Events of this week hit various communities pretty hard. Fashion Designer Kate Spade and Chef Anthony Bourdain were both found unresponsive: dead by suicide. I'm not one to talk about celebrities I know nothing about, but since these events I have been bombarded with questions about suicide, so I thought I might take this opportunity to talk about a darker mental health topic that probably isn't addressed near as much as it should be.
Again, darker, not oft talked about...it's not something terribly pleasant to think about, but it unfortunately does happen, and no, I don't ordinarily speak about it unless my patient either is having suicidal thoughts, or knows someone that committed suicide. So I thought I would attempt to address some common questions/thoughts on the issue.
So...What is it?
Sounds like a dumb question, as we all know that suicide is the killing of self, but there is so much more to the answer. For instance, here in the United States, did you know that overall, women appear to attempt suicide more frequently(3 women to 1 man, I believe) than men? But men are more likely to succeed? How about that Montana has the highest suicide rate in the nation, and that New Jersey has the least? Or how about that men most frequently use firearms, and women most frequently use poisoning of some kind? I mention these because we can speculate as to why and what exactly drive these statistics, but my point is that so much contributes to self harming behaviors that to look at numbers like this and think you understand would be missing the point.
Suicide, above all else, is a complete ignoring of a human being's instinct to self preserve...that drive to keep oneself alive. So the question one has to ask, is why?
When I worked at the inpatient mental health unit, I spoke alarmingly often to patients who had attempted to kill themselves. During these conversations I heard almost everything, from “I didn't mean to”, to “Why did you save me?”, to “Guess I don't know my anatomy as well as I thought”, to “I thought that drug mix would surely kill me”, and even “I guess God wants me around for something.”
For those of you who have never had thinking like this, let me attempt to answer the “why.”
Right or wrong, they feel it is the only way out.
Have you ever felt so guilt ridden over a mistake that you just couldn't stand the thought of it, much less the judgment or condemnation from friends and family? Have you ever had something happen to you that you felt was so horrific that your mind was flooded with thoughts so uncomfortable that you felt the only way out was to die? Feel like a burden to family and society? Feel like you don't belong? How about having something like schizophrenia, depression...or even a chronic medical condition that was just too much to bear?
These thoughts are real.
If you hear someone talking about how they don't want to live, or that things would be better if they were dead, or, God forbid, they leave a note or start to enact some plan to die, these people are crying for help. For goodness sakes, don't invalidate them by telling them they're being stupid or that they aren't making any sense. Anyone who does the above has a very genuine problem of some sort that they need to work out.
Yes, I do know that some folks just seem to want to die and you can't stop them. It happens. It sucks. It's something I hate with a red bloody passion, but it's a reality I can't get around. It doesn't mean we can't help.
Again, these folks are crying for help. They want the pain to stop. So what can you do?
1. Talk to them
Don't try to understand in that moment. You may not be able to. If you can get them talking, get them talking. You just might be able to talk them down. Don't argue with them, but listen. Give encouragement. Ask them if you can do anything. Stay calm.
2. Get help
This could involve staying with them and not leaving until you know they're better, or that they're going to a hospital or a counselor or psychiatrist for help. It could also involve calling the police/ambulance to get them to the hospital.
3. Be there for them, or find someone who can, after they get stable.
Even if the affected person is your child, spouse, brother, sister, etc., don't think you have to do it alone. Some of you may not be mentally and emotionally equipped to deal with this. It's ok if you aren't. You don't have to be superman/superwoman. If you don't feel up to the task, that's what psychiatrists, psychologists, and counselors are good for. You can also get educated if you are going to be that support person.
For education in this area, the best primary resource(s) I can suggest are a series of books on the topic by Thomas Joiner. The theory is called “The Interpersonal Theory of Suicide.” It's our best working theory.
Below are some additional resources that you might find useful.
National Suicide Prevention Hotline 1-800-273-8255
Please Call if you need help.
Great resource to get educated on mental illness. They also have local representatives who are more than happy to speak with you.
If you're here local in the Kansas City Area:
Research Psychiatric Center-Kansas City 816-444-8161
2323 E 63rd St Kansas City, MO 64130
During normal working hours Monday-Friday, you can just walk in the door and ask for help. You can also go to the Research Medical Center Emergency room after hours. Or, just go to your nearest emergency room.
Whether you know someone in this state of mind, or are thinking about hurting yourself, there is help available. Don't give up. Call one of these numbers. It might save a life.