In the US, suicide is the 10th leading cause of death, accounting for 44,193 fatalities in 2015, the most recent year data is available. For youth aged 10-24, it is the 2nd leading cause of death. Each day, 121 people die from suicide, yet still most people have little or no idea what is needed to help when someone may be experiencing a suicidal crisis.
According to the American Association of Suicidology, research based estimates suggest that annually about 147 people are exposed to a suicide, and 6 of those experience a major life disruption, leaving 6.5 million people trying to make sense of this very painful loss. Yet, almost every time we hear about the death of someone by suicide, we are shocked. It’s almost as if we are hoping that if we don’t think or talk about it, it won’t happen to “one of us.” But if we look at the numbers, we see this just cannot be true.
When we hear about a member of our community dying by suicide, we feel devastated, vulnerable and scared; many questions get left unanswered, especially if it’s a young person that has died this way. We want to be sure those closest to us are not considering suicide, and yet we are terrified to think that it might be true. We know that something needs to be done, and it is important for us to learn our part.
Suicide is most often about stopping pain, not about wanting to die. How do we help someone that is feeling so much pain that they feel that suicide is the only way the pain will go away? When we are overwhelmed with emotions due to stressful life situations or physical pain, our ability to think clearly becomes diminished. Finding solutions to the problems becomes extremely difficult; we may begin to feel hopeless and powerless to be able to make things better. Suicide may be considered.
A particularly difficult part of the daunting task of approaching someone who worries us, is just how confusing it is to know for certain that someone is considering suicide. We haven’t been taught the “3 things to know” in case someone is having an emotional crisis and may be at risk, though there are certainly warning signs to look for. When we see these warning signs it is vital that we check them out, even if we guessed wrong. Just as the warning signs of a possible heart attack may ultimately be indigestion, anxiety or other physical conditions, when they occur we take precautions to prevent possible death.
- Talking or joking about suicide: “I wish I were dead,” “I can’t take this anymore” “I just want to kill myself” etc.
- Withdrawing from things they love to do
- Easy access to lethal means including firearms
- Isolating themselves from family or people they enjoy seeing
- Drawing or writing about death
- Looking for or talking about ways to die
- Being forgetful, difficulty concentrating, not doing well at work or school
- Drastic mood changes
- Feeling as if they are a burden or that people will be better off without them
- Worrying and stressing over everything
- Feeling hopeless, depressed or sad for some time
- Impulsiveness or aggressiveness
- A sudden improvement in mood for no apparent reason. Sometimes when a person has a plan to die, they suddenly seem to feel better, perhaps because they see an end to their pain. Asking why they feel better is important here.
Painful life events that can increase the risk for suicide (people who are suicidal are typically facing more than one problem)
- Being bullied at school, work, via text, phone or social media
- History of trauma or abuse, long-standing injury or medical problem, sexual abuse/assault, victim of violence
- Questioning sexual orientation or being labeled lesbian, gay, bi-sexual, transgender
- Recent loss such as moving, changing schools, divorce, relationship breakup, death of someone they love (even a celebrity), job loss
- Legal problems
- Parental psychopathology
- Drug and alcohol problems and other addictive patterns
- Depression, anxiety, schizophrenia and other mental health issues
A person in crisis often gives warning signs that, cumulatively, may indicate there is a risk for suicide. In order to know with any accuracy if a person we care about is currently or has ever considered suicide, we need to ask directly. It is so important that we step through whatever uncomfortable feelings we may have, and simply ask if they ever have or are currently considering killing themselves. Using the word suicide is important in letting the person know that we are willing to discuss this uncomfortable topic because they matter and we want to get them help. Being this direct with the questions actually gives them permission to talk about feelings that they may have been afraid or ashamed to talk about. If they are not suicidal, they will tell us when we ask. Most of the time they will tell us why they’d never consider doing “something like that.”
Adolescent years are confusing for everyone. Moodiness seems like the hallmark of that time in life and it’s often difficult for adults to keep up with the emotional and physical changes taking place. Young people are trying to figure this out too, and as a part of maturation from childhood to adulthood are constantly living with conflicting feelings. This is normal.
How do we distinguish their normal moodiness from a serious emotional problem? We need to be direct and ask them. Really listening to our teens is important. Though we may not understand why they are so impacted by the life event they are telling us about, it is impactful to them. Help them to remember that overwhelming and intense feelings can be confusing but are a normal part of being an adolescent. Let them know that if the feelings become too much to cope with, you can get them help. If they had a cough and cold for an extended period of time, and Vitamin C and chicken noodle soup wasn’t making things better, you would likely take them to the doctor. This isn’t any different. Long term or intense feelings of sadness (depression) or worry (anxiety) can mean more than just being a teen, it may indicate a problem that needs treatment. Then suicidal risk can be evaluated and help can be given.
Just like a heart attack is the sometimes fatal end result of heart disease, suicide is the sometimes fatal end result of diseases such as depression or anxiety disorders. Getting professional treatment is the appropriate response to both of these scenarios. Most often, when help is given, a person can get through a suicidal crisis and get through to the other side and go on with their lives. Finding professional help for suicide can make a significant difference. Whether you’re concerned about someone or are yourself struggling with thoughts and feelings of suicide, there is help. Talking with a therapist, and sometimes using medication, can be the help that a person needs to get through a really difficult time in life.
For those whose lives have been shattered by a suicide, in the initial aftermath, having the support of family and friends can be vital. Talking with a therapist or attending a Survivors of Suicide loss (SOS) grief support group are ways to receive support for this unique grief process. While it may not seem possible at first, those who have lost a loved one to suicide can find a way to go on. Here are some things that are helpful to remember:
The Five “T”s
- Time: grief has its own timing and with the traumatic event of a suicide, it is complicated too.
- Talk with others about the loss of our loved one.
- Tears as needed to relieve all those intense emotions and heal.
- Touch because a hug from someone who cares can be a big help.
- Tolerance for the reality that each of us grieves in our own way.
If you’re concerned that someone may need help for suicide, please ask them. If you yourself need help for suicide, please reach out and ask for it. If you need more information, you can call the National Suicide Prevention Lifeline at 800-273-TALK (8255) and you will be connected with resources in your community.
Gigi Colombini, LMSW
G Colombini Counseling
Psychotherapist, Suicide Prevention Specialist
Advisory Committee Member
Grosse Pointe, MI