We Need To Talk About Suicide

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“The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.” ~ David Foster Wallace

This post is to mark World Suicide Prevention Day, but before I go any further I’d like to point all readers who are interested in this subject in the direction of this awesome TED Talk by JD Schramm, who does the subject far more justice than I can hope to.

I think I’ve done at least as much as my fair share of raising awareness of suicide this year. Firstly by talking to lots of people about my work for Samaritans, and secondly when I started telling pretty much anyone who’d listen that I’d become suicidal myself, had been hospitalised with suicidal ideation, and had taken overdoses.

Discussion of Samaritans has mostly provoked interested questions. Many people assume that all the calls to Samaritans are people who are either in the act of or on the verge of suicide, and believe that the role of a Samaritans listening volunteer would be too much to handle.

This is far from the case. I’ve listened to quite a few people who have been thinking of committing suicide within the next hours or days, but in my year as a volunteer – I’m currently on hiatus – I never took a call from a suicide in progress.

Many callers were people who struggled to cope with mental health issues or other major problems in their lives, and they seem to find that speaking to Samaritans provides much-needed support to prevent them from reaching the ultimate suicidal stage.

There are also an awful lot of ‘snap’ calls. Which is where the caller hangs up without actually speaking to you, presumably because they lose the courage to reveal their feelings to a faceless stranger.

I also had a few inappropriate calls to deal with, but I get those in my day job.

New Samaritans have to undertake a three-month training program before they are let loose on unsuspecting callers. One of the points addressed in that training helped me to identify why it is that some people tend to struggle to find the words to discuss with you your own thoughts of suicide.

That is that many people are afraid that by talking about the idea of suicide, or asking if someone has contemplated, or even planned their own suicide, they might inadvertently cause a suicide. That they may somehow implant an idea into someone’s head that wasn’t there before and make it sound like a legitimate option.

If you are one of those people I am here to assure you that this is not the case. You will not increase the likelihood of someone committing suicide by discussing the issue of suicide with them. 

You may inadvertently increase the risk of someone committing suicide by refusing them to let them be open with you about the fact that they are experiencing thoughts of suicide.

If people feel isolated with their feelings of despair and fantasies of ending it all by taking their own life, if they fear that there is no help available and that there is no hope for improvement in their lives, this can increase the risk of an actual suicide.

I appreciate that it can be very hard to find the words to discuss the subject of suicide, especially if it is not an issue that you are familiar with tackling. You want to be able to say the right thing, you desperately want to avoid saying the wrong thing. It can seem safer just to say nothing at all. But at the end of the day, the words you use will have less of an effect than whether or not you chose to listen and offer support.

If somebody is at the point where they are thinking of, or planning to, take their own life then the situation is already as bad as it can get. You cannot possibly make it worse. There is no lower point for this person to reach, they are already at rock bottom.

So just say something. Anything. The first words that come into your head. If nothing comes try opening with these:

• ‘Okay, I’m not sure exactly how you want me to approach this, but I’m here to help, what can I do?’
• ‘Have you made any plans to take your own life, or do you feel like you can see yourself doing so very soon?’
• ‘How long have you been feeling like you could be suicidal? Have you spoken to a doctor about this?’
• ‘How would you feel about us getting you some help if I come along to support you?’

If the person decides that they do not need to seek help immediately it might be a good idea to arrange to check in with them at a pre-arranged time. Or for you to agree to check up with them that they’ve at least made an appointment with their doctor, and offer to go with them.

When I was suffering with suicidal thinking it helped me a great deal to have a number of people who either checked up on me or asked me to send them regular updates to let them know that I was still alive. In a way that it may not be possible to relate to unless you’ve been there, it broke the time down into more manageable chunks.

Instead of feeling oppressed by the painful enormity of having to live another forty, fifty, sixty years even, enduring the same degree as of pain and hopelessness as I was currently experiencing, I was able to set myself the more manageable goals of making it through long enough to give the next update.

I know there may still be a few people reading this who struggle with this advice, as there were people who struggled to handle my situation, because they can’t get past their own idea that suicide is selfish. Or because they believe that people who are really going to take their own life will just get on with it, and that people who talk about it are somehow not serious about it, or are only seeking attention.

I’ll address the second point first because I think that it is the most pernicious.

The belief that people who are really suicidal just get on with is demonstrably untrue.

If every single person who had ever decided to take their own life had bottled up their feelings, sharing them with no one, and just plowed determinedly ahead with their own plans, then there would be no Samaritans. There would be no Nightline. There would be no network of suicide prevention hotlines the world over. Because they wouldn’t work, they wouldn’t be necessary.

