Santiago Saiz
Updated Monday, March 11, 2024-01:46
Suicide prevention All articles in the Once Lives series
An SOS in an encounter that could seem casual.
"They approach me in the hallways, at recess, some in the office, 'hey, teacher, I want to talk to you.'"
Psychologist
Natalia Rodríguez Robles
has been working as a counselor in schools and institutes for more than a decade.
She listening and channeling the problems of her students.
Trying to prevent her discomfort from leading to risky behavior.
She says that only a minority of those teenagers approached her on their own initiative.
"It's always girls."
Both with this proactive group and with those she receives - the majority - at the suggestion of teachers and even classmates,
the counselor tries to get them to express their restlessness
.
"Girls usually look you in the eyes and tell you 'yes, I'm not fine'. It's harder for them, sometimes they're surprised, they don't want to talk, I've found situations in which they deny it," she says.
Dozens of reasons can contribute to a teenager's suffering.
Personal circumstances.
A couple breakup or parental separation.
Others, academic: exams, grades, inadequate management of self-demand.
There are warning signs such as changes in behavior and sudden disinterest in activities that they were passionate about.
Worrying phrases, "no one cares about me, I wish he were dead."
Risk behaviors.
"We mainly find self-harm and in girls
. "
Natalia Rodríguez Robles points out an intuition.
"Boys' problems are much more difficult to detect and confirm."
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Although, strictly speaking, self-harm should not be confused with the intention to take one's life, the different management of discomfort by men and women suggests a hypothesis about
the so-called gender paradox in suicide
.
This is defined by two disparate trends.
In 2022, among the 4,227 deaths by suicide in Spain, there were three men for every woman;
an invariable and repeated proportion in almost all countries.
And yet - although there are no official data - the known figures agree that the majority of self-harm attempts are carried out by women.
José Luis Ayuso Mateos,
head of the Psychiatry service at the Hospital de la Princesa and professor at the Autonomous University of Madrid, focuses on adolescents and young adults, aged 15 to 24.
"It is the population that makes the most attempts and they are more frequent in women. It is not uncommon to see young people who make many and, fortunately, do not die."
He contrasts this fact with
the highest rates of deaths by suicide, which are recorded in the elderly,
vulnerable to any attack on their body.
Beyond the statistics, he emphasizes that each attempt is relevant because it warns of the risk of a subsequent attempt that could be fatal.
Risk and protection factors
Dropdown
RISK FACTOR'S
Personal
* Previous suicidal behavior.
* Search for loneliness and non-participation in group activities.
* Difficulties communicating in a group.
*No expression of feelings or opinions.
* Difficulty controlling impulses and low tolerance for frustration.
* Presence of illness and/or chronic pain.
* Physical disability.
* Incipient or already diagnosed mental disorder, the most frequent being mood disorders, obsessive-compulsive disorder, eating disorders and post-traumatic stress disorder.
* History of sexual abuse and/or physical and/or psychological abuse.
* Unwanted pregnancy.
* Access to lethal means or methods (psychotropic drugs, weapons, vehicles, machinery, toxic products...).
* Self-harm.
* Stressful life events: Death or loss of a loved one, of a famous person you admire, argument or breakup of a relationship, or a friendship.
* Consumption of alcohol and other drugs
Relatives
* Family history of suicide.
* Alcohol or substance abuse in the family.
* Family history of mental health disorders.
* Violence in the family environment.
* Breakdown of family ties.
* Negative communication factors within the family.
* Family with high levels of demand and perfectionism.
* Recent traumatic loss of a family member or close people.
From the social environment
* Absence or loss of a social support network, social isolation, difficulties relating to peers.
* Situation of sociocultural uprooting (change of country, city, environment...).
* School bullying, both in victim and aggressor students.
* Feeling of rejection.
* Processes of transition in sexual identity or expression of sexual orientation not accepted.
* High self-demand and perfectionism, which lead to feelings of personal failure, hopelessness, and low self-esteem
PROTECTIVE FACTORS
They would be those situations or circumstances that reduce the possibility of a manifestation of suicidal behavior appearing.
