We Need to Talk About Suicide Prevention.

**Trigger Warning** This piece discusses suicide and suicidal ideation, and some people might find it disturbing. If you or someone you know is suicidal, please, contact your physician, go to your local ER, or call the suicide prevention hotline in your country. For the United States, the numbers are as follows:

The National Suicide Prevention Lifeline at 800-273-TALK (8255), or message the Crisis Text Line at 741741. Both programs provide free, confidential support 24/7.

September is Suicide Awareness month with September 6-12 being Suicide Prevention week. It is time to begin an open and honest dialogue and examine suicide. This piece shall do just that, start the conversation about suicide and how to prevent it from happening to you or your loved ones.

You Do Not Want to be Counted in These Statistics

Suicide is not relegated to one demographic group over another. People of any color, country, and occupation have died and continue to die by suicide every year.

According to the Centers for Disease Control and Prevention (CDC), in the United States, suicide is the tenth leading cause of death for all ages. Also, suicide is a major contributor to premature death. Sadly, suicide ranks as the second leading cause of death for people 10-34, and the fourth leading cause of death for people 35-45.

Between the years 1999-2018, the suicide rate in the United States increased by 35%. This increase adds up to a rate increase of approximately 1% per year. However, with the onset of COVID-19 and all that has come with it to shock the world, this projected increase may be dwarfed.

Women had the highest suicide rate between the ages of 45-64, with males dying highest at between the ages of 75 and over. Also, in 2018, the suicide rates were higher in rural counties than in urban counties for males and females.

Why Do People Die by Suicide?

First, it is not ‘commit suicide’ because the people who die by suicide are not committing a crime. Instead, they have fallen victim to many health concerns, including:

• Depression
• Psychosis
• Bipolar disorder
• Borderline personality disorder
• Having had a heart attack
• Having had open-heart surgery
• Substance abuse disorders
• Postpartum depression
• Bullying

The above list is only a partial list of the health conditions that can cause someone to die by suicide.

What Suicide is Not

Contrary to popular belief, suicide is not an easy way out. There is nothing easy about doing self-harm that leads to death. The bottom line is that those who die by suicide or attempt to aren’t bad people. They who attempt or complete suicide are victims of a tragic thought process that tells them there is no other way out but to die.

Suicide is not a selfish act. It may feel that way to those they leave behind because of the pain suicide causes, but their loved one wasn’t thinking clearly at the time they died. I can guarantee that the pain and suffering they would leave behind was not at all on their minds.

It is the same with thinking that those who attempt or complete suicide are trying to get back at someone. This thinking is ridiculous because, again, the person isn’t setting out to get revenge; they just want the pain to stop.

The Signs Someone is Thinking About Suicide

It is impossible to predict all the signs of an impending suicide. In no way are you responsible for the death of a loved one by suicide. They have made a choice, not you. However, there are signs you can watch for to help prevent the tragedy of suicide from visiting your home or life.

Self-Harming or Dangerous Behavior. If someone you know or love exhibits dangerous behavior such as engaging in unsafe sex, increased use of drugs or alcohol, these could be potential signs of an impending suicide. This statement is true because all are signs that the person no longer values their life.

Excessive Sadness or Moodiness. These symptoms may include feeling sad for a long time (usually more than two weeks), mood swings, and rage that is unexpected and out of character.

Feeling Hopelessness and Helplessness. Victims may feel like their life is out of their control, bringing on extreme feelings of being hopeless and helpless.

Sleep Disturbances. Having the inability to get to sleep or stay asleep can be a sign that someone is thinking about suicide. Sleeping too much is also a sign.

Changes in Attitude. Behavior, or Appearance. People considering suicide may show a change in their attitude or behavior, such as moving and speaking slowly. They may take less care of their appearance.

Threatening or Talking About Suicide. It is a myth that people who talk about harming themselves will not. From 50%-75% of those considering dying by suicide tell a family member or friend. Every threat of suicide must be taken seriously. That having been said, it is critical to remember that not everyone who considers suicide will speak about it beforehand. Also, not all people who speak about suicide follow through or attempt it.

Withdrawal. Choosing to avoid friends and social activities while remaining alone is a possible sign of depression, which is a leading cause of suicide. Watch for loss of interest or pleasure in activities they previously enjoyed.

Making Plans to Die. People who are considering suicide will often make plans and put their personal business in order. This behavior may also include giving away possessions, cleaning their room or home, or visiting with estranged family members or friends. Another sign could be that your friend or loved one suddenly decides to purchase a firearm.

Recent Trauma or Loss. A major crisis in one’s life might trigger suicidal thoughts and actions. These crises may include (but are not limited to) the following:

• Divorce
• A break-up
• Death of a loved one
• Death of a pet
• Receiving a traumatic diagnosis
• Loss of a job or career
• Financial problems

A calmness that Happens Suddenly. After a period of moodiness, anger, or depression can be a sign that the person might have made the decision to die by suicide.

