Suicide Awareness and Prevention

Depression isn't an act. Bipolar aren't phases. Suicide is not a coward's escape. Self-harm isn't a cry for help. PTSD isn't something to snap out of. 

September is an important month for all of us to recognize as it's National Suicide Prevention Month, with Suicide Prevention Week kicking off on Sept. 5th to surround World Suicide Prevention Day on the 10th. Raising awareness about suicide is a first step in starting necessary conversations about this often misunderstood and stigmatized tragedy. Understanding suicide and what precipitates it is essential to prevention. 

Let's talk depression and mental health, the leading causes of suicide. While mental health awareness month isn't until May, this element is an essential part of the suicide conversation. These are topics near to my heart, and since I went public with my own mental health diagnoses, I try to seize every chance I have to bring awareness to these often difficult and misunderstood topics. 

Suicide is the 2nd leading cause of death in the world for people ages 10-34, and the 10th leading cause of death in the U.S.

First, let's establish what depression is. Clinical depression is not simply being sad, and is different than circumstantial sadness or grief. While long-term, chronic sadness is a classic mark of depression and the symptom most often discussed when identifying depression in yourself or someone else, depression goes so much deeper. Depression and other mental health conditions such as Bipolar, Schizophrenia (and many more) are complex and serious, sometimes life-threatening, disorders that negatively impact mood and emotion, mental stability, the way a person feels, thinks, and acts. They can drastically affect a person's daily emotional and physical functionalities.

In 2019, there were an estimated 1.38 million suicide attempts.

Know the facts, not the myths:

• Depression is not mere sadness or a weakness of character.
• Mental health disorders have social, psychological, and biological origins. 
• Sadly, anti-depressants don't simply "cure the problem."
• While treatable, there are many intervention approaches to managing depression and other mental health disorders. Medication helps to alter and balance deeply-rooted biological issues with brain chemistry. However, talk and psychotherapy can be important in treatment approaches, especially when combined with other remediation, such as medication.
• Anti-depressants/anti-psychotics won't change a person's personality. 
• You don't simply "Snap out of it."
• Depression is not a sign of laziness, self-pity, weakness, or drama. One doesn't just power through, and cannot be "cured" with good thoughts or an "attitude adjustment."
• Someone can suffer from mental health disorders despite having a "good" or "comfortable" life.
• Depression can affect anyone. 
• While depression symptoms are most frequently reported by women, data shows that suicide rates in the U.S. are 4x higher in men.
• Depression is not caused by diet. 
• Yes, depression is often exacerbated by excessive amounts of alcohol or the use of drugs.
• Yes, a good diet is helpful in all areas of overall health - physical and mental - but it is not a single underlying cause of clinical depression and other mental health disorders. 

There is one death by suicide every 11 minutes in the U.S.

Passive vs. Active Suicide Ideations:

• Passive Ideation: Having thoughts of suicide or self-harm without a plan to carry them out.
• Active Ideations: Having thoughts of suicide or self-harm with a developed plan to carry them out.

Just as a person with diabetes cannot make their bodies produce insulin, a person with depression or other mental health conditions cannot produce the chemicals or neurotransmitters to cure themselves. 

Signs and Symptoms of Suicide:

Behavioral Symptoms:

• Giving away possessions
• Talking about death, dying, or not being around in the future
•  Using phrases like: "When I'm gone" or "If I were to die"
• Saying goodbyes or making amends
• Collecting items that are harmful or potentially dangerous
• Social withdrawal
• Increased alcohol consumption or drug use
• Not participating in activities that once drew interest
• Engaging in risky behaviors

Physical Symptoms:

• Scars or physical marks on the body of past attempts or self-harm
• Drastic changes in eating or sleeping habits
• Chronic illness
• Cognitive symptoms
• Obsessing over ideas that the only end to emotional pain is through death

Psychosocial Symptoms:

• Feelings of helplessness or hopelessness
• Beliefs that emotional pain is unending 
• Self-hatred/loathing
• Paranoia
• Emotional pain
• Frequent or drastic mood swings
• Sudden changes in personality or behavior
• Intense anxiety or increased irritability

What Never To Say:

While it's difficult to watch people we love go through depression or suffer from other mental health disorders, sometimes the things we say in our efforts to help can be either misconstrued or not properly conveyed, resulting in counter-productivity, even with the best of intentions. The wrong kind of platitudes can induce guilt, or make a person already suffering feel minimized or dramatic, misunderstood, or attacked. So what are some of these things? This list is by no means finite.

• Try harder.
• Snap out of it.
• Power through.
• You'll be fine.
• There are many reasons depression develops, and a person cannot necessarily control the symptoms and risk factors.
• Don't over-simplify
• Cheer up.
• Smile.
• Life's too short to be down.
• Just as a person cannot make their body produce the proper chemicals to balance them out, they cannot decide to just be happy.
• Don't express disbelief
• But you look fine.
• But you've got such a good life.
• Many people suffering from mental health are good at hiding their disorder and can come across as healthy.
• Reasons they may hide their disorder: embarrassment, guilt, shame, incompetency, afraid of people's responses, or fear people will think poorly of them or stop loving them.
• Just because some can be good at hiding their disorder publicly doesn't mean their struggle should be minimized or dismissed. 
• Don't dismiss their pain
• It can't be that bad.
• It could be worse.
• You think you've got it bad.
• What may seem a simple problem to a healthy person can be insurmountable to someone with mental health conditions. They often lack the coping skills needed to function or overcome their obstacles.
• Don't blame
• It's just in your head.
• Depression and other mental disorders are not simply in someone's head but instead are clinical illnesses. Just as someone's cancer isn't simply in their head, mental health is also an illness of the body.
• Sometimes when we get frustrated, angry, or even worried, we can seem apathetic to the situation.
• Shaming
• Other people have problems too.
• You're overthinking this.
• It's not always about you.
• Depression is not a matter of being selfish or self-absorbed.
• Don't ignore them.
• Pretending things are fine.
• It's okay to admit you don't understand but you're there for them. Sometimes simply sitting with them can be helpful.
• Reassure that you're there and that you love them.
• Avoid cliches and platitudes
• This will pass.
• God doesn't give you more than you can handle.
• Let it go, move on.
• Escaping their emotional state can seem endless, a future uncertain or unattainable. These statements can also minimize what they're experiencing. 

How to help:

• If you identify any of the symptoms of suicide in someone you know, reach out. Do not wait.
• Establish a safe environment.
• Reach out to a mental health professional or crisis hotline. 
• Call 988
• National Suicide Prevention Lifeline: 800-273-TALK (8255)
• After you've connected someone at-risk with professional support, reach out and follow up. 
• Educate yourself and others on what to look for, how to reach out, and raise awareness where you can to stop the stigma around mental health and suicide.
• If you're suffering from depression, other mental health conditions, or are experiencing suicidal ideologies, know you are not alone and reach out where you can. 

*Sources:

Healthline

Very Well Mind

CDC

BeThe1To

Biltmore Counseling Center

SunStone Counselors

Psychiatry.org

Save.org

AFSP

Nimh.nih.gov