The greater the number of protective factors, the less likely it is that the person will exhibit suicidal behavior (although it does not rule it out).
Many of the protective factors can be acquired through strategies and tools worked from the family, the social environment and the educational field.
Personal
* Socio-emotional competencies: Social, communication, problem-solving and adaptation skills.
* Positive self-esteem.
* Prosocial attitudes and values: Respect, solidarity, cooperation, justice, friendship.
* Feeling of acceptance and belonging to a reference group or community.
* Perception of control over life events (internal locus of control).
Relatives
* Satisfactory family relationships and bonds, adequate levels of communication, emotional expressiveness and attention in the family environment.
* Attachment and/or reference people within the family environment.
From the school or social environment
*Friendly relationships between equals.
* Positive relationships with teachers and relevant people around them.
* Accessibility and confidence to be able to talk about difficult topics with at least one person from your social and school environment.
* Positive expectations for socio-personal and educational development.
* Adequate management of leisure and free time: Carry out physical, artistic, citizen participation, etc. activity, both individually and in groups.
How to improve prevention?
"There are general factors: childhood abuse,
bullying,
contexts of violence... If we lower them, we can have a reduction in attempts. Others are more difficult to modify, such as family history," explains Dr. Ayuso Mateos.
Mental illnesses can influence the entire autolytic chain, from ideation to execution.
"In general, depression and anxiety disorders are more common in women; they are the conditions most associated with suicidal behavior," completes this psychiatrist.
But this majority of attempts by women does not translate to deaths.
"Men try less but they succeed more because they choose a much more lethal method," summarizes
Javier Jiménez Pietropaolo,
a clinical psychologist with 30 years of experience and founding member of the AIPIS Network.
Citing studies from other countries and isolated studies in Spain, he adds that
"the impulsivity to commit suicide, as a general rule, occurs more in men."
There are, however, other factors.
The danger of introversion
Regarding the gender difference, there is a significant age group, in which there are no longer as many attempts as between 15 and 24 years old.
Men and women from 40 to 64 represent, separately, around 19% of the total population.
In 2022, their suicides accounted for 38% of deaths from this cause in Spain;
theirs, 12.5%.
"It seems very important to me that the last straw in men of this age is the traumatic breakup of a couple,"
says Javier Jiménez Pietropaolo.
He lists personal factors that can aggravate it.
Very low self-esteem, introversion - "not telling anyone" - and dichotomous thinking - "this is black or white" -.
He points to a flashing alarm light in the bedroom.
The insomnia.
"If your head is functioning in a distorted way, if you are also deprived of sleep, there is a much greater risk that you will engage in suicidal behavior."
His explanation illustrates why suicide has multiple causes.
The breakup would be the trigger but its impact is conditioned by the individual factors mentioned.
And also by other social ones.
Thus, this clinical psychologist feels that men "educated in a certain way that has marked them" do not usually look for external tools.
"Apart from that imprint of 'men don't cry', there is that of 'the psychologist is a shrink and I'm not crazy'. They think: 'Am I going to pay someone 50/60 euros to tell him my problems? I'll solve them.' me.'
Very often men of a certain age do not resort to professional help
."
In practice, he continues, they avoid almost any help.
"An intimate problem, do you think that as a general rule a man is going to tell it to another? He has to be a very close friend and have a lot of confidence because sometimes they think that they show weakness. And if it is in the workplace, what can affect them? or they can use it against you," he details.
Associations and telephone numbers that offer help
Dropdown
-In case of an imminent vital emergency, call the emergency number
112
directly .
-If you have suicidal ideation
024
- Hope Telephone: 717.003.717.
- Telephone Against Suicide - La Barandilla Association (Madrid): 911.385.385.
- RedAIPIS-FAeDS Association
-Maternity support telephone number 012 (Community of Madrid)
- Suicide Prevention Telephone (Barcelona): 900.92.55.55.
