Thoughts on National Suicide Prevention Month

This post is about suicide. This is Part 1 of a 2 part blog on suicide. If you or a loved one are having suicidal thoughts, please call or text 988, a suicide and crisis hotline. In Colorado, you can also call 844-493-8255 or text 741741.

September is National Suicide Prevention Month and September 4-10 is a week dedicated to suicide prevention. All though suicide affects people at all times of year, this is a time to raise awareness, spread hope, and provide education related to suicide, an often taboo topic. Suicide is a taboo topic, yet many of us have lost someone to suicide or have had suicidal thoughts. This is a month to reduce stigma and shame and listen to people’s personal experiences. Suicide is preventable and by raising awareness about suicide, the hope is to save lives.

Suicidal thinking is common though not normal. It is often the result of an untreated mental health condition, but there are other risk factors too. The pandemic, political divisiveness, inflation, and increasing rates of substance abuse are compounding the problem. The CDC reports that twice as many people had serious suicidal thoughts during the pandemic. 79% of suicides are completed by men and transgender people are 9x more likely than cisgender people to attempt suicide at some point in their life. Colorado and surrounding mountain states have some of the highest suicide rates and lowest rates of people accessing mental health care. Interestingly, 9 out of 10 people who attempt and survive suicide do not go on to die by suicide, showing that intervention and change is possible. We need to hope and actively work to decrease these numbers. Suicide is devastating for loved ones and takes people’s lives far too early.

Understanding the Individual Impact of Suicide

For people who have never experienced suicidal thoughts, it can seem unimaginable to want to end one’s life. For people who experience suicidal thoughts, continuing life feels unbearable. For people who have lost a loved one to suicide, the pain is personally difficult and has a ripple effect.

Suicide prevention has been important to me in my career and personally. My career has included working with youth who were experiencing homelessness, working with youth and families in a crisis center, and working on a crisis team for a major healthcare provider. As a trauma therapist, I’ve worked with too many people who have lost someone to suicide and I too have lost friends to suicide. All of it has been heartbreaking to be honest. It has also been rewarding to see people recover from suicidal thinking.

Some things I’ve learned from all of this is that the person experiencing suicidal thoughts often feels like a burden, they feel extreme despair, hopelessness, can’t see solutions, are usually going through some life stressor, and they want to end their suffering. Usually, people don’t want to die, but they don’t have the will to live. Sometimes, people have intrusive thoughts about suicide and it is like a switch was turned on in their brain. What I’ve also learned is that if people have some basic support, compassion, and can see their value, thinking about suicide is often temporary. On more than one occasion, I’ve witnessed the relief that has come when a person has been able to share they feel suicidal, when they have another person to witness their pain, and help them find solutions other than suicide. I’ve also seen people recover quickly with individual therapy, family support, group therapy, and medication.

Like all mental health problems, suicide has a cultural and societal component to it as well. Particularly when I worked with youth experiencing homelessness and at the crisis center, it was obvious how much our systems were affecting these young people and leading to suicidal thinking. Poverty and financial crisis is an obvious stressor. With the youth, many well meaning parents were working 3 low wage jobs to make ends meet, making the young people feel neglected or have too much responsibility. Pressure to be the best, to get the highest grades, get into the best college, etc, was also a common stressor I saw. The hustle and grind culture is not healthy for the psyche. Discrimination and structural racism play a huge role in access to basic needs, mental health care, and suicide. Years of ongoing trauma and the same things that lead to ongoing trauma are also risk factors for suicide. Physical health, chronic pain, and aging in a society that doesn’t care for the elderly is a factor in high suicide rates. As a society, if we want to reduce suicide, we need to do a better job of making sure all people have a living wage, housing, healthcare, support, and purpose.

Suicide is commonly associated with diagnosable conditions like depression, post traumatic stress disorder, anxiety, schizophrenia, and bipolar disorder. Left untreated, people with these conditions might feel suicidal and are at higher risk. From a less diagnostic, internal family systems perspective, we all have protective parts that serve some purpose within our system. As Frank Anderson, an IFS expert, puts it: “suicidal parts tend to show up when the pain is high and the access to love is minimal or nonexistent”. With a therapist, you can get curious about this part and explore what it’s purpose and intention is. Generally, we can all be curious and compassionate around someone’s suicidal thoughts and feelings while also addressing safety.

Even with compassion and curiosity, it isn’t easy to lose a loved one to suicide. It is devastating to lose a loved one who didn’t see their own value or future ahead of them. People often feel guilt, survivor’s guilt, and are left wondering what else they could have done to prevent this. There is anger that the person didn’t get help or “did this to everyone”. Sometimes it feels like the person was selfish and took the easy way out. There is often confusion. It can also be traumatic for people and I remember the ongoing anxiety when my friends were thinking about suicide. I lost a friend to her depression, 10 years ago, and I think about her all the time. I still wonder what I could have done differently, why her life was so painful, and what she would be like now. The world doesn’t get back any of the people we’ve lost to suicide, but we can be informed and part of the solution.

