Why Are Some People More Vulnerable to Suicide?

Suicide Risk

If I get through the day and don’t take my life then that is a victory. If I don’t go buy that gun, if I don’t use that knife, if I don’t jerk that steering wheel into oncoming traffic, if I don’t hang myself, if I don’t put that hose in my car’s tailpipe, if I don’t go into the garage and start the car, if I don’t jump off that cliff or overpass, if I don’t swallow all those pills, then that is a victory.

These are the words of Zane, a social worker and a counseling patient who managed to survive decades of suicidal ideation. In The Suicide Solution, released Sept. 14, 2021, during National Suicide Prevention Month, authors Daniel Emina, MD, (Amen Clinics psychiatrist) and Rick Lawrence (award-winning author and minister) chronicle Zane’s—and many other people’s—journey out of the valley of the shadow of death. In this excerpt from the book, the authors delve into what makes some people more vulnerable to suicidal thoughts and behaviors.


Like more than 16 million adults in the U.S. today, Zane has wrestled with the impact of a major depressive episode in his life. For many, that “episode” is really more like their new normal. Suicidal ideation is embedded in their emotional weather pattern, lingering like a winter storm on the horizon. And the number of people worldwide who succumb to this darkness is staggering—more than one million end their own lives every year, according to the World Health Organization.

For many, a major depressive “episode” is really more like their new normal. Suicidal ideation is embedded in their emotional weather pattern, lingering like a winter storm on the horizon. Click To Tweet

Down through history, that cascading number includes many well-known cultural influencers, from Marc Antony (Roman general and politician) to Anthony Bourdain (host of Parts Unknown) to Fidel Castro Diaz-Balart (son of Fidel Castro) to Kurt Cobain (lead singer/songwriter for Nirvana) to George Eastman (inventor and philanthropist) to Margot Kidder (actress, Lois Lane in Superman) to Richard Manuel (lead singer of The Band) to Freddie Prinze (actor and star of Chico and the Man) to Anne Sexton (poet) to Kate Spade (fashion designer) to Alan Turing (mathematician and World War II codebreaker) to Vincent van Gogh (artist) to Robin Williams (actor and stand-up comedian).

It’s an endless, heartbreaking funeral procession.

So, why do some of us remain stuck [in patterns of destructive thinking] while others seem to bounce through the potholes and keep on going in life? What makes some people more vulnerable to the pull of suicide than others? In the famous first line of his classic novel Anna Karenina, Leo Tolstoy writes: “Happy families are all alike; every unhappy family is unhappy in its own way.” Translated into this context, every healthy brain is alike in its “wholeness,” but every stuck brain is stuck in its own way.

4 Factors That Increase Suicide Risk

These are the factors that catalyze a descent into the darkness:

1. The brain’s “self-preservation” mechanisms experience a breakdown.

Our brains are hard-wired to help us survive. When internal and external stressors overwhelm these “fail-safe” mechanisms, our natural protections stop working properly. The anxiety we experience in the course of everyday life is deeply linked to our fundamental determination to preserve ourselves. Anxiety is a normal emotion—it’s the brain’s alarm system, letting us know when something is wrong so we can start the process of fixing the problem. But when our response to the alarm is dysfunctional, or our alarm system itself doesn’t work the way it’s designed to work, our self-preservation safeguards fail us.

2. Bugs in the brain’s software (or our psychology) create “cognitive distortions” that lead to hopelessness, negative self-evaluations, and dire predictions for the future.

  • These cognitive distortions undermine our social behavioral skills
  • radically diminishing our problem-solving ability,
  • tempting us to avoid solving problems in the first place,
  • keeping us stuck in existing ways of thinking (“cognitive rigidity”), and
  • limiting our “menu” of healthy coping mechanisms.

3. Bugs in the brain’s hardware (or biology) create “broken links” in the areas tasked with managing our emotions and impulse regulation.

A team of psychiatrists set out to identify “brain alterations that contribute to suicidal thoughts and behaviors,” poring over the data from more than a hundred imaging studies over the course of two decades. They published their findings in the journal Molecular Psychiatry. They discovered a pattern of broken links in the brains of suicidal patients—a “dysregulation” of the specific brain regions and circuits that are supposed to maintain a stable emotional response to stressors.

4. Individual and environmental variables can increase the risk of suicide, especially when they’re mixed into a “cocktail” of circumstances.

