On a visit to the lifeboat museum at Eastbourne last summer, I spotted a statistic displayed on the wall that made an impression on visitors as lasting as the pictures of lifeboatmen’s heroic rescues.

The Eastbourne-based lifeboat covers the area that includes Beachy Head, once famed for its battles, but now known for its suicides.

The unenviable task of retrieving a couple of dozen bodies a year has fallen to the local lifeboat crew. Most of those recovered from the sea are men. Nationally men are between two and three times more likely to commit suicide than women. When women kill themselves they usually avoid a violent death and prefer to overdose with pills. Others drown themselves, but are more likely to jump into the Thames than off Beachy Head.

T. S. Eliot thought that April was the cruellest month. Perhaps his lines were not entirely inspired by poetic licence, but by observation. As Eliot may have noticed, there are seasonal variations in the suicide rate, and late spring and early summer are the most common times for it. On the other hand the highest incidence of depression, rather than suicide, coincides with SAD (seasonal affective disorder) and the long dark evenings. In the early summer new life is bursting forth; women and the countryside are looking at their best. Nothing evokes thoughts of being loveless in a lonely man more than the sight of other males succumbing to vernal, bacchanalian urges, while they feel worthless, social rejects.

Although all truly depressed patients are a suicide risk, those who are most likely to go through with it have certain characteristics. Professor Edwin Shneidman, of the University of California and the Los Angeles School of Medicine, pinpoints in his book The Suicidal Mind, five groups who are at the greatest risk of suicide when depressed. At any one time, nearly 7 per cent of people in Britain suffer from depression severe enough to warrant a visit to the doctor. Depression also complicates the treatment of a third of all patients who are ill with other diseases. Although depressive symptoms are common, they are also as varied as the psychiatric conditions that cause them. Unfortunately, there are not enough doctors with a special interest in depression, nor do those who have this interest necessarily have the time to unravel the patient’s symptoms and make the correct diagnosis.

Recently, Pulse, a magazine for GPs, drew attention to the average 44-day waiting time for psychiatric assessment in general practice, followed by another 50 days before treatment started. Those patients hoping for longer-term care from psychiatrists had to wait 205 days on average.

A letter to The Times from David Nutt, Professor of Psychopharmacology at Bristol University, included an analysis of the relative dangers of different types of antidepressants. The SSRIs (selective serotonin re-uptake inhibitors), the group of drugs that includes the safest and most useful antidepressants, are regularly attacked in the media. Professor Nutt contrasted this with the soft ride given by the media to the older, but cheaper, tricyclic antidepressants. He calculates that in a decade 3,500 people died unnecessarily from tricyclics, and that their lives might have been saved if they had been given one of the SSRI antidepressants, adding that “this is a real scandal about which medical and popular press have been peculiarly silent”.

In the ten years under study nearly 4,000 people died from tricyclic overdosage whereas only 390 died from an overdosage of an SSRI. He concludes that the SSRIs are much safer drugs to give to people who are prone to suicide. In the last year for which data is available tricyclics killed 290 people. Professor Nutt also produced data to refute the notion that SSRIs may cause some patients to develop suicidal thoughts. It showed that in this respect SSRIs are safer than a placebo.

He pointed to the coincidence that tricyclics killed almost the same number of people in a year as did the commonly used painkiller coproxamol, that is about to be withdrawn because of the dangers of overdosage.

Research has shown that when the SSRIs are used correctly the 25 per cent of patients who had suicidal intentions when they started the treatment was reduced to 3 per cent. Although even this raw, cold spring may not induce most of us to go to Beachy Head, it would be reassuring to know that, if we were tempted, there was a greater chance of having early treatment, and the safer more effective drugs to go with behavioural therapy.

Suicidal types

Excessive anger, rage and hostility, coupled with frustrated desire for dominance and aggression

Click here for Medical Q&A with Dr Thomas Stuttaford