Abstract
This paper uses suicidality in bipolar disorder (BD) as a case study
demonstrating the preferability of multidimensional over reductionist
frameworks in accounting for complex phenomena with cognitive,
psychological, socio-environmental, and physiological components.
Suicidality, or behaviors and thoughts concerning an intention to end
one’s life, illustrates the interplay between diverse factors. This
multidimensionality is reflected in the heterogeneous strategies for
managing suicidality, which range from psychosocial and cognitive to
pharmaceutical and technological interventions.
Suicidality in BD is a multi-dimensional phenomenon whose study has been
productive through the methods of several disciplines. For instance,
suicidality in BD is partly genetic and can be aggravated by symptomatic
periods, suggesting physiological causal factors. However, some features
of suicidality in BD underscore the causal roles of cognitions. Notably,
suicidality can persist beyond depressive periods, and is sometimes
experienced during mania. This may be due to persistent suicidal
ideation, highlighting the need to account for cognitive or
psychological causal factors.
Models of suicidality in BD typically adopt a pluralistic approach that
does not reduce one dimension to another. Rather, they are treated as
different facets of a complex phenomenon that interact and influence
each other. Moreover, recent studies have shown the promise of physical
interventions, e.g., electroconvulsive therapy and deep-brain
stimulation, in the treatment of suicidality in BD. Socio-environmental
interventions have been successful in suicide prevention more generally.
This demonstrates how multidisciplinary, multidimensional explanations
are most likely to productively account for how diverse factors
contribute to suicidality along with genetic and physiological
determinants.