Suicide is not complicated.

The preceding ideation is complicated. The aftermath is complicated. The act of suicide itself is simple.

Suicide is a word that people struggle to accept, process and understand. The stigma surrounding suicide makes the word feel dirty. The sensationalizing of suicide in the media can make it feel otherized and dissonant.

In the interest of untangling the complexity of this subject, we decided it was high time to shed light on this subject, which is so often shrouded in shame, guilt and stigma.

Suicidality

Ideation is a scream for help or a weapon –a threat– depending on its use. Yet even attempts for attention still occasionally result in death.

It is common for a supporter to be concerned with a Post Traumatic Stress Disorder (PTSD) sufferer’s suicide risk. Some believe that giving constant love and affection to their partner will stop them from committing suicide. Some take on additional responsibilities, doing everything they can to make their sufferer’s life as pleasant and unburdened as possible. Still, suicide is used as a weapon of threat, or the act is still achieved. Why?

A person commits suicide in a moment of their life where they see no alternative to remove their pain, so they act accordingly to die. This moment, regardless of everything in life surrounding the moment, can lay within minutes or hours alone. The act is decided and accomplished that quickly.

Most Importantly

Don’t blame yourself.

When a person wants to commit suicide, that is what they will do, and there is nothing you can do about it. People in psychiatric wards under suicide watch still manage to commit suicide. Accept the truth and reality of the situation. Suicide is not your fault.

Those who have been exposed to suicide, directly or indirectly, should know first hand that there is little they could have done to stop the attempt. You can’t see suicide coming. You can’t prepare for it. To be honest, you’re lucky if you happen to intervene within the act. Don’t beat yourself up. It isn’t your fault. The brain is powerful, and no one can externally control one’s mind or prevent such a decision from taking place.

Loved ones wear the brunt of guilt and shame following a suicide, often due to the belief they could have stopped it. Well… that is highly unlikely. When a person with depression/PTSD talks about dying for months or years, unfortunately loved ones often become desensitized to the threat when it actually presents itself. When a person decides to die, the decision is often made in a small window of time.

Statistics for Suicide

A piece of advice I want to share from researching suicide statistics is that there are no factual statistics. A current US media trend is to focus on veteran suicide statistics. The media asserts that suicide claims 22 veteran lives each day, yet that statistic is from 2008.

Evidence supports suicide rates declining. Other evidence says they’ve remained the same. Who is right? The one indisputable fact on the matter is that nobody is recording accurate suicide statistics. If one person dies by suicide, then that is enough to warrant attention as a tragic loss of life.

The little that is known shows that women are more likely to attempt suicide than men, yet men are more successful at suicide than women. One must also accept that the majority of people diagnosed with mental health do not attempt or commit suicide. It is the exception, not the rule.

Mental health increases risk for suicide, yet those at most risk for suicide are aged between 40 and 59 who are diagnosed with cancer, heart disease, Parkinson’s or chronic pain.

PTSD, Trauma and Suicide

PTSD itself has no evidence clearly linking it to suicide. However, depression is a common diagnosis that accompanies PTSD; approximately 70% of sufferers are diagnosed with both. Depression is approximated to kill 15% of clinically diagnosed sufferers by suicide. PTSD comorbid with depression, substance or mood disorders increase statistical risk for a suicide attempt. Sexual assault, physical assault, childhood abuse and repeated trauma exposure demonstrate increased risk for suicidal ideation

Why People Want to Kill Themselves

People want to die for many reasons, so please don’t view this list as exhaustive. The desire to die may be due to wanting to simplify life’s complex problems into a simple solution, a way to express pain and suffering, to remove guilt, to punish someone, to feel in control of something, a need to join beloved deceased, to attain a feeling of peace or out of repentance for a real or perceived moral failing.

Medication

Medication is not a preferred treatment for suicide. Aside from the US, the majority of the world accepts the ongoing, robust findings that there is little evidence demonstrating that pharmaceutical intervention results in helping depression. In fact, anti-depressants cause a significant portion of depressed patients to be more depressed. Pharmaceuticals have a low success rate.

