Author: Claudia M. Elsig, MD

Globally, more than 700,000 people die from suicide each year.¹ Tragically, that means every 45 seconds, a human being takes their own life. Sadly, suicide is one of the leading causes of death in young people.¹ 

The statistics on suicide are shocking, particularly amongst young men, who are more at risk of suicide than any other demographic. In Europe and the Americas, suicide is four times more prevalent among males than females.²

So why are young men more at risk? 

Risk factors contributing to suicidal behaviours in youth

Suicide is an extremely complex issue, and in most cases, multiple factors combine to push someone to take their own life. Situations that can put young people at risk include:

• Being bullied
• Academic pressures
• Relationship problems
• Difficulties with sexual orientation
• Experience of physical, emotional, or sexual abuse (or a history of any trauma)
• Bereavement, loss of a loved one
• A debilitating or painful illness
• Psychiatric disorders, particularly mood disorders like depression
• Social isolation, or a lack of meaningful relationships in life
• Drug or alcohol misuse
• Lack of purpose
• Neglect or lack of support
• Cultural and religious beliefs
• Specific personality characteristics, such as neuroticism
• Dysfunctional family processes
• A family history of suicide

Why is the suicide rate so high in young men?

Young people are particularly vulnerable to suicide. In the U.S., teenagers and young adults have the highest rates of suicide compared to other ages. And in Europe, suicide is the second leading cause of death in youth.

Causation is complex, but in young men, there are some unique factors to consider. In research studies, this is known as ‘the gender paradox of suicide’.

Gender differences, immunity, and sex hormones

A systematic review and meta-analysis revealed differences in emotional and behavioural problems between genders. 

“The higher rates of suicide deaths among male youths may be associated with a higher prevalence of externalizing disorders (e.g., conduct disorder, substance abuse disorder, deviant behavior) and a preference for highly lethal methods.”³

Research highlights the possible role of the immune system and sex hormones in psychiatric conditions associated with suicide vulnerability. Literature shows there is a dysregulation of the immune system and altered sex hormone levels in suicidal patients.⁴

Puberty and sex hormones can play a role in suicidal ideation. The influence of hormones and social stressors on neural systems during puberty could increase the risk for suicidal thoughts and behaviours, especially in adolescents with a neurobiological sensitivity to hormonal changes.⁵

Note that much of the research on gender differences in suicide doesn’t include nonbinary people.

Impulsivity and ADHD

Impulsivity has been identified in numerous studies as a key factor in the risk of suicidal behaviour. UCLA Health’s, Dr. Carl Fleisher says, “The things that make [young people] vulnerable are where they stand socially and … developmentally.

“Their judgment and decision-making abilities are still coming online. The prefrontal cortex — the brain’s executive control center — doesn’t fully develop until one’s mid-20s. That makes young people more impulsive.”⁶

The pre-frontal cortex plays an important role in functions like planning, decision-making, and self-control. It is larger in females and develops a full two years before males. 

Youth with ADHD are also at an increased risk of experiencing depression and anxiety during their adolescent years, which may increase the likelihood of suicidal thoughts.⁶ Research shows that ADHD is more commonly diagnosed in boys. This may be because, in girls, the symptoms are more subtle and harder to identify. Impulsivity is a typical symptom of ADHD in boys, which explains why this cohort is more likely to act in dangerous ways.

Emotional suppression

Emotional suppression is a key factor behind the high suicide episodes in young men. For generations, boys and men have been encouraged to ‘man up’ and be tough. How often have you heard the phrase ‘boys don’t cry’?

This may be a very traditional and outdated view, but to many young men in modern society, it still rings true. Many young men are afraid to express emotion for fear of appearing weak. There is a fear of ridicule. A strong stigma exists, especially within the male population, on the issue of openly discussing mental health. 

Even today, it is much more socially acceptable for women and girls to express their emotions. As a result, boys, male adolescents, and men are less likely to speak out when they are struggling with mental and emotional well-being, relationship issues and/or sexuality. 

Violent suicide methods

According to suicide statistics, while women are more likely to attempt suicide, men are more likely to die from it.⁷ Male suicide attempts are often more violent and therefore make intervention less likely. Men tend to choose lethal methods, such as firearms, hanging, and asphyxiation, whereas women are more likely to overdose on medication or drugs or choose to bleed out from a cut, such as a ‘slit wrist’.

Suicide prevention: what can be done?

Addressing the suicide rate in young men requires a multi-faceted approach. First, the stigma of talking about mental health among young people, particularly young men, must be tackled. To achieve this mental health advice needs to be targeted to vulnerable groups and support given to those who may feel uneasy about speaking to loved ones or accessing mental health services. 

To break the stigma around mental health, there must be action and investment at a socio-political level. In education, mental health awareness must become compulsory in the curriculum. And in the workplace, health and safety policies should have as much emphasis on mental well-being as physical health. Educators and employers have a key role to play in helping to normalize conversations about mental health.

Ultimately, improved early identification and treatment of mental health issues will help to avert the tragedy of suicide. Extra vigilance is required to spot the warning signs of deteriorating mental health in young men. It means taking advantage of every opportunity to enquire about mental well-being. Unlike many physical ailments, mental illness can much more easily evolve undetected.

For suicide prevention, depression, anxiety, and behavioural disorders must be recognized early on. It needs to be much easier and less stigmatized for young people with mental health issues to access the treatment they need.

Treatment at CALDA

Treatment for suicidal ideation belongs in the hands of specialists. CALDA offers a safe healing space to individuals who are experiencing suicidal thoughts. Our team of experts develops a personal, creative treatment strategy for each client, which draws on all proven formulas of integrative medicine.

We use detailed psychiatric diagnostics, alongside a comprehensive clinical-chemical analysis and targeted genetic analysis, to determine status and use the results to tailor a personalized program to suit the individual. We treat the causes, not the symptoms, and wherever possible, we work without using psychiatric drugs.

Our holistic therapeutic programs are designed to discover the causes of suicidal ideation, heal past trauma and foster socio-emotional life skills, so the person can move forward and enjoy a balanced and healthy life.

CALDA is a private clinic for self-payers only. We offer the utmost discretion and dedicate our whole team to treating one client at a time.

If you would like a private, preliminary chat about a young person you have concerns about, please contact us. We would be happy to discuss your family needs and explain more about how we can help.

Sources/References:

1. World Health Organization website. Fact Sheet: Suicide. [Accessed 11Nov2022].
2. Bilson J. 30Oct2018. Suicide and Youth: Risk Factors. Published in Frontiers in Psychiatry.
3. Miranda-Mendizabal A, et al. Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies. Int J Public Health 64, 265–283 (2019).
4. Lombardo G. Dec2021. New frontiers in suicide vulnerability: immune system and sex hormones. Brain, Behavior & Immunity – Health.
5. Ho, T.C. et al. 11Jun2021. Psychobiological risk factors for suicidal thoughts and behaviors in adolescence: a consideration of the role of puberty. Mol Psychiatry 27, 606–623 (2022)
6. Ackerman J. 20Aug2019. ADHD and Youth Suicide: Is There a Link? Nationwide Children’s Hospital.
7. Schimelpfening, N. 11Feb2022. Differences in suicide among men and women. Website: verywellmind.com [Accessed 12Nov2022].