethical and social standards—describes individuals whom Durkheim proposes lack meaning in life. Their circumstances, whether through family, religion, or social connections, do not provide sufficient stability to generate a sense of purpose. Egoistic suicides include individuals who are iconoclastic in general—neither well integrated into the social fabric nor responsive to societal mores and norms (Comer, 2013).
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Barnes, D. H. (2010). The truth about suicide. Retrieved from https://www.overdrive.com/media/322303/the-truth-about-suicide
Comer, R. J. (2013). Abnormal psychology. New York, NY: Worth Publishers.
Colucci, E. (2006). The cultural facet of suicidal behaviour: Its importance and neglect. Australian e-Journal for the Advancement of Mental Health, 5(3).
Draper, B. M. (2014). Suicidal behaviour and suicide prevention in later life. Maturitas, 79, 179–183. doi: 10.1016/j.maturitas.2014.04.003
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Jacobs, D. G., et al. (2003). Practice guidelines for assessment and treatment of patients with suicidal behaviors. American Psychiatric Association Publications.
Pooja, R., & Kochar, S. R. (n.d.). Suicide in youth: Shifting paradigm. Journal of Indian Academy of Forensic Medicine, 32(1), 45–48.
Roscoat, E., & Beck, F. (2013). Efficient interventions on suicide prevention: A literature review. Epidemiology and Public Health, 61, 363–374. doi: 10.1016/j.respe.2013.01.099
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