This article contains sensitive or potentially triggering content related to suicide. If you are struggling with suicidal ideation, please call the National Suicide Prevention Hotline at 1-800-273-8255.
This has been an incredibly tough and triggering week, especially for those who struggle with mental health issues, suicidal ideation, self-harm or are mourning the loss of someone from suicide. With the tragic deaths of Kate Spade and Anthony Bourdain, we are reminded that these issues do not discriminate and that mental health is something that needs to be prioritized.
Unfortunately, there is still a great amount of emotional invalidation, stigma, and shame surrounding the topic of suicide. That’s why it’s so important to continue the conversation.
It’s important to talk about why suicide attempts and ideation occurs. It’s important to destigmatize the suffering of those who may be shouldering their pain in silence. It’s important to be mindful of how we treat those who choose to share their struggles and to be mindful that not everyone may not be as open in coming forward or reaching out for help.
Here are five reasons why people attempt suicide and how we, as a society, can be more mindful of how we engage in this dialogue:
1. Perceived burdensomeness and depression.
Perceived burdensomeness is the feeling of being a burden to others and it places already vulnerable people at an even higher risk of suicide. Depression and mood disorders are one of the number one risk factors for suicide, and they can skew your perception of reality, leading to an amplified sense of perceived burdensomeness.
What people don’t understand is that suicidal people aren’t acting out of selfishness – on the contrary, they feel that the world would be better off without them. They are struggling with feelings of isolation, worthlessness, shame and a strong desire to end the pain they’re feeling. So the next time you feel tempted to tell a suicidal person in a judgmental or guilt-tripping way what they would be leaving behind and who they would hurt, remember that their willingness to leave everything behind is actually an indication of how severe their pain must be.
What to do: Don’t tell them they’re being selfish, or say, “But you have so much to live for!” or “How could you even think that way?” Yes, they do have a lot to live for, but the truth is, someone who is suicidal is not in the state of mind to feel that way and this can come across as invalidating. Invalidation and judgment can cause this person to further withdraw, feel like more of a burden to their loved ones and feel ashamed of their feelings.
Instead, do let them know that you’re there for them if they need it. Do tell them that you care and love them. Do make them feel like they matter and that their recovery matters. Spend time with them and make time for them. Refer them to helpful resources. Note what you most love and cherish about them. The key is to remind them that their existence is valuable and has a positive impact, without guilting or shaming them about their authentic emotions.
2. Their pain outweighs their sense of hope or coping resources.
There are many complex reasons and factors that go into a suicide attempt, but possibly the most simple way to explain it is that the individual’s perception of their pain outweighs any hope they may have for the future.
Yes, it does get better and there is support out there – but that doesn’t necessarily mean the person in question feels that way. The reality they may be living in might be quite different from the way you perceive their life from the outside.
It’s easy, for instance, to look at a successful, seemingly outgoing and happy person and think that they are doing okay. But we honestly have no idea what people go through – whether they’re suffering from depression, acute loneliness, anxiety, or another mental health issue that may be affecting their day-to-day functioning. Until you’ve been in a suicidal person’s shoes, it can be difficult to discern how excruciating their pain might feel.
What to do: Be a supportive, listening ear and offer encouragement from a non-judgmental stance. Avoid saying judgmental things like, “I would never kill myself over something like that” or “That’s a small issue” if they bring something painful up. This is their pain and you have no right to invalidate it.
What is painful to one person may not be as painful to another, but that can be due to a number of factors such as the presence of a trauma history, a history of depression or differences in personality.
Do find ways to remind them of how loved they are. Let them know how important they are to you. If you don’t understand their pain, it’s okay to say, “I am not in your shoes so I have no idea how terrible that must feel. I am so sorry you’re feeling so much pain. I am here for you. What do you think would help you most today?”
3. A history of trauma or complex trauma.
One of the factors I rarely see mentioned in the dialogue about suicide prevention is the presence of a complex trauma history. Yet research has told us that those who have four or more adverse childhood experiences are twelve times more likely to be suicidal. Early childhood trauma can literally rewire the brain, making it more vulnerable to stress and pain in adulthood. When one trauma is layered upon several other traumas, it can cause the person in question to feel as if the pain will never end. When one suffers from the symptoms of PTSD or Complex PTSD, suicidal ideation can enter the picture quite easily.
When someone has been terrorized again and again, it can lead to a sense of learned helplessness in which the person feels unable to escape their adverse circumstances. Knowing this, people should realize that they cannot judge someone’s suicide attempt as selfish. You have no idea what they have been through nor do you know what factors later exacerbated the traumas they experienced.
What to do: Give them the space to share their story, only if they want to – and let them know you’re always there to listen if they feel comfortable doing so. Let them know you’re there for them no matter what. Acknowledge any adverse circumstances they may have been through that you may be aware of. Research the effects of trauma so you are equipped with a better understanding of why a person with a trauma background may be feeling this way. This will help you to give compassion without judgment.
4. A history of abuse.
While this factor is inextricably connected to “a history of trauma,” it needs to be emphasized. Research has shown that domestic violence survivors are at a higher risk of suicide, with 23% of domestic violence survivors having attempted suicide. This includes not only physical abuse but also emotional and verbal abuse. The tragic suicide of Jessica Haban illustrated the ways in which domestic violence could take a person’s life all while leaving the abuser’s hands clean.
What to do: If you suspect someone may be a victim of abuse and is suicidal, refrain from judgment on both fronts. Abuse survivors already struggle with deep feelings of shame due to stigma of society. Again, we have no idea what happens behind the closed doors of another person’s life. Someone may be an abuse survivor and you may not know it.
Remember that abusers manipulate, coerce, threaten, stalk and harass their victims even after the relationship has ended, so it is not always easy to leave. If someone reveals to you that they are in an abusive relationship and that they are feeling hopeless, it’s important to be validating and understanding.
Let them know that that help and support is out there should they need it, and that while it may be difficult, they can create a better life for themselves without their abuser. Don’t try to pressure them to leave if they’re not ready – instead, provide them with resources and emphasize that they are not alone in this.
5. Struggles with addiction.
Addiction can be a silent killer and is another leading cause of suicide. Not only does substance abuse increase the likelihood that someone will attempt suicide, it may even be used as part of the attempt. When people are under the influence of drugs and alcohol, their inhibitions can be lowered, their impulses can run the show and any existing mental health conditions can also be exacerbated.
What to do: Like the other factors mentioned, it’s the stigma that prevents people from getting help or reaching out. Learn the signs of addiction. If you know someone who has addiction issues, be mindful of the fact that they may be suffering in ways you may not know about.
While you cannot fix the addiction for them or take responsibility for it, you can encourage them to get help and help them remember that they are absolutely worthy of getting quality care. Find healthy, sober activities you can do together that place a focus back on self-care. Remind them that you’re here for them and you support their commitment to treatment and recovery.