While previous studies on chronic pain and suicide have focused on subjects already receiving treatment for their pain, a recent study, published in the November/December issue of the journal of General Hospital Psychiatry, drew upon a broader pool of subjects. The results are notable because the data was adjusted to account for mental illness; even taking these adjustments into account, the results reflect that almost 14 percent of subjects suffering from three or more chronically painful conditions (and not from additional mental illness) reported suicidal thoughts, and almost 6 percent of subjects in this group reported suicide attempts.

While the results confirm that the majority of people suffering from chronic pain do not experience suicidal tendencies, the subjects who do may, according to Florida State University professor Thomas Joiner, be misunderstood in their motivations. The usual assumption is that the suicidal are a hopeless and depressed lot, and Mark Ilgen, the study’s lead author, confirmed that pain can certainly depress an otherwise optimistic disposition. Joiner suggests, however, that while “in the public mind, a kind of fearlessness does not seem to fit with suicide…Here, the public mind is mistaken.”

In this respect, science has eluded the obvious; the personality profile of the suicidal person experiencing chronic pain may not synch with the hopeless, or weak, image with which most people might associate him or her. For this person, exposure to sustained pain may have weakened natural fears surrounding death, for much of this fear, in most people, is related to unknown pain and suffering. For a person coping with chronic pain, these factors are familiar, and therefore less threatening. According to Joiner, “The natural and deep fear of pain, injury and death stops people from hurting themselves, and this includes people who have high desire for suicide. It might not be as hard for someone who has already had to contend with a lot of physical pain.”

Don’t cue the Debbie Downer “wah-wah” just yet; the more scientists, doctors, and the public know about what can result from chronic pain, and about factors contributing to suicidal tendencies, the better equipped we are to be there for, and to care for, those who suffer from these conditions.