Suicide Warning Signs

                  One way to take action during Suicide Prevention Month is to learn the warning signs that someone may be at risk for attempting suicide. Often, warning signs are overlooked or not seen because suicide is something most people would rather not think about. Sometimes people treat the warning signs as being attention seeking and don’t realize the seriousness of these signs. It is important to know that these signs are not attention seeking and must be taken seriously.

                  Let me start by saying that people who are experiencing suicidal thoughts are not seeking attention. I have been there. I have sat in the depths of suicidal thoughts and in those moments, I have never been seeking attention. I have been suffering and feeling alone, isolated from the world around me to the point that I wanted to escape. So, please don’t believe for one moment that a person who is expressing the warning signs of suicide is just seeking attention. They are in crisis and need help.

                  I defined suicide in my last post (World Suicide Prevention Day Post). “Suicide is when a person harms themselves with the goal of ending their life, and they die as a result.” (the National Institute of Mental Health). A suicide attempt is when a person harms themselves with the intent of dying, but do not die.  

                  The National Institute of Mental Health lists the following as warning signs of suicide:

                  “·  Talking about wanting to die or wanting to kill themselves

·      Talking about feeling empty or hopeless or having no reason to live

·      Talking about feeling trapped or feeling that there are no solutions

·      Feeling unbearable emotional or physical pain

·      Talking about being a burden to others

·      Withdrawing from family and friends

·      Giving away important possessions

·      Saying goodbye to friends and family

·      Putting affairs in order, such as a will

·      Taking great risks that could lead to death, such as driving extremely fast

·      Talking or thinking about death often

·      Displaying extreme mood swings, suddenly changing from very sad to very calm or happy

·      Making a plan or looking for ways to kill themselves such as searching for lethal methods online, stockpiling pills or buying a gun

·      Talking about feeling great guilt or shame

·      Using alcohol or drugs more often 

·      Acting anxious or agitated

·      Changing eating or sleeping habits

·      Showing rage or talking about seeking revenge.”

 

It can be difficult to know if a person is suicidal, but these warning signs give an

indication that the person is considering it or may be ready to act. A change in behavior or a new, concerning behavior is an indication that there is need to get help as soon as possible.

                  Sometimes it is difficult to know if a person is engaging in some of these behaviors. For example, you may not know someone is stockpiling pills.  I stockpiled pills until I had significant amount, and no one knew. That is why it is important to have conversations with the person if you suspect they might be considering suicide. No one knew about my pills until I felt safe enough to tell one of my mental health providers. In the same way, you may not know a loved one has made a plan to attempt suicide. For that reason, it is important to watch for other signs. Noticing some of the other signs may lead you to finding out that they have made a plan. It is okay to ask a person if they are thinking about or planning to attempt suicide. Some people fear that bringing it up will put the idea in someone’s head. Research shows that it won’t. It is better to have honest conversations if you notice one or more of the warning signs. That will get the conversation started and lead to intervention. 

                  The times I have been asked if I was thinking about attempting suicide, I have been honest. That has led to getting me help. It did not make my thoughts worse or increase my likelihood of acting on my thoughts. Just asking is not enough. You need to get the person help. How do you do that?

                  First, stay with the person. Do not leave them alone. It is important not to tell the person you will keep their thoughts a secret.  You need to get help. Calling 988 for support is a first step. 988 is the Suicide and Crisis Lifeline. If there is an immediate, life-threatening situation you should call 911. Be sure to tell the person who answers that this is a mental health crisis and involves a possible suicide attempt. 

                  If there is not an immediate threat, 988 is the best option. You can call or text 988. You can also log on to https://988lifeline.org/. The 988 Suicide and Crisis Lifeline provides 24-hour, confidential support to anyone involved in suicidal crisis or emotional distress. You will be connected to a trained crisis counselor.

                  Today’s world has changed a lot. It is possible that you may learn someone is suicidal on social media. Some of the social media sites have a process to get the person help. You can find information on how to get help on the different social media platforms on the 988 Lifeline website at https://988lifeline.org/help-someone-else/support-on-social-media/.

