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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Taking care of oneself by regaining control - a key to continue living four to five decades after a suicide attempt in severe depression

Authors: Lisa Crona, Margaretha Stenmarker, Agneta Öjehagen, Ulrika Hallberg, Louise Brådvik

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

Depression is a strong risk factor for suicide and suicide attempt. Several studies have examined the pathway to suicide attempt, but few studies have considered aspects important for overcoming being suicidal. The aim of the present study was to examine personal strategies to continue living after a suicide attempt.

Methods

A qualitative grounded theory approach was used. Thirteen former inpatients diagnosed with severe depression (1956–1969) participated in a follow-up 42–56 years after their last suicide attempt, which occurred between the ages of 21 and 45. They were interviewed on one occasion between June 2013 and January 2014, using semi-structured interviews.

Results

The pathway to a suicide attempt was defined as ‘being trapped in an overwhelming situation’. Three categories described the recovery process: ‘coming under professional care’, ‘experiencing relief in the personal situation', and ‘making a decision to continue living’. These categories emerged in a core category, labelled ‘taking care of oneself by regaining control’. Overcoming being suicidal occurred regardless of recovering from depression.

Conclusion

In the very long-term course following a suicide attempt, the process of recovery is multi-dimensional and fluctuating, and includes appropriate treatment, connecting with others, decision making, and overcoming existential issues.
Literature
1.
2.
Nordentoft M. Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Dan Med Bull. 2007;54:306–69. Review.PubMed
3.
Brådvik L, Mattisson C, Bogren M, Nettelbladt P. Mental disorders in suicide and undetermined death in the lundby study. The contribution of severe depression and alcohol dependence. Arch Suicide Res. 2010;14:266–75.CrossRefPubMed
4.
Thomson W. Long term follow up of suicide in a clinically depressed community sample. J Affect Disord. 2012;139:52–5.CrossRefPubMed
5.
Holma KM, Melartin TK, Haukka J, Holma IA, Sokero TP, Isometsä ET. Incidence and predictors of suicide attempts in DSM-IV major depressive disorder: a five-year prospective study. Am J Psychiatry. 2010;167:801–8.CrossRefPubMed
6.
Azorin J, Kaladjian A, Besnier N, Adida M, Hantouche E, Lancrenon S, Akiskal H. Suicidal behaviour in a French cohort of major depressive patients: characteristics of attempters and nonattempters. J Affect Disord. 2010;123:87–94.CrossRefPubMed
7.
Owens D, Horrocks J, House A. Fatal and non-fatal repetition of self-harm. Systematic review. Br J Psychiatry. 2002;181:193–9.CrossRefPubMed
8.
Runeson B, Haglund LP, Tidemalm D. Suicide risk after nonfatal self-harm: a national cohort study, 2000–2008. J Clin Psychiatry. 2016;77:240–6.CrossRefPubMed
9.
Beutrais A, Collings SCD, Ehrhardt P, Henare K. Suicide prevention: a review of evidence of risk and protective factors, and points of effective intervention. Wellington: NZ Ministry of Health; 2005.
10.
Tidemalm D, Beckman K, Dahlin M, Vaez M, Lichtenstein P, Långström N, Runeson B. Age-specific suicide mortality following non-fatal self-harm: national cohort study in Sweden. Psychol Med. 2015;45:1699–707.CrossRefPubMed
11.
Cutcliffe JR. Research endeavours into suicide: a need to shift the emphasis. Br J Nurs. 2003;12:92–9.CrossRefPubMed
12.
Hjelmeland H, Knizek BL. Why we need qualitative research in suicidology. Suicide Life Threat Behav. 2010;40:74–80.CrossRefPubMed
13.
14.
15.
Michel K, Valach L, Waeber V. Understanding deliberate self-harm: the patients´ views. Crisis. 1994;15:172–8.PubMed
16.
Lakeman R, Fitzgerald M. How people live with or get over being suicidal: a review of qualitative studies. J Adv Nurs. 2008;64:114–26.CrossRefPubMed
17.
Chi MT, Long A, Jeang SR, Ku YC, Lu T, Sun FK. Healing and recovering after a suicide attempt: a grounded theory study. J Clin Nurs. 2013;23:1751–9.CrossRefPubMed
18.
Sun FK, Long A. A suicidal recovery theory to guide individuals on their healing and recovering process following a suicide attempt. J Adv Nurs. 2013;69:2030–40.CrossRefPubMed
19.
Crocker L, Clare L, Evans K. Giving up or finding a solution? the experience of attempted suicide in later life. Aging Ment Health. 2006;10(6):638–47.CrossRefPubMed
20.
Bostik KE, Everall RD. Healing from suicide: adolescent perceptions of attachment relationships. Br J Guid Couns. 2007;35:79–96.CrossRef
21.
Jordan J, McKenna H, Keeney S, Cutcliffe J, Stevenson C, Slater P, McGowan I. Providing meaningful care: learning from the experiences of suicidal young men. Qual Health Res. 2012;22:1207–19.CrossRefPubMed
