Human over all species in the World has grown by leaps and bounds,it has its foot prints on Mars beyond Moon extending for Sun,setting all milestone to produce another Human from remanant,Robots doing better synchronised actvities, conquering death by nipping in bud different diseases,Genetic Treatment,can produce modify and utilise any form of Energy as per it's will and desire and produce devasting atomic,nuclear weapons not for destruction but also to perform many good things but has failed amazingly before Depression or a state of mind having agony,fear,sorrow,grief,despair,tension,apprehension,frustation,total self breakup,self confidence and hope of coming out leading to no lust for life leading to self destruction or Suicide.

                                  Depression occurs if one bears  personal as individual ,familial,social loss on ground of some co habitat individuals,health wealth of reputation and personality or purely economical enabling survival but now a days seen more as one loose control over sorrow or happiness on some minor issues as tolerance and bearibility has decreased markedly as Human has more and more desires,expectation of climbing ups an ups without a downstair look or satisfication or a halt or stoppage or a state of no more.Suicide is seen in every sphere of Humanity irrespective of cast,cred,color,nationality,religon,profession,language and socio economical status.

           
            World over about 1 million people commit suicide every year.Suicide is the 10th leading cause of death worldwide and account for 1.2% of all deaths.In the US, suicidal rate is 10.5 per 100,000 people.In America and advanced countries suicide is increasing in middle aged adults who are educated wealthy and competant.There are 10 to 40 non–fatal suicide attempts for every one completed suicide.The majority of suicides completed in US are accomplished with fire arm (57%); the second leading method of suicide in US is hanging for men and poisoning in women.Patients with prior history of attempted suicide are 5–6 times more likely to make another attempt.Fifty percent of successful victims have made prior attempts.
             One of every 100 suicidal attempt survivors will die by committing suicide within one year of the first attempt.The risk of suicide increases with increase in age; however, younger and adolescents attempt suicide more than the older.Females attempt suicide more frequently than males but males are successful three times more often.The highest suicidal rate is amongst those individuals who are unmarried followed by those who are widowed, separated, divorced, married without children or married with children in descending order.Living alone increases the risk of suicide which is very common now a days people donot interact in society physically  but by social media or in office only .Unemployed and unskilled patients are at higher risk of suicide than those who are employed.A recent sense of failure may lead to higher risk.
                Clinicians are at higher risk of suicide.It is very much seen in young doctors doing PG or super speciality or even reading Basic or in search of establishment .Nurses and apra medical staffs are often victim of it due to depression The suicidal rate in male clinicians is 1.41 and that in female clinicians is 2.27.Adverse childhood abuse and adverse childhood experiences increase the risk of suicidal attempts.

               So,Depression,the root cause of self Destruction or Suicide is a major public health problem as a leading predictor of functional disability and mortality.Although Optimal depression treatment improves outcome for most patients but Most adults with clinical significant depression never see a mental health professional but they often see a primary care physician.A non–psychiatrist physician misses the diagnosis of depression 50% of times.

             All depressed patients must be specifically asked about suicidal ideations.Suicidal ideation is a medical emergency.Risk factors for suicide are psychiatric known disorders, medical illness, prior history of suicidal attempts, or family history of attempted suicide.Demographic reasons include older age, male gender, marital status (widowed or separated) and living alone.

           Seventy–nine percent of patients who commit suicide contact their primary care provider in the last one year before their death and only one–third contact their mental health service provider.Twice as many suicidal victims had contacted their primary care provider as against the mental health provider in the last month before suicide.The first step in evaluating suicidal risk is to determine presence of suicidal thoughts including their concerns and duration.Management of suicidal individual includes reducing mortality risk, underlying factors and monitoring and follow up.
              Major risk for suicidal attempts is in psychiatric disorders, hopelessness and prior suicidal attempts or threats.High impulsivity or alcohol or other substance abuse increase the risk so they must be avoided but most of depressed person start using alcohol or other substance thinking such use will take away their worries and will calm them which must be reomved by treating physician by repeated counselling of patient.