Things you should know about suicide

Suicide is often, but not always, the result of an untreated mental health condition including depression, anxiety, ptsd, substance use disorders, and other conditions. Not all people with mental health conditions have suicidal thoughts. Not all people who die by suicide have mental health conditions. Suicidal thoughts can also be caused by relationship problems, personal crisis, and life stressors.

Language matters. People used to say committed suicide which is like saying someone committed adultery or a crime, and can be stigmatizing. We now say died of suicide, much like we would say died of cancer. Suicide is not cancer, but unbearable pain and if someone dies of this, they have died of their unbearable pain and sometimes of their mental health condition. This language matters. It influences our attitudes, behaviors, and people’s willingness to seek help.

Suicide is not selfish or the easy way out. People having suicidal thoughts don’t want to die necessarily. They want to live, they want their suffering to end, and don’t see a way to do that. A person who has suicidal thoughts or dies by suicide often has distorted thinking. They often believe they are a burden to others and that suicide will relieve others of this burden. Last, suicide is often impulsive, rather than a calculated move to hurt others.

Talking about suicide does not lead to suicide.  Talking about suicide reduces stigma and opens up a conversation so the person can get new perspective, seek help, and share their story with others. Talking about it reduces the shame and allows us to approach suicide with compassion. It also increases the chances that someone will seek help. Thoughts of suicide come from inside a person’s brain, not from others.

People who talk about suicide are not simply attention seeking. Even if the person was seeking attention, there is probably some reason for that. It is always important to take people seriously when they talk about feeling suicidal. People who die from suicide have often told someone about their thoughts. When talking with someone, please be kind, sensitive, and ask direct questions including “Do you want to hurt yourself?”, “Do you have a plan to hurt yourself? “, “Do you have access to firearms, medications, or other items to hurt yourself”.

Suicide is preventable. Interventions including therapy, crisis services, and support groups do work. Other things that do prevent suicide are locking up firearms and medications. In the case of young people, adult supervision and a youth knowing that an adult is available can help prevent suicide.

Protective Factors include:
Access to mental health care and caring for one’s mental health.
Feeling connected to family and community
Limited access to lethal means
Cultural/religious beliefs that encourage connection, self esteem, and seeking help
A future orientation

Risk Factors include:
Mental and physical health conditions including pain, substance use, and traumatic brain injury.
Access to lethal means
Prolonged stress like bullying, harassment, relationship problems, and unemployment
Stressful life events such as rejection, divorce, loss, and trauma
Exposure to someone’s recent suicide, family history of suicide, and previous attempts
Abuse, neglect, and trauma

Suicide does not happen without warning. In fact, there are almost always warning signs and risk factors. If someone suddenly changes their behavior, is giving away items, and saying goodbyes, this may be a warning sign. Their mood may also suddenly change and look like depression, anxiety, loss of interest, irritability, shame, agitation, or relief.

Warning Signs:
The person talks about:
Killing themselves
Not wanting to be here
Feeling hopeless
Having no reason to live
Being a burden
Feeling trapped
Feeling the pain is unbearable

Increased substance use
Searching online about suicide
Withdrawing from enjoyable activities
Isolating
Sleeping too much or too little
Aggression and agitation
Giving things away and saying goodbyes
Relief(because the person has decided)

Support
Support can look different for everyone. If you have thoughts of suicide, have lost someone to suicide, or are supporting someone who struggles with suicide, support and care is important and available. Some people find support in therapy, individually or as a family. Others like to meet in groups or reading and podcasts can be helpful. Talking about suicide with a friend, family member, stranger, or therapist can be scary for the person who has suicidal thoughts. People fear being judged, burdensome, or being hospitalized. It is best to encourage someone to seek support in the way that feels good to them and have compassion for how difficult it can be to seek support.

If you or a loved one needs immediate support, please call 988 or 844-893-8255 in Colorado. If support through therapy is something you are curious about, I am here to answer questions about suicide and would love for you to reach out for more information and resources.

I work with suicide through a trauma informed approach. I am not quick to contact emergency services or hospitalize someone. Instead, I want to hear your story. I want to listen to your reasons for not wanting to be here and find the reasons to keep living. For loved ones, I will help you gain some clarity, peace, and support you supporting your loved one. Therapy is also an opportunity to do deeper healing and decrease your suffering. I am also happy to connect you to other resources if therapy with me is not right for you.

In the next post, I’ll share more about what you can do if you feel suicidal and how to help when a loved one is feeling suicidal.