                  If you are young person reading this, please never keep a friend’s suicidal thoughts a secret. It is important to reach out to a trusted adult if a friend expresses suicidal thoughts or intentions. Even if you are unsure of your friend’s intent, tell a trusted adult. 

                  I am not a professional. I am a person with lived experience. I have lived with suicidal thoughts. I have been in crisis. As I reflect on those instances, I don’t think I really wanted to die as much as I wanted to escape the emotional and mental pain I was experiencing. I needed help. I couldn’t do it on my own. Suicide often seems like the only escape, but suicide is not the answer. There is help available. I am grateful to those who have ensured that I received help over the years. 

                  So, if you see any of the warning signs in someone, take action. Stay with the person and reach out for help. 

 

 

World Suicide Prevention Day

                 September 10^th is World Suicide Prevention Day. This is an important day to me for a few reasons. First, I believe we need to draw awareness to the number of people living with and fighting suicidal thoughts. There are too many people dying by suicide. Another reason is more personal. I have lived with suicidal thoughts for most of my life. I understand the struggle and know the pain. Another reason is that too often people are shocked when a loved one or friend dies by suicide. The warning signs are missed. (Thursday’s post will discuss warning signs.) One more reason is that if we can prevent even one death by being more aware, we are making progress. World Suicide Prevention Day draws attention to seriousness of suicide and the need for more prevention efforts.

                  The slogan for this year is “Changing the Narrative on Suicide.”  There is a call to action to “Start the Conversation” with the aim of “transforming how we perceive this complex issue and shifting from a culture of silence and stigma to one of openness, understanding, and support.” To put this simply we need to talk about suicide in a way that reduces stigma and allows for providing help to those experiencing suicidal thoughts. This includes learning the warning signs and knowing how to get help for someone who is struggling or in crisis. 

                  The need is obvious when we look at the number of people who die by suicide. The World Health Organization (WHO) states that globally there are more than 700,000 deaths by suicide each year. We can’t ignore a number like that. This is where the awareness piece comes into play. We need to be aware that suicide poses a real crisis. When we look at the data in detail, it is heartbreaking to see how many people die by suicide. According to the National Center for Health Statistics, suicide is the second leading cause of death for people aged 10-14 years, 15-24 years, and 25-34. The American Psychological Association stated that 20% of teens seriously considered suicide between 2011 and 2021. In 2021 the National Institute of Mental Health (NIH) reported suicide claimed the lives of over 48,000 people. That number is nearly two times as many as the number of homicides in that same year.

                   There are three definitions we should understand. According to NIH suicide is defined as “death caused by self-directed injurious behavior with intent to die as a result.”

They define a suicide attempt as “a non-fatal, self-directed, potentially injurious behavior with intent to die as a result of the behavior.” Finally, suicidal ideation “refers to thinking about, considering, or planning suicide.”

                  I mentioned that I have a more personal reason for believing that World Suicide Prevention Day is important. I have dealt with suicidal ideation since I was in my teen years. I have been on the edge of attempts. Thankfully, I have been helped in these instances. I wouldn’t be here if the people who helped me hadn’t been aware of suicide. Several times my ideation has been relieved, or my attempts stopped by mental health professionals, but there have been times when a friend or family member has stepped in and made sure I received help. It is the awareness of these friends and family that is important on this day and every day. We need to build more awareness in people. We never know when someone we care about might need help. Awareness that suicidal ideation does not go away on its own, but it is a step in the direction towards making a difference. Knowing how to direct the person toward help is also important. The more aware we are, the more likely we are to be able to make a difference.