When both personal and circumstantial variables pile on top of each other, it can create a “perfect storm” that overwhelms a person’s normal defenses.

In spite of these factors, it is still possible to find a way out of the darkness and into the light.

If you are having suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

The Suicide Solution by Daniel Emina, MD, and Rick Lawrence offers hope and a practical toolbox for people who are struggling to find their way out of a cave of anxiety, depression, and suicidal thoughts—and for anyone who cares for someone who’s been lost in that cave. Informed by the clinical realities of anxiety, depression, and suicide, the authors draw from the transformational relational strategies of Jesus to chart a path into life and freedom.


  1. I personally have not struggled with the ideations in this article, but know others who do. And I don’t know about anyone else, some of the opening statements in this article are more intense than I’m use to and it makes me wonder how it would effect someone who is familiar. Don’t get me wrong, I understand the thought patterns discussed here are real in many ppls reality. Is there a way to connect your reader to this topic in a way that is not as overwhelming or triggering? More solutions and grace directed?

    Comment by marie — September 17, 2021 @ 4:17 AM

  2. Great article. Thank you.

    Comment by Timothy Lee — September 17, 2021 @ 5:04 AM

  3. Hang on to any /all of the gurus that work for you.

    Comment by Frank — September 17, 2021 @ 5:11 AM

  4. I would love to know more about this- the solutions, the process.

    Comment by Genevieve Doyle — September 17, 2021 @ 5:23 AM

  5. Two forces that have become extremely prevalent in our culture are at work here: 1) the push to remove God from our national life, our culture and all cultural institutions and the weak resistance or out right collaboration by the church in that effort, 2) the increasing influence of a death culture resulting in dystopian philosophies and ideas, policies, laws, books, films, and as a basis for much school curricula. Anyone born after 1980 has grown up with massive doses of these two hyper destructive forces shaping their character and informing their beliefs. It is just about impossible to swim against this cultural tide.

    Comment by Debra Stevenson — September 17, 2021 @ 7:50 AM

  6. Most of the people I know who are suicidal were abused by someone they depended on, loved and trusted as a child. They become damaged for life. Never able to understand why this person would do such a thing to them.

    Comment by Lisa Mullikin — September 17, 2021 @ 8:20 AM

  7. Can you give me the name of a psychiatrist in the south shore area who is taking new patients?rockland Abington nor well Weymouth ……….have not been able to find anyone due to Covid. I pray every morning and nite for God help🙏

    Comment by Carol mullen — September 17, 2021 @ 9:28 AM

  8. We need more info like this!!! Hope is majical! Thank you💚

    Comment by Berget — September 17, 2021 @ 11:32 AM

  9. I am a person who is 27 years clean and sober continuously. In the 12-step community I am in, there have been a lot of people who have committed suicide and people who I’ve grown up with have committed to suicide. Most of them had nothing to do with having been abused, though that can play a part I’m sure. Most of them are the ones who you wouldn’t ever expect to kill themselves. They have had good lives, successful, as defined by society usually monetarily, not necessarily how I define success.
    The day of their death, when they choose to end their lives, they have generally taken care of everything, clean the house, one friend I had actually boxed things up and labeled the boxes before she killed herself. So trauma is not always apart of why someone commits suicide it can be, but I am very interested in buying this book to help me with some of the women in recovery that I work with. Thank you, Jennifer

    Comment by Jennifer — September 17, 2021 @ 12:03 PM

  10. This is what I’ve gone through for many years, it would be nice to find how to fix it.

    Comment by Anonymous — September 17, 2021 @ 3:33 PM

  11. Involvement in receiving professional mental health counseling, medications, mental health hands on treatments, practicing meditation and being in spiritually supportive groups help mitigate downward cycles to keep on keeping on. It’s tough, but suicide is unacceptable in my philosophy.

