Suicide Facts and Myths: Choice or Disease? Experts Weigh In

Suicide Facts and Myths: Is It a Choice or a Disease?

For generations, people have talked about suicide in a certain way. We say someone “committed suicide,” the same way we say someone committed a crime.

That language is starting to change, and for good reason. After more than 40 years as a clinical psychologist, I want to walk you through why.

This article will cover the facts and myths about suicide that I believe matter most, especially the biggest myth of all: that suicide is a choice.

Quick Takeaways

• Mental health professionals now say “died by suicide,” not “committed suicide,” to reflect that suicide is usually a symptom of mental illness, not a choice.
• Suicide is the second leading cause of death among teenagers and young adults.
• Older adults facing isolation, declining health, and financial insecurity are also a high-risk group.
• Suicide and addiction share important similarities. Both involve brain-based factors, not simple willpower.
• A “contagion effect” is real and well documented, especially among adolescents and young adults.

Why We No Longer Say “Committed Suicide”

Language shapes how we think about something. The word “committed” suggests a crime or a willful act, the same way we say someone committed a robbery.

Mental health professionals have moved away from that phrase. We now prefer to say a person died by suicide, the same way we would say someone died from cancer or died from heart disease.

This shift reflects something important. We believe suicide is mostly a symptom of mental illness, not a deliberate choice someone simply makes.

Most people who die by suicide did not actually want to die. They were suffering, often from a mood disorder, that made the world look hopeless and dark, with no other choices visible to them.

Let’s look at why this distinction matters so much.

Myth: Suicide Is a Choice. Fact: It Is Often a Disease.

This is the central myth I want to address directly. Many people still believe suicide is simply something a person decides to do.

The truth is more complicated, and more hopeful. Suicidal thoughts are most likely part of a mental disorder, and sometimes even a physical disorder.

In some cases, an undiagnosed medical condition can contribute to suicidal thoughts. Brain tumors and certain neurological diseases are examples of physical conditions that can play a role.

Viewing suicide this way changes everything about how we respond. If suicide is a disease-like process rather than a choice, then it becomes something we can treat, the same way we treat any other illness.

This brings up an important parallel I want to draw with another stigmatized condition.

The Surprising Connection Between Suicide and Addiction

Mental health professionals are working to remove stigma from suicide in much the same way we have worked to remove stigma from addiction.

For years, addiction carried a harsh label. People would say, “He’s an alcoholic, leave him alone,” as if nothing could be done to help.

We now understand addiction differently. Addiction is most likely not a choice. It is a brain disease, where certain parts of the brain are malfunctioning, leading a person to use substances to soothe pain.

Suicide and addiction often share something called comorbidity, meaning two or more conditions exist together. Both conditions tend to have a strong biochemical and genetic component.

Treating either one well requires the same basic approach: proper medical diagnosis, psychotherapy, and stronger social support.

Now let’s look at who is most at risk, since the patterns may surprise you.

Watch the video here

Who Is Most at Risk?

Suicide does not affect every age group equally. Two groups stand out clearly in the data.

Teenagers and young adults. Suicide is now the second leading cause of death in this age group, with accidents ranking first.

Older adults. Geriatric individuals facing isolation, poor social support, chronic medical conditions, and declining financial security represent another high-risk group.

What connects these two very different age groups is striking. In both cases, a lack of strong social support plays a major role.

This leads to what I believe is the single biggest factor in prevention.

The Real Key to Prevention: Connection

The biggest problem in society today is loneliness and social isolation. I learned this lesson early, going back to my training in social work.

Anything we can do to help people feel part of a community matters. This does not need to be complicated. It might mean shooting hoops with a struggling teenager, or inviting an isolated older adult to a community gathering.

Reaching out to people who feel estranged or disenfranchised is not a small gesture. It can be the thing that interrupts a dangerous spiral.

There is one more important pattern worth understanding, especially for parents and educators.

The Contagion Effect Is Real

When one person in a community dies by suicide, others sometimes follow. This is called a contagion effect, and it is a genuine concern, particularly among adolescents and young adults.

A single incident at a school can sometimes lead to several other students expressing similar thoughts shortly after. We see a similar pattern with other tragic, highly publicized events.

We do not yet fully understand every psychological and social factor that drives this pattern. It remains an important area of ongoing study.

What we do know is that swift, compassionate, well-coordinated response after any such event matters enormously.

A Team Approach Matters

I have deep respect for the medical expertise psychiatrists bring to this issue. Whenever I work with a patient who has suicidal thoughts, I routinely request a psychiatric consultation.

I believe suicide and violence both require a thorough medical evaluation, not just psychotherapy alone. Sometimes a psychiatric colleague will identify a biological mood disorder that needs medication alongside talk therapy.

This is not about any one professional having all the answers. It is about working as a team, combining medical evaluation, psychotherapy, and genuine human connection.

If You or Someone You Know Is Struggling

If you are having thoughts of suicide, or if you are worried about someone else, please know that help is available right now.

988 Suicide & Crisis Lifeline: Call or text 988, available 24 hours a day.
Crisis Text Line: Text HOME to 741741.

You do not have to be in immediate danger to use these resources. They are there for anyone who is struggling, scared, or simply needs someone to talk to.

The Bottom Line

Suicide is not a character flaw, and it is rarely a simple choice. It is most often a symptom of an underlying condition that can be treated, much like addiction.

Changing how we talk about suicide is not just about being polite. It reflects a real, evidence-based shift in how mental health professionals understand it.

If you are struggling, or if you love someone who is, please reach out. Connection, treatment, and compassion save lives.

Martin E. Keller, Ed.D., ABPP
Diplomate in Clinical Psychology, Private Practice
Scottsdale, Arizona