                  September 8^th was National 988 Day. 988 is the Suicide and Crisis Lifeline. If someone you know is expressing thoughts of suicide this is the number to call. If you are having these thoughts, call this number. You will be provided with the support necessary to get you through the situation and keep you safe. 988 provides judgement-free care. The conversation you have can save your life or the life of someone else. You can call, text, or chat with this line. There is a website, https://988lifeline.org/get-help/. I have a friend who didn’t know what to do when her friend repeatedly expressed suicidal ideation. She asked me what to do. I recommended she call 988 and ask for support. The person who answered was able to get support to my friend’s friend. This was the first step in providing her with help. She is alive today because of the help provided by 988. As we raise awareness about suicide prevention, we should make sure people know about 988. A simple phone call can really save a life. 

                  This month I am going to focus several of my posts on raising awareness about suicide. It is not just my personal experiences with suicide. I have also had students who lived with suicidal ideation. Perhaps living with these thoughts and knowing others who have also lived with the thoughts has made me more aware and allowed me to understand the importance of awareness. While September 8^th was 988 Day and September 10 is World Suicide Prevention Day, the whole month of September is set aside as Suicide Prevention Month. A month is not enough to raise the awareness we need to raise, but it is a start. My posts this month might make some people uncomfortable because I am going to discuss suicide. It is a topic people try to pretend doesn’t exist, but it does exist. I have experienced the pain of suicidal ideation and attempts. I know firsthand that awareness makes a difference. I apologize if I make you uncomfortable, but sometimes to help another person, we need to step outside of our comfort zones.  Let’s do everything we can to increase awareness about suicide. We never know whose life we are saving in doing so. 

Ask the Question

                  September is Suicide Awareness Month. It is a month we try to raise awareness about suicide and how many people are affected by suicidal thoughts. This cannot be limited to one month, but we need a platform to raise awareness. So, a month of awareness activities is beneficial.

                  Today I am going to focus on checking in on friends and family. Many people live with depression and suicidal thoughts in silence. When you look at them you don’t see the struggle they are living with. That is because many of us learn to put on a mask. This mask hides the depression and suicidal thoughts. Whatever our reason for hiding, we are hurting on the inside. Maybe we hide because we don’t want others to worry. Maybe we hide because we don’t think others will understand. Maybe it is a fear that we will lose our jobs. I have hidden my depression and thoughts for each of those reasons. 

                  Even though we try to hide our depression or suicidal thoughts, there are signs. There is usually some sort of change in us or something out of the ordinary that a loved one can pick up on. That is why I urge people to check in on their friends and family. Ask the question! It is a simple question, “Are you okay?” When you ask this question, don’t just accept “yes,” “I’m okay,” or “I’m fine.” Follow up. Ask them if they are really okay. Don’t let the person just blow you off. If you have seen a change in the person or noticed that they seem different, be persistent in checking on them.

                  I’ll share from my own experience. When my depression starts to increase, I often try to hide it from others. I don’t want others to worry. When I was working, I feared that if anyone knew I how much I was struggling, I would lose my job. For these reasons, if I was asked how I was doing, I always replied with “I am fine.” Usually that was the end of the discussion. Most people accept that as an answer. Unfortunately, often I wasn’t fine, and I needed help. The only people who didn’t accept my answer were the people on my mental health team. What if a friend or family member had pushed me to give more of a response? What if someone had asked “Are you really okay?” What if they had said “I have noticed you seem down?” or “I noticed you are keeping to yourself?” It likely wouldn’t have stopped my suicidal thoughts, but it would have been an opening to let someone in. It might have pushed me to seek out my mental health team sooner. 

                  It is important understand that often people with depression or other mental illnesses don’t want to be a burden on others. We don’t want others to see our struggle. But if you let me know that you see I am struggling and that you won’t just accept my answer that I am fine, I am more likely to open up. I am more likely to get help. 

                  When you ask these questions, you are not expected to solve the problem. You do not need to have the answers or know exactly what to do. Just being there is important. Be aware of changes in the behavior of others. It could be an indication that the person is struggling and in need of support. 

