August 28, 2007
The Washington Post reported yesterday that the Virginia Tech shooter had an anxiety disorder as a child. I don’t want to say much more about that, and I don’t know enough about Seung Hui Cho to know whether this did or did not play a role in his actions in April.
But such news can provide a useful reminder to review the prototypes and heuristics clinicians have in our heads about suicide. Specifically, we need to resist the temptation to only think or ask about suicide in cases of depression. Although depression is present in a large proportion of people who die by suicide, suicide is by no means synonymous with depression. Anxiety disorders, personality disorders, and psychotic disorders are all associated with risk for suicide. This begins to make sense when you think about suicide often being a response to hopelessness, despair, agitation, and a feeling of being trapped (often with an overlay of substance abuse disinhibiting the person’s symptoms and behavior). When put that way, it’s not hard to see how chronic intense anxiety could lead to suicidal thinking (or action).
I think this is something many clinicians know, but old prototypes can be stubborn and often get in the way of us accessing what we know. When we refresh our thinking, we can more effectively remember to to ask about suicidal ideation in every case, not just when depression is prominent.
Related posts:
Murder-Suicide, Domestic Violence…Common threads in violence against self and others
Suicide turned outward: Times of London Article by Dewey Cornell
Erratum on previous post: Cornell not author, just interviewed
Yes. I know from experience that having an anxiety disorder at such a young age can really do damage. It did it to me. Really nice post. I’d like to add you to my blogroll if you don’t mind.
-Steven
Steven: Thank you for your comment. It means a lot to me that this post spoke to your personal experience. I would be delighted to be on your blogroll–thank you for asking. Please let me know the URL of your blog, either here or through the contact form I have recently added to the About Me page. Thanks again, Tony
You’re very welcome.
I recently read about this individual in I think “Time” magazine and although I was shocked and sad, I understood what it was that he felt and why he did it, but I was even more shocked to find out that he may have had indeed an anxiety disorder.
Well, keep up the great work!
-Steven