There would also be no Mental Health Crisis Teams, nor legislation allowing doctors to place patients under a ‘section’, ‘psychiatric hold’, or whatever other term is used in your country.

As to whether or not people who talk about suicidal feelings are doing so for attention, that’s a slightly more complicated question.

Was I seeking attention when I first approached my friends and told them that I was worried by these overwhelming feelings that I was having that it would be better if I wasn’t alive any more, and that I had made plans to take my life?

Absolutely.

I wanted attention. I needed attention. I needed someone to pay attention to the fact that I needed help.

I had a life threatening mental health condition for fuck’s sake!

And I’d decided that the best chance I had of surviving my condition was to have as many people who I trusted as possible looking out for me to make sure that I was alright. In much the same way as everyone in the room will watch a small child to make sure that it doesn’t accidentally do anything dangerous.

At times my thoughts of suicide were so strong that I genuinely, completely forgot that taking two hundred tramadol pills or slashing your own wrists are generally considered to be really bad ideas.

And as to whether or not people make false reports of suicidal ideation in order to gain attention, well, there’s not much I can say for certain with regards to the frequency of such occurrences, being that I’m not a doctor or a researcher.

What I can say is this.

I have your attention.

I’ve had your attention for a good five minutes now. And all it took me was to sit down down with my laptop for half an hour and write pretty much the first thoughts that came into my head.

And I don’t even know you.

It’s not difficult to get people’s attention. Most of us do it without thinking at least several times a day.

Every time we purchase something in a store, show up for work, make a phone call to a utility company, send out an email, drop round to visit friends or family, we get their attention.

So why would anybody go to the bother of inventing suicidal ideation to get yours?

If they feel that to be necessary does it not, for the most part, suggest that either;

a) this person nevertheless has some serious issues that really need to be addressed through the appropriate treatment or support,

or

b) that you really need to reexamine what it is in your own behaviour that would make someone close to you feel that it was necessary to go to such lengths to get your attention?

I would also hazard a guess that you aren’t a doctor either and are in no better position to judge whether a person is genuine than I am. So do you really want to place your bet on a vicarious game of Russian roulette on the basis of ill-informed, uneducated guess work? I know I wouldn’t.

Now, to come back to this idea that the act of suicide is inherently selfish.

Well, I became suicidal because I had a chemical imbalance in my brain. I don’t know that it’s possible for a chemical imbalance to be selfishly acquired. But people did suggest this to me when I raised the subject of my illness, so I did give it some consideration.

And the conclusion that I came to was that, yes, in some ways suicide is selfish. In that, at the times when I was seriously contemplating suicide the only thoughts that I had were for myself, my own feelings, and the prospect of my own, as I saw it, intolerable future.

The definition of selfishness is after all – ‘characterized by or manifesting concern or care only for oneself’.

But I think it’s only selfish in the same way that someone who has just been run over by a car is  selfish. At the particular moment of having been hit by a car that person’s primary concern is for their own injuries; their own need for treatment and pain relief. And given the circumstances their self absorbency is entirely legitimate.

I think that’s ultimately how I reconciled my own belief that I was being selfish with the fact that I was on the internet every day researching ways to kill myself. I found living to be unbearable, I could not stand the thought of having to continue feeling the way I did for the rest of my natural life, and so I felt that it was perfectly reasonable for me to seek a way out of my misery.

In fact I started to think that everyone else was being selfish in wanting me to continue living when I hated it so much.

If that sounds crazy to you, it probably is. Did I mention that I had a chemical imbalance in my brain at the time that was stopping it from working properly?

That being said, I did refrain from killing myself at my lowest point because it coincided with the death of a friend’s mother. I thought that it would be unfair to put him through two bereavements so close together. And because, despite all that I said earlier, I was worried that I would push another friend who was experiencing depression over the edge into taking her own life as well.

I’m not telling you this to suggest that you should start trying to emotionally blackmail any one who approaches you and confides that they are suffering with thoughts of suicide. But giving them someone or something else to focus on, or some reason to hold on at least long enough to see a professional who can help, might not be a bad idea.

Of course this post is no substitute for qualified medical advice. If you are reading this and worried about either your own thoughts of suicide, or concerns that someone you care about might be suicidal, please seek help from the your local emergency medical facility.

If you are someone who has suffered with thoughts of suicide in the past you may find The Ten Minute Suicide Guide entertaining. I think it can be best be described as a satirical look at suicide. It has actually kept me from hurting myself on more than one occasion.

And for anyone else I hope that I have done at least a little to either inform you about suicide or make the subject a little less scary.

If you have any comments or questions please feel free to share them.