Stress and Suicide

Michelle M. Cornette, Medical College of Wisconsin
Andrew M. Busch, University of Wisconsin — Milwaukee

“Stress” is a well-known contributor to mood, mental disorders, and suicide risk. Stress is a term often used synonymously with negative life experiences, or life events. Negative life events conferring risk for depression, suicidal thinking, and behavior, includes interpersonal, occupational, and traumatic childhood events. Trauma, especially childhood trauma, has significant short and long-term impact on risk for suicidal behavior. Specifically, child abuse (emotional, sexual, and physical), parental death, parental mental illness, and witnessing domestic violence during childhood have all been linked to suicidal behavior, both acutely, and over longer time intervals.
Interpersonal life event also increase risk for suicidal behavior. Parental or spousal death, serious arguments with a spouse, and social "exit events" (e.g. a child leaving home) have been linked to suicide attempts among adults, while parental separation and relationship break-ups have been linked to suicide among adolescents and young adults. The interpersonal events most relevant to suicidal behavior appear to be those involving loss or conflict in existing interpersonal relationships, rather than simple social isolation.
Negative occupational and academic events also increase risk for suicidal behavior. Specifically, occupational loss and other difficulties at work have been linked to completed suicide. Unemployment and financial strain are also common among those who commit suicide. Among adolescents and young adults, failing a grade, suspension from school, and drop-out have all been linked to later suicide. Interestingly, objectively neutral and even positive life events to include marriage/ engagement, birth of a child or other new person in the home, and relocation, can also increase stress and risk for suicidal behavior.
Recent research in college students, older adults, outpatient clinic samples, and military veterans suggests that events which lead one to feel burdensome on others (e.g. job loss, physical illness, or other role transition) may be particularly important risk factors for suicidal behavior. For example, research has revealed that suicide notes from individuals completing suicide contain more references to perceived burden than the notes of individuals attempting suicide.