22.
Cutcliffe JR, Stevenson C, Jackson S, Smith P. A modified grounded theory study of how psychiatric nurses work with suicidal people. Int J Nurs Stud. 2006;43:791–80.CrossRefPubMed
23.
Cutcliffe JR, Stevenson C, Jackson S, Smith P. Reconnecting the person with humanity. How psychiatric nurses work with suicidal people. Crisis. 2007;28:207–10.CrossRefPubMed
24.
Strauss C. Basics of qualitative research. Grounded theory procedures and techniques. California: Sage Publications; 1998.
25.
Glaser BG, Strauss A. The discovery of grounded theory. In: Strategies for qualitative research. Chicago: Aldine; 1967.
26.
27.
Stenmarker M, Hallberg U, Palmérus K, Márky I. Being a messenger of life-threatening conditions: experiences of pediatric oncologists. Pediatr Blood Cancer. 2010;55:478–84.CrossRefPubMed
28.
Charmaz K. Grounded theory. Objectivist and constructivist methods. In: Denzin NK, Lincoln YS, editors. Handbook of qualitative research. 2nd ed. Thousand Oaks: Sage; 2000. p. 509–35.
29.
Hall WA, Callery P. Enhancing the rigour of grounded theory: incorporating reflexivity and relationality. Qual Health Res. 2001;11:257–72.CrossRefPubMed
30.
Essen-Möller E, Wohlfahrt S. Suggestions for the amendment of the official Swedish classification of mental disorders. Acta Psychiatr Neurol Scand. 1947;22 Suppl 47:551–5.CrossRef
31.
Brådvik L, Berglund M. Repetition and severity of suicide attempts across the life cycle. A comparison by age-groups between suicide victims and controls with a severe depression. BMC Psychiatry, 2009; doi:10.​1186/​1471-244X-9-62.
32.
Crona L, Brådvik L. Long-term course of severe depression. Late remission and recurrence may be found in a follow-up of 37-53 years. Ment Illn 2012; doi:10.​4081/​mi.​2012.​e17.
33.
Frank E, Prien RF, Jarrett RB, Keller MB, Kupfer DJ, Lavori PW, et al. Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Arch Gen Psychiatry. 1991;48:851–5.CrossRefPubMed
34.
Crona L, Mossberg A, Brådvik L. Suicidal career in severe depression among long-term survivors: In a follow-up after 37-53 years suicide attempts seem to end long before depression. Depress Res Treat 2013; doi:10.​1155/​2013/​610245.
35.
Heath H, Cowley S. Developing a grounded theory approach: a comparison of Glaser and Strauss. Int J Nurs Stud. 2004;41:141–50.CrossRefPubMed
36.
Williams JMG, Pollock LR. Suicidal behaviour as a cry of pain. In: Hawton K, Van Heeringen K, editors. The international handbook of suicide and attempted suicide. Chichester: Wiley; 2000. p. 89.
37.
Akiskal HS. Mood Disorders. In: Sadock BJ, & Saddock VA, editors. Kaplan & Saddock’s Comprehensive Textbook of Psychiatry. 7th ed Lippincott, Philadelphia, Williams &Wilkins: 2000 Philadelphia; p. 1284-1440.
38.
Ringel E. Selbstmordverhütung. Verlag Hans Huber Bern Stuttgart: Wien; 1969.
39.
Samuelsson M, Wiklander M, Åsberg M, Saveman BI. Psychiatric care as seen by the attempted suicide patient. J Adv Nurs. 2000;32:635–43.CrossRefPubMed
40.
Sun FK, Long A, Tsao LI, Huang HM. The healing process following a suicide attempt: context and intervening conditions. Arch Psychiatr Nurs. 2014;28:55–61.CrossRefPubMed
41.
Mann JJ, Waternaux C, Haas GL, Malone KM. Toward a clinical model of suicidal behaviour in psychiatric patients. Am J Psychiatry. 1999;156:181–9.PubMed
42.
Sinclair J, Green J. Understanding resolution of deliberate self: qualitative interview study of patients’ experiences. BMJ. 2005;14:1112–5.CrossRef
43.
Yalom ID. Existential psychotherapy. New York, NY: Basic Books; 1980. p. 9.
44.
45.
Blair-West GW, Mellsop GW, Eyeson-Annan ML. Down-rating lifetime suicide risk in major depression. Acta Psychiatr Scand. 1997;9:259–63.CrossRef
46.
Angst J, Hengartner MP, Rogers J, Schnyder U, Steinhausen HC, Ajdacic-Gross V, Rossler W. Suicidality in the prospective Zurich study: prevalence, risk factors and gender. Eur Arch Psychiatry Clin Neurosci. 2014;264:557–65.CrossRefPubMed
47.
Brådvik L, Berglund M. Late mortality in severe depression. Acta Psychiatr Scand. 2001;102:111–6.CrossRef
48.
Berglund M, Nilsson K. Mortality in severe depression. A prospective study including 103 suicides. Acta Psychiatr Scand. 1987;76:372–80.CrossRefPubMed
49.
Lakeman R, McAndrew S, MacGabhann L, Warne T. That was helpful … no one has talked to me about that before': research participation as a therapeutic activity. Int J Ment Health Nurs. 2013;22:76–84.CrossRefPubMed
Metadata
Title
Taking care of oneself by regaining control - a key to continue living four to five decades after a suicide attempt in severe depression
Authors
Lisa Crona
Margaretha Stenmarker
Agneta Öjehagen
Ulrika Hallberg
Louise Brådvik
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1223-4

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