What You Should Know About Suicide
This might save someone else's life. Or yours.
Suicide. It’s an uncomfortable topic. But sometimes the most painful subjects are the ones we need to talk about the most. We are long overdue for an informative and compassionate dialogue on what is now the second leading cause of death in America for teens and young adults.
Last week, the recovery community was jolted by the sudden suicides of two prominent senior executives in the addiction treatment space. My deepest sympathies and heartfelt support go out to everyone who was impacted both directly and indirectly by the loss of these two respected leaders. In addition to the massive organizational and financial ripple effects, these deaths were especially alarming on a fundamentally deeper level.
Why? Because these deaths defy our societal preconceived stereotypes about who is at risk for suicide. We often think about suicide risk in our patients and loved ones who suffer from chronic and persistent depression and serious mental illness. Suicidal thoughts are commonly recognized potential symptoms of these medical conditions. But when it comes to very successful senior business leaders, suicide is not on our radar (although it should be). It’s the sudden thunderstorm in an otherwise dry desert. We just don’t see it coming. We’re not prepared. It disrupts our preconstructed social world order. It makes us wonder, “Who else in my life might be struggling?” And “What can I do to help?”
I get it. These questions crossed my mind this week, too. To help us navigate these complex issues, here are 4 of the biggest myths (and corresponding facts) you should know about suicide:
1. Asking somebody about suicidal thoughts will prompt them to become suicidal.
Many people are worried that if they broach the topic of suicide, the conversation will somehow prompt the recipient to become suicidal. So, folks avoid the topic all together. The reality is that talking about suicidal thoughts does not create them. Asking about suicidal thoughts shows that you care. Plain and simple. It does not create or prompt suicidal thoughts that were not there prior. Expressing genuine empathy, care, and concern is one of the best universal medicines for the human condition.
2. Talking about my suicidal thoughts will cause me (or my loved one) to get hospitalized against my will.
Some people struggle with chronic suicidal thoughts for large periods of time. Talking about these thoughts with a medical provider or a loved one is the first step to developing a support network and a safety plan. These discussions will be key components of your recovery. They will guide you in learning how to interact with and talk about these thoughts in a safe and healing way. In most states, you will not get hospitalized against your will unless you are in danger of acting on these self-harm thoughts. Folks with chronic suicidal thoughts who can reasonably assure others that they are not in any danger of acting on them can be treated on an outpatient basis.
3. People who have suicidal thoughts want to die.
Most of my patients who struggle with suicidal thoughts desperately want to live. They just can’t see a better alternative to their struggles. They want their pain and suffering to end. The famous novelist David Foster Wallace described his struggles with suicide as follows:
“The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.”
David Foster Wallace passed away from suicide in 2008.
Whether it be emotional pain, physical pain, or circumstantial pain, suicide is often viewed as a way to end substantial and seemingly unavoidable suffering. But most folks struggling with these thoughts don’t want to die. They are simply looking for a viable way to end their agony. Our role as loved ones or medical providers is to provide unwavering, unconditional hope, treatment support, and love.
4. Only “depressed” people commit suicide.
When we hear someone committed suicide, we often assume they suffered from depression or bipolar disorder. And indeed, the risk of suicide in depressed individuals is about 20 times higher than that of the general population. But only a little over half (about 2/3) of suicide victims suffer from depression. That leaves many victims we do not anticipate.
My very best childhood friend and my first semi-romantic teenage “boyfriend” both committed suicide in their early twenties. My childhood friend was creative, lively, and happy. She was always drawing or dancing. At the age of 22, she hung herself in her family’s garage after an explosive fight with her father. My first boyfriend-who was a first cousin of the childhood friend- died from a self-inflicted gunshot wound to the head after an argument with his wife. Neither suffered from depression. Neither ever appeared sad. Like the executives, like Anthony Bourdain and Kate Spade, no one saw it coming. It paralyzed our small southern community for quite some time.
Suicide by the stats
We do have substantial evidence that suicide is genetically linked. Researchers have isolated a region of chromone 7 containing DNA variations that can substantially increase the risk that a person will attempt suicide. Also, older white men ages 85 and above are at the very highest risk of suicide- a staggering 51 deaths per 100,000. While the elderly are most at risk, suicide rates among youths have increased over 200% in the last 50 years. Finally, although three times more women than men attempt suicide, four times more men than women actually succeed in killing themselves- perhaps due to men often using more lethal means than women. About 7 out of every 100 men and 1 out of every 100 women diagnosed with depression will go on to commit suicide.
Although suicide might not always be predictable, it is preventable. The more we discuss it openly and honestly in empathic, non-judgmental, supportive conversations, the more we empower others to do the same. It is ok to not feel ok. Sports superstars Michael Phelps, Simon Biles, and Naomi Osaka and political figures like Senator John Fetterman from Pennsylvania are powerful ambassadors of this message. The more we normalize the full spectrum of human emotions, the more we give others permission to better understand themselves and seek help.
We desperately need more resources and funding for suicide prevention. For the past two years, the federal government has put forth approximately $1 billion to fund 988-the 24/7 national suicide hotline for those experiencing a mental health crisis. However, after this money runs out, individual states are on their own to fund this vital resource. Since last summer alone, 988 has received over 5 million calls and texts. But only 8 states have enacted funding sources to continue supporting the hotline when federal funding ends. Long-term state funding plans are critical.
At the end of this article, I’ve listed some of my favorite existing suicide prevention resources. Please share them. In addition to 988, these include large national suicide prevention initiatives, LGBTQ+ support, anti-bullying support, sexual identity support, suicide safety phone apps, and suicide support chats. The list is certainly not exhaustive. Please tell me your favorites and I’ll add them to the list.
Suicide is tragic. It reverberates through every race, religion, sexual orientation, and socio-economic group. It occurs in those who do not suffer from any pre-existing mental illness. It occurs in the rich and famous, the uber successful, and the super wealthy. Increasing the dialogue on suicide, dispelling myths and stigma about self-harm, and increasing funding and awareness of suicide prevention resources will all help to save lives.
Most of all, remember: you are never alone. There is always hope. Things can get better. Things will get better. I promise. And when you really feel like giving up, just recall all the reasons why you’ve held on for so long.
-Lauren
Suicide Prevention Resources
Thank you for sharing that. Myself and my children have also experienced the pain that suicide brings. My husband of 15 yrs committed suicide 14 yrs ago at the age of 33. Although he had experienced childhood trauma and chronic depression of the years, this was still unexpected. As a mental health provider, the act of speaking about suicide to my patients has become easier over the yrs.
Your email touched me and has broadened my understanding tremendously, especially the viewpoint you made about jumping from the building. Again, thank you.
Jennifer Strickland