Extreme heat affects mental as well as physical health.

As the summer of 2023 comes to a close, many people across the nation are still dealing with extreme heat. When you think of health risks associated with hot weather, you likely think of heatstroke, heat cramps, and other physical maladies. But research has consistently shown that heat also affects mental health, leading to an uptick in self-harm and suicide.

For instance, a 2018 study found that an increase of one degree Celsius in monthly average temperature led to a 1% increase in suicides in the United States and Mexico — an effect that was consistent in both hotter and cooler regions. Earlier this year, another study found that a one-degree increase in ambient temperature led to a measurable increase in depression and anxiety.

While more research is needed to fully understand the effects of extreme heat on the human brain, the broad takeaway is clear: heat is one of many environmental factors that increase the risk of suicide, and awareness of those factors is a key part of suicide prevention.

How and why extreme temperatures affect suicide risk

Although the link between heat and mental health is not entirely understood, research has indicated that increased temperatures may affect the neurotransmitter environment in the brain (that is, the chemicals that transmit messages to and from the brain), which in turn can affect mood and cognitive functioning.

Heat waves and other dramatic swings in temperature can be particularly dangerous. “It’s not necessarily the hottest days of the year that are associated with the greatest number of suicides and suicide attempts,” Brown University professor Josh Wartzel told Time Magazine, “but actually when the temperature changes dramatically.”

In addition, suicidality can be a secondary consequence of other problems that are inflamed by extreme heat. Studies have shown that in very hot weather, hate speech, harassment, and aggressive behavior increase. There is a growing body of research that shows hot weather leads to significantly more assaults, sexual assaults, and other violent crimes. And it is well known that victims of those crimes are in turn at elevated risk of suicide.

In short, heat is not just a threat to physical health, but also mental health. When cities and towns wisely open “cooling centers” to protect their residents from the physical effects of extreme heat, they should also put plans in place to address mental health crises that can occur during heat waves.

Suicide prevention needs to take into account the weather and seasonality

As we’ve previously discussed, suicide risk, like many other health issues, rises and falls with the seasons. Also like many other health issues, suicidality is caused by a combination of individual and environmental factors. Healthcare professionals who treat people who are at risk of suicide need to take those factors into account when designing care plans, recommending additional services, and so on.

Suicide is preventable, and families who have lost loved ones deserve accountability and justice. If you have lost a loved one to death by suicide or an attempt with serious medical injuries, the team at The Law Offices of Skip Simpson would be honored to listen to your story and explain your options. We are based in Texas but serve families nationwide.

Prompt intervention can prevent suicide

Death by suicide is preventable.

People who are at risk of suicide display warning signs that can be observed and acted upon by those close to them. And with prompt intervention, the risk of suicide can be mitigated and a life saved, both in the short-term and long-term.

One of the most effective suicide prevention methods anyone can learn is called the QPR (Question, Persuade, Refer) method. Full disclosure. Skip Simpson is honored to be on the faculty of the QPR Institute.

Understanding the QPR method

QPR is intended to be analogous to CPR (cardiopulmonary resuscitation), the Heimlich maneuver, and other immediate interventions that anyone can learn to stop a medical emergency. The QPR method treats suicidality as an acute mental health emergency, just like cardiac arrest or choking is a physical health emergency. People with QPR training are equipped to:

• Recognize the warning signs that someone may be at risk of suicide
• Understand common myths and misconceptions about suicide
• Ask questions to assess suicide risk
• Offer hope to people who are at risk of suicide
• Persuade people at risk of suicide to get help
• Refer a person at risk of suicide to appropriate mental health resources

Much like CPR, the goal of QPR is to stop the immediate crisis until a professional with more advanced training can provide further care and treatment, up to and including inpatient care if necessary. It’s part of a “chain of survival” intended to increase the probability that a life-threatening crisis can be survived.

QPR Gatekeeper training through the QPR Institute can be completed in just one to two hours. More extensive training, mentioned below, is also available. The more members of the general public trained in QPR, the more likely it is that suicides can be prevented with immediate intervention from a family member, friend, or colleague.