Some Possible Warning Signs of Suicide

Remember, you can’t see suicidality in a person, but you can acknowledge signs that may lead to suicide. When someone you know talks to you about wanting to hurt themselves, speaks as if they have no future (“no need to buy me that birthday gift, I won’t be around by then”), expresses a will to obtain drugs or weapons outside their character or writes a plan to die or as though already dead, they feel trapped with no possible solution to their problems, or they feel no purpose to live. Spouses may recognize when a partner begins getting their affairs in order, ensuring you know everything there is to know about finances, assets, insurance and such. And then there are those with zero warning signs at all.

You then have increased symptoms of depression to look for: a rapid decline in interests that were keeping them active and healthy, a worsening towards addictive behavior or dropping all psychiatric care, medications and such, without suitable explanation. A more prominent symptom is hallucinations, such as voices telling them to do X.

Talk with Them about Their Plan

When someone you live with or love is suffering suicidal ideation, one of the best things you can do is discuss it with them. Ask if they want to kill themselves. Ask if they have a plan. If they have a plan, what is it? How badly do they want to live/die? Do they have a specific date? Is someone or something telling them to kill themselves? Will they give up any instruments of death? Will they visit a therapist with you?

Those who have established plans are more likely to commit suicide. Especially those who have a set date, i.e. “if the pain isn’t gone by X, I’m going to kill myself.” Consider that as serious.

Knowing their plan is a huge help towards possibly stopping their death. You may not be able to stop it if they’re committed, but knowing such things may be enough to stop your loved one. You never know; you just may save them inadvertently by limiting their access to their planned course of action. Remember, most people don’t really want to die, they just want the pain to stop.

A loved one actively talking about what is wrong with them is exactly the therapeutic outcome you want them to achieve. They’re getting the pain out. You should be concerned when they don’t talk about it, won’t see a professional and won’t help themselves. They are the more dangerous times.

One of the primary reasons a person does not commit suicide is for loving someone or something, and fearing leaving that person or thing behind. This may be a partner, parent, child or pet. These are excellent things you want to hear from a suicidal person.

Possible Prevention of Suicide

Suicide requires professional help. Never fool yourself into thinking anything else.

An important aspect for loved ones is to report suicidal discussion to the treating therapist. If they aren’t in treatment, they need to be ASAP. Discuss making an appointment with them, or you can even go with them if needed.

Remember, if they wanted to kill themselves, they would already be dead. So don’t be scared to help them help themselves. Take them to the doctor and discuss options. Call a suicide line and be part of the conversation. Don’t be scared to find solutions and then offer solutions of help, and if you believe a plan is imminent, don’t leave them alone. Bring in help immediately.

Listen, never dismiss or discount their pain or suffering. Don’t tell them “You’ll feel better after X” or “It’s not that bad.” Listen, accept where they are, and try to understand their pain. The more they talk, the better for them. If you say nothing at all, just listening, you may well be preventing their suicide. If you say anything, try to understand what it feels like for them.

Most people who have achieved suicide never sought help. The best thing to catalyze an outburst of survival is to discuss suicide and talk about active solutions that can help.

In Conclusion

But wait, you may be thinking, where was the treatment section?

Well, there is no effective treatment for suicide other than care, concern, and lots of talking with the person. Cognitive Behavioral Therapy (CBT) is the preferred treatment for depression, yet a person does not need be clinically depressed to be suicidal.

The #1 rule is to trust your instincts. You know yourself and your loved ones the best, so if you get dismissed when seeking help, ask to see someone else. Keep reaching out. There are many tired, over-worked healthcare providers, and getting one with a bad attitude will not solve your concerns.

What a suicidal person projects in a 10 minute psychological assessment versus what they project at home, living with them, are vastly different assessable outcomes, and it is important to find resources that present solutions and support, not invalidation and dismissal. Keep looking. Keep talking. Keep reaching out.

If you are suicidal, get talking in our community.

Bio’s

Written by Anthony, who founded MyPTSD in 2005. He is a veteran, writer, and web designer. He lives with his wife and two heinously cute puppies in Melbourne.

Edited by Simon, who earned her writing degree in 2011. She hopes to one day garner a doctorate in composition. You can find her on MyPTSD, where she talks (too much) about her dogs, life, the multiverse, and Everything.