The Link Between OCD and Suicide

Obsessive-compulsive disorder (OCD) is a chronic mental illness that can be associated with significant disability and suffering. People with OCD often report serious relationship difficulties and problems at work.

For some people, especially those with other mental health issues, living with OCD can become overwhelming, causing them to lose hope and contemplate or even attempt suicide. If you have a family member or friend with OCD who's exhibiting potential warning signs of suicide, it's important to know what to do.

OCD and Suicide

Although it has long been known that the risk of suicide is higher for people with mood disorders and schizophrenia, the relationship of suicide to anxiety disorders such as OCD is less clear. However, recent studies suggest that people with OCD are 10 times more likely to die by suicide than the general population. Actively thinking about suicide (suicidal ideation) also appears to be relatively common among people affected by OCD.

Factors that predict whether someone with OCD will attempt suicide include the severity of their OCD symptoms, the co-occurrence of depression, feelings of hopelessness, the presence of a personality disorder such as obsessive-compulsive personality disorder, and a prior history of self-harm, such as cutting. The risk of suicide also goes up if the person with OCD is actively using drugs or alcohol, is unemployed, or is socially isolated.

Potential Suicide Warning Signs

It's not always easy to know if someone is going to attempt suicide, but there are a number of warning signs, including:

• Increased hopelessness: Your loved one may talk openly and at length about feeling hopeless, helpless, or that they "can't take it anymore."
• Speaking of death or suicide: Out-of-character remarks about death, speaking openly about suicide, or an expressed desire to die by suicide should always be taken seriously. This may be their way of asking for help.
• Increased depression: Your loved one may exhibit symptoms of depression, such as withdrawing from others, crying all the time, loss of interest in hobbies or activities, disrupted sleep, and lack of appetite.
• Preparing for death: People actively contemplating suicide will sometimes take out an insurance policy, adjust and/or create a will, or advise someone close to them of their final wishes.
• Changes in behavior: A normally cautious individual may engage in reckless or impulsive behavior and express little fear of the consequences of such behavior. Conversely, someone who is depressed may suddenly act cheerful for no apparent reason.
• Giving away possessions: It's not uncommon for individuals who are actively contemplating suicide to give away prized possessions to trusted friends or family members.

What You Can Do

If you know someone with OCD who's exhibiting potential warning signs of suicide, you can help by talking with them and encouraging them to get help.

Keep Communicating

Talk openly and frankly about what your loved one is feeling; talking about suicide doesn't make it more likely that they will harm themselves. Don't be afraid to express your feelings as well. If you're scared and worried about your loved one, say so.

Ask Questions

Although it can be uncomfortable, ask frank questions about whether your loved one is thinking of suicide or self-harm. Inquire about other details, too, such as how and when they're considering doing it, whether they have access to a weapon, or if they have stockpiled large amounts of medications, for example. This can help ensure that suicide does not become an untouchable subject.

Empathize, Don't Minimize

As you might imagine, admitting suicidal thoughts or a suicide plan can be extremely difficult, embarrassing, and painful. Simply telling your loved one to "stop thinking about it," "think good thoughts," or even to "get over it" may make them feel even more rejected, insecure, and depressed. Let your loved one know that you understand how difficult this experience must be.

Getting Help

Suicide and suicidal ideation are serious, often requiring hospitalization and the assistance of qualified professionals. Should you feel your loved one is in immediate danger, accompany them to the hospital emergency department or wait with them until help (e.g., police or ambulance) arrives. In less urgent cases, help them access resources such as the National Suicide Prevention Lifeline, a support group, or a mental health professional.