Additional training is important for professionals who regularly encounter at-risk people

While suicide prevention training is important for anyone, it’s particularly important for workers in professions that regularly come in contact with people at risk of suicide, such as:

• Educators
• Lawyers and legal professionals
• Law enforcement
• Emergency responders
• Foremen, supervisors, and team leaders
• Parents
• Ministers and religious leaders
• Healthcare workers

Unfortunately, many healthcare professionals in particular are under-trained in suicide prevention. Medical professionals who are not specifically trained in mental health often do not know what to do when they encounter a patient who is at risk of suicide. A doctor’s or nurse’s responsibility to their patients includes referring them to appropriate resources or specialists when they encounter a problem that is outside their area of expertise. When they fail to meet that standard, the consequences can be tragic.

If you have lost a loved one to suicide, our law firm can help

The team at the Law Offices of Skip Simpson is dedicated to suicide prevention, and that includes holding medical professionals accountable when they fail to meet their responsibilities to patients who are at risk of dying by suicide. If you have lost a loved one to suicide completion, we would be honored to listen to your story and explain your legal options. Contact us today for a free, confidential consultation. We serve families throughout the United States.

Researchers investigate the lag time between suicidal thoughts and suicide attempts

If you ask the average layperson what time of year has the most deaths by suicide, they would probably guess the winter months. But as mental health professionals and suicide prevention advocates have long known, that seemingly intuitive answer is actually false. Suicide peaks in the spring, with April, May, and June being the deadliest months in the United States and across the Northern Hemisphere.

What is not as well understood is why the spring months have so many deaths by suicide. However, a new study published in Translational Psychiatry has attempted to get to the root of this tendency. Researchers found that while suicidal thoughts do indeed peak in the winter (as many would guess), there is a lag period of several months between the peak of suicidal thoughts and the peak of suicide attempts.

Researchers from Harvard University, the University of Nottingham, and the University of Amsterdam reviewed responses from patients in the United States, Canada, and the United Kingdom who completed questionnaires and tasks about their moods and thoughts of suicide and self-harm over a period of six years. The study results revealed that explicit suicidal thoughts peaked in December and implicit thoughts of self-harm were at the highest level in February, months before actual suicide attempts reach their peak in the spring.

Study authors investigated the reasons for the lag between suicidal thoughts and suicide attempts

The reasons for this lag period are complex and still not perfectly understood, but the study authors noted that people who are deep in the throes of severe seasonal depression, while they may have thoughts of suicide, may not have the energy to actually plan and carry out a suicide attempt. As mood improves somewhat in the spring, many individuals enter a danger zone where suicidal thoughts are still present, but they also have enough energy to attempt suicide.

Dr. Brian O’Shea, the University of Nottingham professor who led the study, put it this way: “Our research shows that suicidal thoughts and mood are the worst in December and the best in June. Between these two points, there is a heightened risk of suicidal behaviour, and we feel this is occurring because the gradual improvements in their mood and energy may enable them to plan and engage in a suicide attempt.”

Researchers drew an analogy between this tendency and the well-known suicide risks in the first month after a patient starts taking antidepressants, as the medication brings the patient’s mood just high enough to enter that same danger zone — although they were quick to note that the seasonal effect is much weaker than the medication effect.

Researchers also speculated that increased engagement in outdoor activities during springtime may play a role. Again, outdoor activities, in general, are not a cause of suicidality, but when someone who is emerging from a difficult winter and already having thoughts of suicide sees others engaged in outdoor activities and perceives that they are much happier or more satisfied in life, this comparison may increase the risk of suicide.

Healthcare professionals need to take these tendencies into account when treating at-risk patients

The results of this study speak to a larger truth about suicide risk: just because someone appears to be getting better does not mean that they are out of danger. In fact, the period when someone first starts to get better may be precisely when the risk is highest. The study results also indicate that this dangerous period is finite, and if the person can be kept safe during that time, their risk of suicide can decrease. In short, death by suicide is not inevitable; it is preventable with the right interventions and safety protocols during the period of highest risk.