-ANAR Telephone/Chat for Help for Children and Adolescents 900 20 20 10
- Papageno 633 169 129 vivos@papageno.es
-The Yellow Girl Association
-P81 Social Association
- APSAV.
Association for the prevention of Suicide.
Green Hugs.
Asturias.
- AFASIB (Familiars i Amics Survivents per suïcidi de Les Illes Balears (Balearic Islands)
-AIDATU.
Basque Suicideology Association
- APSAS: Association for the Prevention of Suicide and Assistance to Survivors.
(Gerona)
- APSU: Association for the prevention and support of those affected by suicide (Valencian City)
- ASAM: (Burgos).
- KISSARKADA-Hug: Navarra.
- BIZIRAUN: Basque Country
-BIDEGUIN: Basque Country
- After the Suicide: (Barcelona)
- Alaia Foundation (Madrid)
- Metta-Hospice Foundation (Valencia)
- Goizargi: Navarra
- León Survivors Group.
- There is Exit, Suicide and Duel: (Cantabria)
- Ubuntu (Seville)
- Light in the Dark Association (Tenerife)
-Return to Live Association (Tenerife)
José Luis Ayuso Mateos, head of the Psychiatry service at the La Princesa Hospital in Madrid, assumes that affective disorders have the same prevalence in men and women.
But some men take a wrong turn.
"Sometimes this emotional discomfort is alleviated, not with appropriate strategies, but with others such as drug or alcohol consumption
, which is very widespread. And that, far from alleviating the situation, makes it worse," he says.
Javier Jiménez Pietropaolo, from the AIPIS Network, sees women of the same age as more willing.
"They don't feel inferior for externalizing their problems, they are more flexible, they talk more, they reconsider more, they can look for other alternatives. That's why they have attempted suicide and have no problem going to the psychologist," he summarizes.
Different relationship with work
The social psychologist
José Antonio Llosa Fernández
adds to the equation, for this group of women,
the traditional division of functions: they, breadwinners;
they, caregivers.
"That you have culturally assigned roles of care, of parenting, means a relationship of very high dependency with people around you, that
you cannot allow yourself to not be there even if you are unwell.
That stops suicide and is channeled through other problems," he says. he.
This professor from the University of Oviedo has investigated how job uncertainty and precariousness affect mental health problems, especially depression, which can lead to suicidal ideation
.
The sad shadow of the unemployment line is projected on everyone, but not in the same way.
"In men it is very clearly related to career, to the fact that losing my job will mean a setback in my career, a loss of professional status."
Women, he clarifies, already contribute income and develop similar professional careers.
But his concern incorporates other profiles.
"There is also a reflection very related to his context: to those close to him, to his family. Not only how it affects me but also mine."
A collective look that would protect.
Faced with that bond and, aggravating everything, the isolation that sometimes accompanies unemployment.
A room with the door locked tight.
"If there is no one by their side, any person will end up wondering 'what did I do wrong'. If they start to question themselves, feel guilty, and see no way out, it is very easy to lead to a situation close to depressive or directly depressive. If you are alone, you can sink very easily," explains Llosa Fernández.
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The same goes for personal tragedies and mental health problems. Positive interpersonal relationships can mitigate their damage.
The psychiatrist José Luis Ayuso Mateos presents them as the best protection factor.
"The social and family support network is important when facing situations of adversity."
Natalia Rodríguez Robles, psychologist and counselor, explains it to those adolescents who are going through their worst moment.
"That life is sometimes difficult, that we have to live through situations for which we are not prepared.
Above all, let them look for a way to talk about it with someone, which is liberating
. Let them not hide their discomfort, their tears, their anger, their sadness." , that validate that all emotions are telling us something. And that those of us around can see it and realize it."
An open door, a message, a call to break the siege of pain alone.
Breaking down self-imposed barriers of silence also helps prevent suicide.
This report is part of the 'Once Lives' project promoted by EL MUNDO for the prevention of suicide and of which Yaiza Perera, Rafael Álvarez, Rebeca Yanke and Santiago Saiz
are part .