A new tragedy. Loss of life again. Several days ago we witnessed what has become a familiar story: a shooter enters a crowded venue, terrifies the crowd, kills with a high speed weapon and then we witness, repeatedly, the video clips of throngs of people running in terror, and also some blood on the airport floor. The “why he did it?” questions then abound. The answers are many and varied. From a focus on too available guns, early exposure of our children to violent media, and mental illness, to the national economic picture and the like. And lastly how can we apply what we know to preventing such horrific events. This last issue interests me the most and I will return to it.

Here are a few of the facts we know about mass murders. We know that the typical profile of a mass murderer is that of a single white male who is somewhat isolated, maybe depressed, and possibly feeling revengeful after a rejection perceived as an irreparable destruction to his life. Mention is also made of the fact that there might have been recent mood changes, increased aggression, or expression of or interest in ideas that seem unusual or bizarre often containing conspiracy theories or paranoid and even bizarre worries. There might have been statements, writings or readings about death, suicide, seeking of weapons, or blaming the government or others. Despite the fact that mental illness in and of itself does not confer a higher risk, there is some evidence that mentally ill individuals who stop needed medication and or use substances/alcohol have a slightly higher risk of committing violence. The availability of guns is a common part of the discussion and although I personally prefer better gun control laws I still have not seen direct evidence of gun availability, as a whole, causing these heinous acts by individuals. All in all we know a lot, but not enough, to somewhat accurately identify a potential mass murderer.

Thus, we can do something. We as family, friends, neighbors, teachers, doctors, clergy and others see people every day. We observe change in people we know. That is the key. We are in a position to start a dialogue, learn more about what is going on, or see what’s troubling someone. If we get too little cooperation we can call a mental health professional or even the legal authorities for help. This is not easy. It makes us anxious. We would like to ignore frightening truths. We hope it goes away like a passing bad mood. But it is possible to help.

Get concerned if you notice one or more of the following:

1.      Increased anger, aggression, tantrums, irritability, and revenge episodes especially when you can’t make any sense of the situation and the person seems more depressed, isolated and unruly than usual.

2.      The appearance of strange ideas especially having to do with anti-government themes, conspiracy theories, and other paranoid trends especially if accompanied by hearing voices.

3.      Interest in and ownership of weapons that are a new or heightened twist for the individual.

4.      Overt or thinly veiled threats, writings, interest in and worship of lethal ideas towards self or others, including suicide by cop which this most recent tragedy might have been.

5.      Increase in substance use by people with a history of violence and especially in those who have been treated for a severe psychiatric illness who have stopped their medication.

This is an incomplete list but a good starting point. While we cannot predict with total accuracy who will commit violence, we have enough evidence of when to act. If we have the courage, and trust ourselves about our observations we might make the world a bit safer.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.