If you have lost a loved one to suicide completion, we would be honored to listen to your story and explain your family’s rights and options. The Law Offices of Skip Simpson is based in Texas but serves families throughout the United States. Give us a call or contact us online for a free, confidential consultation.

Study shows a frightening trend among children and teens

As we’ve covered previously, recent years have seen an alarming increase in self-harm, suicide, and suicide attempts among children and teens. A new study sheds light on one particular suicide method that is on the rise in this population: poisoning.

The study, which was published last month in the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report, compared suspected suicide attempts by self-poisoning among young people aged 10-19 in 2019 and 2021. Overall, the rate of suspected self-poisoning suicide attempts increased by 30% in that two-year span.

The largest increase, 73%, was found among children aged 10-12. Self-poisoning attempts increased by 48.8% among adolescents aged 13-15. Females made up a larger portion of the increase than males.

“I think the group that really surprised us was the 10- to 12-year-old age group, where we saw a 73% increase, and I can tell you that from my clinical practice, this is what we’re seeing also,” study co-author Dr. Chris Holstege told CNN. “We’re seeing very young ages, ages that I didn’t used to see attempting suicide by poisoning.”

Common household medications are often used in suicide attempts

The study found that many of these youth suicide attempts involved over-the-counter (OTC) medications that are readily available in most homes. Suicide attempts involving acetaminophen (Tylenol) jumped 71% from 2019 to 2021, according to Dr. Holstege. Other commonly used substances include ibuprofen (sold under many brand names including Advil and Motrin) and diphenhydramine (Benadryl).

This trend is particularly disturbing because many children have easy access to these medications, often in large quantities.

In both children and adults, suicide is usually an impulsive decision, so limiting access to lethal means makes a significant difference in the outcome. Keeping even seemingly innocuous over-the-counter medications in a lockbox is a key step to preventing suicide attempts.

It’s also critical for parents and guardians to respond immediately and take their child right to the hospital if they suspect a self-poisoning attempt. The toxicity of medications like acetaminophen worsens over time, so the sooner the child receives medical attention, the better.

These findings highlight the need for improved youth mental health and suicide prevention services

While limiting access to potentially dangerous medications is an important part of suicide prevention, these findings also highlight the need to address the underlying causes of youth suicide. Even prior to the COVID-19 pandemic, youth suicide rates were on the rise, but the pandemic supercharged what was already a troubling trend. While the worst of the pandemic itself has passed, children and adolescents remain emotionally vulnerable and at elevated risk of dying by suicide.

Greater investment is needed in youth mental health services to diagnose suicide risk factors and provide effective treatment. Parents, caregivers, educators, and others who work with children need to know the warning signs of suicide risk in children and respond accordingly. And pediatricians and other medical professionals who treat children likewise need to know the warning signs, appropriately diagnose suicide risk, and follow standards of care when working with suicidal patients.

Our law firm fights for children and families nationwide

There is nothing more tragic than losing a child to a preventable suicide. Unfortunately, that is the reality for too many American families today. If you have lost a loved one to suicide completion, the Law Offices of Skip Simpson can listen to your story and explain your legal rights and options. Contact us today for a free, confidential consultation. We are based in Texas but handle cases nationwide.

An 11-year analysis of hospital admissions sheds light on youth mental health

It’s well known that children’s mental health is a significant and growing problem in the United States, and a newly published national study has highlighted the severity of the problem.

Dartmouth researchers studied pediatric hospital admissions between 2009 and 2019. The study found a massive 25% increase in mental health-related hospitalizations, the majority of which were for self-harm or suicidal behavior.

It’s also worth noting that this entire study predates the COVID-19 pandemic, which other studies have found had a massive negative effect on youth mental health and suicide risk. As such, even these findings almost certainly understate the problem as it exists today.

According to Dr. Gabrielle A. Carlson, director of child and adolescent psychiatry at Stony Brook University, these results represent a “whole system failure” that includes every aspect of youth mental health, from overworked clinicians who won’t take new patients, to poorly staffed crisis intervention teams, to insurers that won’t pay for youth mental health services.

