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Let's talk suicide

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anthony

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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.
 
I attempted suicide about a dozen years ago. I felt that my situation was hopeless, and even though I was in therapy at the time, I told no one of my plans. I planned it for 4 months. I received my doses of medicines from my healthcare provider every 4 months and so I just planned to take all 4 months worth of my meds in one shot the next time I received them.

I was being date raped nightly by my sponge of a boyfriend. I could not support myself financially, needing his and my money combined, as well as money that I begged for in the streets, just to pay for a cheap motel room every night and get a little food for us to eat. Usually Raman noodles.

My husband was suffering from a massive stroke, was crippled and in a wheel chair. He was in a nursing home and we had lost our life’s savings and our motel which was also our home. The nursing home had taken it all. Technically, I was homeless, and had been for maybe about 2 years. I felt I was on a treadmill. I never had a day off from going out in the streets begging for money. I saw no way to change the situation, I was so exhausted. I felt suicide was my only way out.

After taking all four months worth of the meds, I lay down in bed and went to sleep. I awoke about 10 days later in the hospital with a nurse fussing over me, asking me why I would do such a thing to myself and I was so pretty and all that.

I still had all the problems I had, had before the suicide attempt, but now the new one of being forced to stay in the hospital until they thought I was no longer at risk.

In the meantime, my sponge of a boyfriend had jump started my car (my only real valuable possession left) and had ruined the ignition. I then had to use a screw driver to start it.

My therapist was shocked that I had never discussed my plans with her about the suicide, she’d never seen it coming.

Anyway, suicide is way over-rated. It does not solve any problems, but just adds to your misery if you survive it.

Eventually, I was able to escape from the boyfriend. I had tried to do so many a time before the suicide attempt, but afterwards, the hospital had recommended a place where I could go that was for mental patients. I could stay there and they took my money every month, giving me a small allowance to live on for shampoo and soap and toothpaste and the like. There were some 30 people staying there and I lived there for a year and a half, until I had to move to another facility like that one, and then a third one. Each facility had rather bad living conditions, so I finally found a tiny apartment of my own.

Life has been so much better since I have been living on my own, and to be sure that I never see my abuser again, I have moved 625 miles away from that city where he resides. (My husband, God rest his soul, passed away in 2005).

One good thing did happen during all of this nightmare. I was given a dollar and a little leaflet about Jesus when I was begging for money. I read it and eventually joined a church. That church helped me out a lot and I still go to church now. Jesus is really important in my life, and He gives me such peace. I don’t regret what happened to me. It was all worth it, because now I know and love Jesus and He loves me. Life is so much better, since that happened!
 
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There have been suicides of college students with no warning, or indication of depression. Brogan Dulle, Kelly Nash, and Mengyao Zhou are examples. In the first two cases the students can be seen on video walking alone just before committing suicide. Zhou told her roommate she would run errands. Instead she drove ninety miles to a junior college parking lot, took over the counter sleeping medication, and climbed into the trunk to die.
 
It’s not ourselves that need to die; it’s our egos that need to die.
In other words, we need to stop trying to “figure things out” with doctors and medication and fit our heads through the door of a STRONG 12-step meeting and then accept and work through the 12 steps in order to heal.

The mental part of humanism gives us a million reasons not to do this. Again, that’s the ego trying to keep us from being well.

I think that given what’s going on out there, that it’s time we all open our minds a little more.

It’s not for those who need it; it’s for those who want it.
 
I am so glad your relationship with Jesus gave you strength. That was what brought me out of a 12 year mental and emotional breakdown. I lived with a friend’s mother who had true faith. She saved her son from suicide when she was able to convince him of the reality of God’s love for him.
Only Christ gave me pure joy and confidence that I was loved no matter what I did. Others didn’t care about my life, or if they did it didn’t seem to matter to me. I was in constant pain. I was the object of victimizers, but I was convinced by the love she received by her faith in Christ.
Then I found a wonderful church – the first thing I noticed was the joy the people had and love for each other.
I learned more about life than in any other arena and found friends who loved me through Christ. I understand the Bible and know that the Holy Spirit lives in my heart and will never leave me. Nothing else in this world matters as long as I have Him.
There is no fear in love for perfect love cast out fear. I will be in God’s presence through eternity.
 
Thank you both for the article. I thought it both factual and very sensitively written. It insightfully framed aspects of my own suicide attempt and ideations. I’m sure it will be a source of help and comfort to suffers and supporters.

Cheers – mit
 
I have attempted a few times…some reason it didn’t work. I got over and threw the depression.
This is round three. I was younger and had a lot more to live for. Now, I’m older and there isn’t much.
Ive had a lot of losses and frankly don’t see that the future holds very much promise of good …just more negative …currently I’m more numb than anything else…..feeling is to painful….
 
I have attempted a few times…some reason it didn’t work. I got over and threw the depression.
This i...
Nessa, futuristic thinking is a negative thinking style. It is far better to put one foot in front of the other, and take it not much further than one day at a time. Achieve something today, not worry about what a week, month or year from now might be. That is how you tackle depression and suicidal ideation. The now, the present tense.
 
I came here because the last two days I have had suicidal ideation. I am having a difficult time with concentration so bookmarked for later.
 
I dont want to be here anymore. I dont want to hurt my kids. But im not enjoying life. Even time with my grandkids isnt enough. I need a new immune system, I understand I need to look at things differently but I dont care. I am tired. I have been trying to help myself for 30 years and im no better off. They just keep changing the medical and psychological diagnosis. Its not helpful. They dont know much about the new ones either. I keep hoping that I will die from natural causes sooner rather than later. I know others have it worse but I don’t understand what keeps them wanting to live life.
 
Genie, are you on the forum? Please don’t compare yourself to others. You are suffering and that is just as valid as anyone else’s suffering.
 
Is it possible to have PTSD after a suicide attempt? I had a suicide attempt about ten years ago, and the memories still haunt me. I remember feeling numb, just before it, and it wasn’t something that I had planned, it just sort of happened. I am feeling numb in the present moment, and that feeling just triggers the memories. Of course, the healthy me does not want to die, I went to a doctor and was prescribed anti-depressant medication. But reading articles and talking with friends on anti-depressants, I get the idea that it is not necessarily effective. So I am not taking anti-depressants. I am in group therapy, and have talked to therapists, but have not gotten an ‘answer’ per say, just a lot of talk of what happened.

There has not been an ‘event’, or crisis in my life either, the doctor said it sounded more ‘chemically’. I have been diagnosed with dysthymia, major depression and generalized anxiety disorder at that time. I have a husband, but scared of having children, since I don’t think I can manage taking care of others, to be quite honest. He wants children. And I don’t even feel like we have enough money for children. I don’t know what to do.
 
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