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Let's Talk About Suicide

Suicide is a growing epidemic, not just in the United States, but all around the world.  In the United States alone there is an average of 123 completed suicides per day, with 25 times that amount of non-completed attempts.  Those with the highest risk of completing suicide are older white males, although women are four times more likely to attempt suicide than men.  Through my years as a psychologist, I have encountered patients with various levels of suicidal thoughts and tendencies.  I think that it is important to discuss suicide this week because of how prevalent it has been in the news recently, and how much I know it weighs on each of our minds.

Suicide often correlates with depression, but not everyone who is depressed is suicidal and vice versa.  In addition to depression, suicidal thoughts and actions are often correlated with terminal or chronic illnesses, and other serious life stressors.  However, when someone is deeply depressed, it is less likely that they will attempt suicide because it requires more emotional effort and focus then they are able to muster.  If you know someone who had been depressed and then suddenly seem to be in a good mood, or if they begin giving away their possessions, writing wills, etc, they may be planning to commit suicide.  In this case, they will appear happier because they believe that their suffering will soon be over.  If this is the case, I suggest you work with them to find a therapist or check them into a psychiatric ward until you know they are safe, if possible.  Most fundamentally, you always want to convey a sense of nonjudgmental support, and let them know you care for and want to understand them: this will increase the likelihood that they will feel safe and supported by you, and also be honest with you about what is going on with them.

There are many thoughts and feelings that go along with suicidal ideation. Perhaps the most fundamental cognition is hopelessness: someone who is suffering may believe that things will never improve, or that their suffering will never decrease. They may also feel they don't fit in anywhere, and that they are unable to socialize or relate to other people.  While some people can be content being alone, when someone is unable to engage in their life or find meaning in anything they do, this correlates positively with depression and hopelessness.  When I encounter someone struggling with hopelessness, I first empathizing with their struggles, acknowledging how much pain they are in and how difficult this is.  I am also sure to ask them what evidence they have to support this belief.  Invariably, they are endorsing a cognitive distortion called "fortune telling" - assuming that one knows precisely what the future will hold - and when we are depressed, we assume that the future invariably holds negative things for us.  I can then discuss with the possibility of a better future, and sometimes even the slightest rational possibility of feeling better can give them hope.  

I want everyone reading this to know that suicide is not the answer.  There are people who want to help you, and your future can improve with time and proper treatment, usually quiet significantly.  No matter how much you are suffering things can always improve.  If you, or someone you know is suffering to the extent that you feel that you need professional assistance I, or one of the other therapists at the practice, would be happy to help you.