Brain injury and suicide risks

An acquired brain injury (ABI) can cause sudden and lasting changes in a person’s thinking, how they react to certain situations, their work and how they relate to others. Brain injury can lead to an increase in stress, as well as difficulty in managing emotions and relationships. At the same time, brain injury adversely affects a person’s ability to deal with these challenges. 

People might appear the same but nevertheless feel a disturbing sense of change within. Brain injury can cause people to be more impulsive and have trouble considering other perspectives. This can lead to feelings of isolation and helplessness without appropriate support. 

These are among the factors that cause depression and increase the risk of suicide among people with brain injury. Without support, a person in this situation might see suicide as an answer to seemingly unsolvable problems, such as enduring emotional distress or disability, which the person may fear more than death.

A suicide attempt is rarely made following a sudden or impulsive decision. Rather, it is more common for individuals to shift between stages on a continuum. These range from initial suicidal thoughts all the way to the act of committing suicide. A person may move back and forth across these stages – progressing forward in severity or returning to earlier stages where suicide is no longer considered. The broad stages include:

• planning 
• organising means to attempt suicide
• attempting to commit suicide (intentional or subintentional) 
• committing suicide

Initial signs to be aware of  

• statements such as ‘It would have been better if I had died’ 
• any threat about committing suicide
• behaviour that is very withdrawn or depressed 
• a history of having attempted suicide in the past. 

It is important to look for cues, particularly when a person has attempted suicide before, and assist the person to seek professional help. Self-harming behaviour is similarly dangerous because it can lead to death, albeit unintentional. 

Signs of increased risk 

• having access to lethal means 
• evidence of a specific plan 
• drug abuse or extreme behaviour 
• catastrophic reactions to relatively mild stress 
• a crisis that precipitates the event. 

A person who is considering suicide desperately needs to know that others care. Sometimes just being with a person helps, even without talking. Simply listen to what the person is saying about themselves and their life. It’s reassuring for the person to know that you care and are always willing to listen and talk with them. 

Encouraging them to reach out is also important. Counselling services and GP’s can provide initial support but the person may not know how to initiate these interactions. You can also help the person to stay in touch with friends or make new ones to decrease the chances of social isolation.

Crisis intervention can include immediate support via telephone counselling, referral to a psychiatrist, close monitoring or moving the person to a less stressful environment. Medical and psychiatric treatment is an option, including the use of medication, hospitalisation and psychological therapy. In the long term, it is important that people are linked to support systems such as mental health case management.

If you have an acquired brain injury and are considering suicide, you should know that you are not alone. Most people think about suicide at one time or another. Thinking about it does not mean things can’t get better. 

Brain injury causes physical issues that can lead to depression. It is important to seek medical and professional advice to help deal with these physical problems. Remember, the crisis will pass. If you have a brain injury, it might be particularly hard to see your way through some problems but others do care. 

Don’t be afraid to talk about your problems with someone who can help. Let family members, friends, your doctor or other professionals know how you feel. 

If you are in need of immediate support, contact Beyond Blue directly on 1300 22 4636 or visit them online at beyondblue.org.au