“The hospital ends up being the place you go when all else fails,” Dr. Carlson told the New York Times.

Children between 11 and 14 represented the largest increase

According to the study, the increase in mental health hospitalizations was almost entirely among children aged 11 to 14; older and younger groups actually saw a decrease in the number of hospitalizations. Girls also made up a somewhat larger share of hospitalizations in 2019 than in 2009. Most alarmingly, there was an increase of over 80,000 hospitalizations for suicidal behavior over the 11-year period, from 49,285 in 2009 to 129,699 in 2019.

While the study did not look at the causes of these trends, one of the co-authors pointed to a growing use of social media in the age group. Other studies have shown a significant link between social media, self-harm, and suicide risk.

Hospitals are unprepared for the increase in mental health crises

While patients with acute mental health crises, including suicidality, make up a growing percentage of hospital patients, hospitals have struggled to address the culture of focusing on physical health emergencies to the detriment of mental health emergencies. As hospitals increasingly grapple with depressive disorders, self-harm, and suicidal behavior among patients, more mental health training and awareness are needed among medical professionals to ensure that they are prepared to manage suicide risk and keep patients safe.

Again, however, the increase in hospitalizations is only a symptom of a larger problem. Our nation needs more mental health resources for both children and adults to ensure that people at risk of suicide are able to receive treatment before they are in crisis and need to be hospitalized. Better access to care across the entire continuum is needed to address the growing problem of youth mental health and suicidality. And parents, educators, coaches, and other adults who work with at-risk youth need to understand the warning signs of suicidality and follow up appropriately.

Our law firm fights for justice for parents and families

Losing a child to suicide is a preventable tragedy, and medical professionals who treat at-risk youth need to be held accountable when they fail to meet standards of care. If you have lost a loved one to suicide completion, contact the Law Offices of Skip Simpson. We’d be honored to listen to your story and explain your legal options, with no obligation and no pressure. Our firm is based in Texas but serves families nationwide.

A new report from the Centers for Disease Control and Prevention (CDC) shows a dramatic increase in suicide risk among American teenagers, especially teenage girls.

The report is based on the CDC’s Youth Risk Behavior Survey (YRBS), which is conducted every two years, most recently in 2021. The 2021 survey found that almost 60% of female high school students experienced persistent feelings of sadness or hopelessness, the highest level found over the last decade, and that 10% had attempted suicide. The numbers were even more stark among students who identified as LGBTQ+, at 70% and 20% respectively.

By comparison, 29% of high school boys reported persistent feelings of sadness or hopelessness in 2021, up from 21% in 2011.

“High school should be a time for trailblazing, not trauma,” Dr. Debra Houry, the CDC’s chief medical officer, told USA Today. “These data show our kids need far more support to cope, hope and thrive.”

These findings highlight the increased need for teen suicide prevention

Unfortunately, when teens express feelings of suicidality or even outright say they’re considering suicide, they are often dismissed as just wanting attention. Nothing could be further from the truth. As the CDC’s findings show, suicidality is a real risk among our youth, especially girls and LGBTQ youth. Indeed, suicide is the second-leading cause of death among children aged 10-14 and the third-leading cause of death among people aged 15-24, according to the National Institute of Mental Health.

It’s critical for parents, teachers, administrators, and other adults to know the warning signs of suicide risk in youth, which include:

• Talking or writing about death
• Expressing feeling “trapped” with no way out
• Giving away prized possessions
• Drug or alcohol use
• Self-harm
• Risk-taking behavior
• Significant mood changes
• Delusions or hallucinations

Adults need to be on the lookout for these and other warning signs in teenagers, particularly after a triggering event such as loss of a friend or family member, relationship breakup, bullying at school, or experience of abuse or discrimination. Just as importantly, responsible adults need to know how to intervene, which may include:

• Listening empathetically to the at-risk youth.
• Acknowledging and validating their feelings.
• Directly asking “are you considering suicide?” or “are you thinking about hurting yourself?”
• Removing lethal means such as weapons and medications.
• Telling another adult immediately and seeking appropriate professional help.
• Referring the at-risk youth to appropriate mental health services and following through.
• The best training for adults interacting with teens or anyone at risk for suicide is to contact the QPR Institute for a course on becoming a gatekeeper as an important step for suicide prevention.