    Comment by Kenneth Lukasik — September 18, 2021 @ 3:36 AM

  12. I thought this article was helpful especially in its outlining of things/categories, to be aware of as an outsider in aiding one with suicidal ideation. I was however, halted and confused by the final sentence of this article, which states: ” the transformational relational strategies of JESUS to chart a path into life and freedom.”
    WHAT DOES THAT MEAN? and how is it applied to the strategies outlined in the article? I very much would like to see, here, a response to this question for others to read who perhaps were confused by this and did not ask about it. Thank you. Ruth L Phares, MS

    Comment by Ruth Phares — September 18, 2021 @ 5:20 AM

  13. This article bring hope for the case of my kid, only 12 and wants to end his life.

    Comment by Maria Quintana — September 18, 2021 @ 6:09 AM

  14. I’m looking for one of your clinics at Houston, but I don’t think it’s any one…

    Comment by Mary — September 18, 2021 @ 6:13 AM

  15. After reading this… my comment is: What happens if it is too late and they are dead by suicide

    Comment by Erin — September 18, 2021 @ 6:18 AM

  16. Alcohol, as indicated by Dr. Amen, changes brain physiology and I believe was the major catalyst to my brother’s suicide. He never mentioned giving up before he did. The guilt never goes away, the not realizing how he must have been wanting that escape and nobody recognized any signs until after the fact. The pain, like grief revisits the stages now and then. It is very difficult to help an alcoholic kick this habit, this terrible grip over their existence.

    Comment by Lorrie Morris — September 18, 2021 @ 7:36 AM

  17. This is a good article. Having suicidal thoughts from time to time , bad weather and past problems remembered set me in a down set!

    Comment by Betty Bratcher — September 18, 2021 @ 10:13 AM

  18. If you think things are bad now, see where you will end up if you take your life.

    Comment by Joseph — September 18, 2021 @ 10:21 AM

  19. where can I find this book ? As I have been suffering with major depressive disorder for quite sometime

    Comment by RUTH GOODWIN — September 18, 2021 @ 1:44 PM

  20. I’m looking forward to reading Dr. Emina’s book. We need to work with our senators to pass legislation that insurance companies pay the cost of scans and longer term treatment. I am disgusted at the rate of unwell people discharged from hospitals that are not stable just because the Insurance companies will not pay for a longer stay. Their profits are huge! Insurance companies need to think of People over Profits!

    Comment by Paulette M Lukas, MA, NCC, CCDVC — September 19, 2021 @ 5:46 AM

  21. As one who was first molested in early puberty I have struggled mightily, valiantly, for most of the intervening decades as a borderline survivor. First, in early puberty, four upperclassmen at my boarding school, which I then left. Then the housemother at the next school. So I left that school and sought the help of a counselor. He sexually assaulted me. As did one of his clients. Need I include my cousin? And most recently, one of the UPS drivers who frequented my business, in my own office, absolutely out of the blue….all of which , added together, have left me with seismic after-shock that at age 77 I doubt I will ever recover from completely. Despite being in therapy twice a week, which feels just barely enough to keep me sane…..which sometimes feels marginally attainable.

    Comment by Dare Kellogg — September 20, 2021 @ 12:20 AM

  22. I lost my first husband four years ago to suicide. Should have seen it coming, but it was so outside of my own world view that it blindsided me. I’ll never fully have all my answers, but every time I read something like this I find another nugget of truth that helps make sense of the situation.
    We lost my nephew (his nephew, mine by marriage) to suicide last year. Heartbreaking.
    Some insensitive individuals think suicide is a choice. But bugs in the hardware/software explain that it really isn’t.

    Comment by Mary A — September 20, 2021 @ 4:48 AM

  23. Thanks for a great article.

    Comment by Timothy Lee — September 20, 2021 @ 6:05 AM

  24. Hello Ruth, thank you for reaching out. Dr. Emina’s new book can be found on Amazon: https://www.amazon.com/Suicide-Solution-Finding-Your-Darkness/dp/1684511593/ref=sr_1_1?dchild=1&keywords=dr+daniel+emina&qid=1632156108&sr=8-1

    Comment by Amen Clinics — September 20, 2021 @ 9:42 AM

  25. Hello Mary, thank you for reaching out. The closest clinic to Houston is in the Dallas Metro Area. Amen Clinics currently has 9 locations all over the US: https://amenclinics.com/locations/. For more information about scheduling, please contact our Care Coordinators: https://amenclinics.com/schedule-visit/.

    Comment by Amen Clinics — September 20, 2021 @ 9:44 AM

  26. My sons girlfriend killed herself. She was an artist a n artist and really gifted. Her advisor had her taking two classes at the same time and she working as well. Her instructor was very critical of her work and would leave her in tears. She was so determined to be perfect. Then she was puton SSRIs and there was little or no counseling. The SSRIs didnt help as they promoted suicidal ideation. So did her prescription sleeping pill and pain killerr.

    Comment by Adelia Hitt — September 23, 2021 @ 12:22 AM

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