Tough Conversations: Talking about suicide

Recent high profile suicides and the popularity of the show 13 Reasons Why have made it apparent that this is an issue that is increasingly commonplace and yet incredibly misunderstood. The CDC reports that in the United States, deaths by suicide have been increasing over the last decade. Suicide is now one of the top five causes of death for teenagers 15-19 years old. These are chilling truths. I'd like to demystify this complex, confusing, and frightening issue with some facts and information. What are the risk factors and warning signs for suicide? How can you help a loved one you suspect is thinking of taking their own life? Let's look some of these signs and how you can address them with loved ones. 

Suicidal Thinking

Suicidal ideation can take the form of passive or active thoughts. Passive suicidal thoughts include things like, "the world would be a better place if I didn't wake up tomorrow," or "I wish I'd just get hit by a bus." Active suicidal thinking involves considering (or talking about) the methods one would use to kill them self, researching and planning, and purchasing the implements with which to take one's life. Not everyone experiences suicidal thinking, however, for those who do, it feels commonplace. This is true because many people who struggle with depression and suicidal ideation have done so for as long as they can remember. These thoughts are part of their day-to-day psychology. How can you tell if a loved one is considering taking their life? It is simple. If you suspect it, ask them. They may not tell you, but, on the other hand, many people who are struggling feel isolated, worthless, and alone. Asking them how they feel and demonstrating genuine concern can make all the difference. This is a difficult conversation to have because you may not like what you hear, but having the courage to ask can truly be life-saving.  If you suspect that a loved on is suicidal and they deny it, you should seek the help of a professional. Whether this be a licensed professional or a help line, speaking to an expert can help you make important decisions about how to proceed. Even if you have a frank conversation, and your friend or family member confessed that they are considering suicide, it is always beneficial to seek the advice of a mental health professional.  

Are there factors that increase the risk of suicide?

The weight of life's troubles is different for every person and while there is not a single cause or event that leads to suicide, there are, however, some precipitating factors that may increase the risk for susceptible individuals. Depression often causes people to feel worthless, ashamed of themselves, and hopeless. These feelings can be hard to overcome and when depression is untreated, it can be a major risk factor. This is true of other major mental health conditions, as well. Substance abuse can exacerbate negative feelings and is another key risk factor for suicide. Every person is unique, and likewise, the factors contribution to suicidal thinking vary greatly. Open communication is the key to recognizing negative thinking in loved ones. 

Know the warning signs  

While each person is unique, one warning sign for suicide that should never be ignored is the active form of suicidal ideation described above. When someone has made plans about the manner in which they would end their life, loved ones should be on high alert. When you observe this warning sign, either because they are verbalizing plans or posting about killing themselves on social media,  it is important to address it head-on while providing as much emotional (and physical or financial, when necessary) support as possible and getting them professional help. Isolation and mood swings can also be warning signs that a loved one is suicidal. Other signs to note are increased use of alcohol or drugs, unusual sleep patterns, or expressions of hopelessness.

It is important to note that research shows, when suicide is reported in the media, as is the case now, and specific details about the methods are shared, there can be a spike in similar types of suicides. The CDC studied these clusters and determined that there is indeed a spike in suicide after repeated news reports on the subject and it is, therefore, vital that the media report on these cases carefully and responsibly. This suicide contagion is sometimes referred to as "copycat suicide" because the methods used mirror those described in media reports.  

Some of the best ways to help depressed and suicidal people are by connecting and communicating with them and helping them to connect to supports within the community. Depression can make people feel extremely isolated and sometimes a lifeline is all that's needed to get someone on the right track. Other times interventions my be required.  

If you or a loved one is feeling suicidal
Depression is the world's leading cause of disability, according to world health experts approximately 800,000 people commit suicide annually. If you or a loved one is feeling distressed, call the National Suicide Prevention Lifeline. The crisis center provides free and confidential emotional support. If you are in crisis and need help, call this toll-free number, available 24 hours a day, every day: 1-800-273-TALK (8255). This service available to anyone. You may call for yourself or for someone you care about, and all calls are confidential. You can also visit the Lifeline’s website at http://www.suicidepreventionlifeline.org.

In Addition, you can text with someone by contacting the Crisis Text Line. Text CONNECT to 741741 (in the United States). This is also a free service.

If you are feeling anxious or depressed, I am available to help develop coping strategies that will put you on the path to feeling better. Formerly on staff at the Tulane University Student Health Center Department of Psychiatry, helping emerging adults uncover the best path to success is my passion. I am a professional psychotherapist and also specialize in academic, success, and life coaching. I work primarily with college students and young professionals. I would love to put my expertise as a certified success coach to work for you.

Sincerely,
Dr. Eileen Wynne