The current increase in youth suicide risk is alarming, but it is not irreversible. Professionals who work with at-risk youth, from educators to medical professionals, need to be aware of the risks and proactively intervene.

We fight for accountability and justice for families

Part of the fight to eliminate youth suicide is the need for accountability for medical professionals who do not meet standards of care in treating at-risk youth. Our law firm fights for families who have lost loved ones to preventable suicide.

If you have lost a loved one to suicide completion, the Law Offices of Skip Simpson would be honored to explain your legal rights and options. We’re based in Texas but serve families throughout the United States.

Taking a closer look at approaches to help students who struggle with suicidality

Suicide is the second-leading cause of death among college students nationwide, ranking only behind accidental deaths (including both motor vehicle and non-motor vehicle accidents).

And the current generation of college students may be at an even greater risk than their predecessors, thanks to the lingering mental health effects of the COVID-19 pandemic. As we wrote last year, there has been a highly concerning uptick in suicidality on college campuses across the United States.

College students do have access to campus mental health services to help reduce suicide risk, but every student responds to treatment differently. An innovative new study is investigating adaptive, targeted strategies to better treat college students and prevent suicide.

Breaking down the CAMPUS trial

The Comprehensive Adaptive Multisite Prevention of University Student Suicide (CAMPUS) trial is a large-scale, multi-site controlled trial funded by the National Institutes of Health (NIH). Four universities are participating in the trial: Duke University in North Carolina, Rutgers University in New Jersey, University of Nevada-Reno, and the University of Oregon.

According to Dr. Scott Compton, the lead investigator for the Duke University arm of the trial, “Providers at college counseling centers have little empirical evidence to guide them about what treatments work best to address college student suicidal risk, and perhaps of equal importance, what treatment to provide next for those students who show little benefit from an initial course of care.” Dr. Compton explains that the goal of the trial is to shed light on these issues and provide better clinical guidelines to manage student suicide risk.

The trial divides treatment into two stages. Stage 1 will randomize students into either a suicide-focused treatment (Collaborative Assessment and Management of Suicidality, or CAMS) or treatment as usual and assess to see whether the student responds well. Those who don’t respond well to Stage 1 will be re-randomized into either CAMS or Counseling Center Dialectical Behavior Therapy (DBT). The goal is to understand which combination of treatments provides the best reduction in suicide risk at the end of treatment and at a three-month follow-up, especially among the critical group of students who do not respond well to initial treatment.

The study is an important step to identify suicide prevention strategies for college students

Central to the purpose of the CAMPUS study is the underlying truth that suicide is preventable. With the right mental health interventions and ongoing support, college students can be protected from the risk of dying by suicide. Identifying what those strategies are is an ongoing process, as suicidality is highly personal and individual.

Just as important, however, is the need for mental health professionals to actually follow standards of care and provide quality treatment to those who are at risk of suicide. Mental health treatment settings need to stay abreast of suicide prevention techniques and implement those techniques to better serve their patients. When they fall short of that responsibility, they must be held accountable.

Our law firm fights for families who have lost loved ones

As studies like the CAMPUS trial look for more effective ways to prevent suicide, it’s critical that medical professionals are held accountable when they fail to follow the currently accepted best practices in suicide prevention and mental health care. If you have lost a loved one to suicide completion, the Law Offices of Skip Simpson would be honored to listen to your story and explain your rights and options. We are based in Texas but serve families nationwide. Schedule your free consultation today.