                  People who die by suicide often seem fine, but if we really pay attention, there are signs.  I am reminded of the actor, Robin Williams. People were shocked when he died by suicide. He was always so funny. People thought he was happy, but he was struggling with depression. He hid it well. None of us knew until it was too late. He masked his depression by trying to make others happy. There is no way of knowing if someone could have prevented his death and I am not going to make assumptions. I just use him as an example of someone who masked his depression and suicidal thoughts. We need to check in on all our friends and family. Ask people how they are doing and really listen to their answer. I know this is not going to prevent every suicide, but if checking in on someone saves one life, it has made a difference. 

                  So, this month and every month, check in on others. Have conversations with friends and family. Share your emotions and encourage them to share theirs. The more we really listen to each other, the more aware we will be aware of how each of us is doing. This is just one step to reducing the number of deaths by suicide, but it is an important step. It is a step each of us can take.

 

 

Darkest Moments

“It is during our darkest moments that we must focus on the light.” – Aristotle

 

                  I saw this quote on the Giving Voice to Depression Podcast social media. This is one of my favorite podcasts, definitely my favorite mental health podcast. I often find inspiration in their posts and podcasts, which feature lived experience with depression. 

                  Back to the quote. This quote really resonates with me because I have always described depression as a darkness and healing as a light. My book A Light Amidst the Darkness illustrates this belief through poetry. What I find striking about this quote is the idea that even in darkness we can focus on light. As someone who has been trapped in the depths of the darkness of depression, I can attest to just how difficult that is. When depression is at its darkest it is difficult to believe in the light of healing. It is difficult to reach out and have hope. 

                  I have written a lot about the darkness. It is suffocating. It is all-encompassing. When depression wraps its cloak around a person, the light of healing seems to be extinguished. Many times, I have wondered how I would ever get out from beneath the darkness. Those dark moments hurt and numb me at the same time. I hurt because I fear I will never see the light again. I am numb because there seems to be no reason to search for the light when the darkness is at its most pitch black. This darkness is depression. It is an illness. In these times I must remember that it is an illness and not a part of me. To do that I must turn my focus away from the darkness. Not an easy task, but a necessary one. 

                  How do we change our focus to the light? It is something we need to learn. It is not going to come naturally. I have learned by listening to my mental health team. They are a part of my light. They pull the light into my darkness so that I can focus on it. Often, I don’t see it on my own and need reminders. That is okay. Mental health professionals dedicate themselves to helping people focus on the light. 

                  Changing our focus to the light requires us to latch onto hope. Hope is a difficult concept to grasp. Having hope means believing that the darkness does not have total control. Even when the darkness wraps us in its veil, holes can be found. They may be pinpoints, but they let light into our lives nonetheless. I think there are several pinpoints dotting the darkness of my depression. They exist as my mental health team, my friends and loved ones who support me, the medical professionals who fight my physical health issues, and even the music that uplifts me. If I can turn to these pinpoints of light in my darkest moments and hold onto their support, I can break down the darkness of depression. It is by no means an easy or clean process. There are ups and downs. Shadows cross the sky of my consciousness at times, but for a shadow to exist there must be light.

                  I have come to believe that we cannot have darkness without the existence of light. It is often difficult to remember that when the darkness of depression is suffocating me, but opposites fill our world. There is no dry if wet does not exist. We can’t be hot if we don’t know cold. If something doesn’t open, how can it close? In the same way, darkness cannot exist without light. Illness cannot exist without healing. 

                  It may seem like I am oversimplifying depression by describing it in this way, but I am not. Depression is complicated. It affects each one of us differently. Healing also appears differently for each of us. Despite the differences, I believe the commonality lies in the light of hope. Hope transcends darkness. It is the light that brightens the darkest of days. We need to look for it, reach out to it. As Aristotle states, we must focus on the light. That light may contain therapy, medication, TMS, esketamine, or other treatments. It may contain a hand reaching out to a loved one. Whatever the light contains, whatever it requires of us, we need to focus on the light. The darkness will attempt to consume us. That is how the illness of depression works. It fears the light because the light has the power to brighten the lives of people struggling with depression. 

                  We all need to focus on the light, even if it is just a pinpoint right now. That pinpoint can let the light in and in time we will heal.