Drugs and alcohol are closely associated with suicide risk

By now, it’s a well-known and well-studied fact that alcohol and drugs are linked to suicide risk. According to various studies:

• Alcohol intoxication is a factor in 22 percent of suicide deaths and between 30 and 40 percent of suicide attempts, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
• A 2020 study found that substance use disorders (SUDs) are associated with a high risk of suicide mortality, especially in women, and especially among people who have multiple SUDs.
• A 2021 study found that alcohol can increase maladaptive coping behaviors and weaken self-regulation, which increases suicide risk. The same study also found that opioid use causes neurobiological changes that increase suicide risk.
• Lower minimum drinking age laws are associated with an increased risk of youth suicide, according to the Department of Health and Human Services.

It’s important to note that people with substance use disorders frequently have other medical conditions (such as depression) and life circumstances (such as family difficulties or financial problems) that also contribute to suicide risk. However, research has found a link between substance abuse and suicide that cannot be explained by those other factors. As such, suicide prevention efforts must take the risks associated with substance abuse into account.

Substance abuse treatment settings need to play a role in suicide prevention

Like any other profession or service that works with a population that is prone to suicide, substance abuse treatment settings need to make suicide prevention the top priority. Some of the steps that substance abuse treatment centers and agencies need to take include:

• Training staff and volunteers on suicide prevention, including a culture of safety and environmental safety.
• Conducting regular screenings for suicide risk.
• Following lethal means safety best practices in physical treatment locations.
• Preparing treatment plans that address the elevated suicide risk that comes with substance abuse.
• Communicating with other care providers, community resources, and family members to ensure continuity of care and make sure suicide risks do not fly under the radar.
• Referring substance abuse patients to appropriate suicide prevention resources, from the 988 Suicide and Crisis Lifeline to inpatient services, as appropriate.

These guidelines don’t just apply to substance abuse treatment centers, but also to all care settings that work with people who are struggling with substance abuse, from hospitals to mental health clinics. Medical professionals need to be mindful of suicide risk at all times when treating patients who struggle with substance use disorders. It’s part of their obligation to meet standards of care and keep patients safe.

Suicide prevention and substance abuse treatment go hand in hand

As the United States continues to struggle with the opioid crisis in addition to alcoholism and other substance abuse disorders, suicide prevention and substance abuse treatment efforts need to be coordinated to keep patients and the public safe. Part of that effort is seeking accountability for medical providers who do not meet standards of care and put patients at risk of dying by suicide.

If you lost a loved one to suicide completion, we would be honored to listen to your story and explain your options to pursue justice. Schedule your free consultation with the Law Offices of Skip Simpson. We are based in Texas and serve families nationwide.

The findings highlight the complex relationship between race and suicide.

It’s well-known that White Americans (particularly White men) have higher suicide rates than Black and Hispanic Americans, but a new report indicates that this gap may be closing.

The report published by the Centers for Disease Control and Prevention (CDC) looked at the three most commonly used suicide methods: firearms, suffocation (which includes hanging), and poison. Researchers found that after peaking in 2018, suicide rates among non-Hispanic White Americans declined by 2020, from 18.1 suicide deaths per 100,000 people in 2018 to 16.9 per 100,000 in 2020. On the other hand, suicide rates among Hispanic and non-Hispanic Black Americans increased significantly in 2020, to 7.5 per 100,000 and 7.8 per 100,000, respectively.

While the suicide rate among White Americans is still significantly higher — and preliminary 2021 data suggests that this decline may be temporary — it’s still a data point that highlights the complex and shifting relationship between race and suicide.

Why do suicide rates vary by race?

Although racial disparities in suicide rates have been known for some time, the reasons for this relationship are not always clear. What is clear is that no demographic is intrinsically more vulnerable to dying by suicide than any other; rather, differences in suicide rates are most likely caused by differences in societal expectations and cultural and environmental factors. If White men make up a disproportionate percentage of suicide deaths (as they do), then there must be some environmental factor or combination of factors that disproportionately puts them at risk.

A 2017 article in the Yale Global Health Review identified several key suicide risk factors that may explain some of the disparities in suicide rates:

• Social isolation: as became painfully clear during the COVID-19 pandemic, social isolation substantially increases suicidality.
• Housing instability: having a sense of belonging in a place is foundational to good mental health, so people who don’t have a stable residence are at a significant disadvantage.
• Unemployment: long-term unemployment can be devastating to mental health due to loss of structure in the day, financial struggles, and a loss of self-worth.
• Access to firearms: as we’ve written before, firearm access has a dramatic effect on deaths by suicide because guns are much deadlier than other commonly used suicide methods.

The more recent increase in suicide rates among people of color is likewise complicated to explain. An increase in online racism in the wake of the killings of George Floyd and Breonna Taylor in 2020 may be a factor, as we’ve discussed before. And while the COVID-19 pandemic affected everyone, communities of color were disproportionately impacted as well.

Suicide prevention needs to take into account a full range of risk factors.

While more research is certainly needed to understand the cause of disparities in suicide rates, what’s clear is that broad societal factors have a significant impact on suicide risk. There are larger issues that need to be addressed at the local, state, and national levels, including a sense of social connectedness and access to mental health and suicide prevention resources. There is also a need for individual medical and mental health providers to recognize the risk factors and meet standards of care when treating patients at risk of suicide.

Suicide doesn’t discriminate; it affects people and families from all walks of life. If you lost a loved one to suicide and suspect medical negligence may be a factor, we would be honored to evaluate the circumstances and give you our opinion. Contact the Law Offices of Skip Simpson for a free, confidential consultation. We’re based in Texas and serve families nationwide.

Understanding the possible connection between stopping medication and suicide risk

A recent case report published in the Journal of Clinical Psychology is the first known report of antidepressant discontinuation syndrome (ADS) and a suicide attempt.

The patient in question was a 22-year-old woman with a history of major depressive disorder (MDD), generalized anxiety disorder (GAD), alcohol use disorder (AUD), and anorexia nervosa (AN). She had been taking escitalopram, a selective serotonin reuptake inhibitor (SSRI) best known by the brand name Lexapro, for two years, before discontinuing the medication seven days before the suicide attempt.

While this is the first known, documented instance of an actual suicide attempt related to discontinuing antidepressants, previous studies have shown a link between ADS and suicidal ideation. More research is needed, but there is enough evidence to raise red flags that discontinuing antidepressants may increase the risk of suicide.

What is antidepressant discontinuation syndrome?

Antidepressant discontinuation syndrome (ADS), sometimes called antidepressant withdrawal, is a medical condition that occurs in people who stop taking an antidepressant after continuously using it for at least a month. The risk is higher for those who have been taking the medication for longer, and it can be reduced but not eliminated by tapering — that is, slowly reducing the dosage of the medication instead of stopping it all at once. Symptoms of ADS can include:

• Flu-like symptoms (nausea, vomiting, headaches, sweating).
• Sleep disturbances, such as insomnia and nightmares.
• Sensory and movement disturbances, such as tremors and vertigo.
• Mood disturbances, such as anxiety and agitation.
• In rare instances, acute psychosis.

ADS is usually mild, with symptoms ending in one to four weeks. However, especially in patients already at elevated risk of suicide, there is a risk of much more severe consequences, including increased suicidality.

Doctors need to be aware of suicide risk and monitor patients appropriately.

ADS is just one example of a condition that may put a patient at an elevated risk of suicide during treatment. Other high-risk moments include medication changes more broadly, transitions from inpatient to outpatient care, and discharges from a psychiatric hospital or emergency room when mental health has been evaluated. In these situations, medical professionals need to be aware of the elevated risk of suicide and respond appropriately. That may include proactively scheduling follow-up appointments and check-ins, ensuring that patients have support resources in place, and communicating thoroughly during discharges and transitions to ensure that the patient doesn’t slip through the cracks.

Unfortunately, when medical professionals do not meet this standard of care, preventable tragedies can occur. If you lost a loved one to death by suicide, we would be honored to listen to your story and explain your rights and options. Our conversation is confidential, and there is no obligation, just answers. Contact the Law Offices of Skip Simpson for a free consultation. We’re based in Texas and represent families throughout the United States.