Suicidality and COVID-19

The sudden onset of COVID-19 has become an international concern when it comes to behavioral health and suicide. Isolation, fear, and anger have overtaken many people who considered themselves to emotionally healthy.

Because humans are social creatures, the isolation of the lockdowns associated with COVID-19 has made people vulnerable to depression and other mental health disorders. People have begun to use substances to cope, which only makes depression and anxiety worse.

There are many personal and family situations where COVID-19 has caused major concerns that can lead to suicidal ideation or actions. These include:

• Fear that you or a loved one will catch COVID-19
• Grief over the loss of a loved one or friend to COVID-19
• Being at home with the family due to stay-at-home orders
• A sharp increase in child abuse and domestic violence
• Suddenly being unable to visit with family or friends
• Having no chance to be with a loved one who is seriously ill or dying
• Exacerbation of mental health issues such as major depression, bipolar disorder, post-traumatic stress disorder, complex post-traumatic stress disorder, etc.

Many people also face uncertainties related to their work, including:

• The anxiety that the job will no longer exist because of the economic downturn
• Working in a short of staff situated in a nursing home or hospital
• Experiencing burnout
• Not having enough money to buy food or provide shelter for the family
• Worry about the financial hardships that may accompany a layoff or loss of a job

As one can see, COVID-19 can increase the overall anxiety of people, leaving them open to suicidal thoughts and actions.

The Greatest Suicide Myth

Perhaps the greatest myth that we must bust is that talking about suicide will lead to and encourage suicide.

The facts are that not speaking about suicide increases the stigma attached to getting help for such thoughts and ideations. Talking about suicide has the opposite effect; allowing those who are would-be victims to understand there is no shame in reaching out for help.

We must talk more about suicide, not less.

It is only by bringing suicide out of the shadows and discussing it openly and honestly that we can gain an even better understanding of how to prevent people from becoming suicide statistics.

How to Prevent the Tragedy of Suicide

While no one has control over anyone else’s choices, many things can be done as a society to prevent suicide.

• Strengthening economic supports
• Strengthening household financial security
• The availability of safe and affordable housing
• Strengthening of access to and the delivery of suicide care
• Better coverage of mental health conditions on all health insurance policies
• The reduction of shortages of mental health providers in underserved areas
• Communities banding together to promote connectedness for everyone
• Peer-run projects such as living rooms and respite centers
• Teaching teenagers about what they can do if they feel overwhelmed and suicidal
• Greater availability of treatment for those at high risk for suicide
• Creating crisis intervention centers that are available to all
• Treating those who have attempted suicide after they leave the hospital

Cancer was once a disease that was kept hush-hush. Those who contracted cancer were shut away because of the shame that accompanied having it. Now we have dinners and fundraisers for cancer victims and openly discuss cancer prevention.

Clearly, prevention of suicide is a daunting task, but we as a society must change the dialogue about this killer just as we have about cancer.

Again, if you or someone you know is talking, thinking, or acting in a suicidal manner, please, get help now. You can call your physician, speak to a pastor, call your local hotline, or call the United States national hotline:

The National Suicide Prevention Lifeline at 800-273-TALK (8255), or message the Crisis Text Line at 741741. Both programs provide free, confidential support 24/7.

If you live outside the United States, contact the suicide prevention hotline in your country.

We need you. You are worthy. We care about you. You are too important to lose to suicide.

“When we accept and embrace our emotions as the way they are rather than what we wish them to be and discover that in the deepest darkest moments, we are okay – this is the true emotional healing. Emotional healing is when you face your worst fears only to realize you are okay. You have no control over what life throws at you, but you have control of how to relate to whatever comes your way.” ~ Susan Wenzel

“Today, I finally recognize the mistake that almost became my downfall: I expected too much out of life. I thought it would owe me happiness and cheerfulness. In fact, life offers neither good nor evil. Happiness is a fruit you cultivate and harvest inside your soul. You cannot gain it from the outside. Why should I be fretful like a child that has got no gift? I have years ahead to be happy.” ~ Shan Sa

If you a survivor or someone who loves a survivor and cannot find a therapist who treats complex post-traumatic stress disorder, please, contact CPTSD Foundation. We have a staff of volunteers who have been compiling a list of providers who treat CPTSD. They would be happy to give you more ideas for where to look for and find a therapist that will help you.

Are you a therapist who treats CPTSD? Please, consider dropping us a line to add you to our growing list of providers. You would not only get aid in finding clients but also you would be helping someone find the peace they deserve.

Shortly, CPTSD Foundation will have compiled a long list of providers who treat complex post-traumatic stress disorder. When it becomes available, we will be putting it on our website www.CPTSDFoundation.org.

Make sure to visit us and sign up for our weekly newsletter that will help keep you informed on treatment options and much more for complex post-traumatic stress disorder.

If you or a loved one are living in the despair and isolation that comes with complex post-traumatic stress disorder, please, come to us for help. CPTSD Foundation offers a wide range of services, including:

• Daily Calls
• The Healing Book Club
• Support Groups
• Our Blog
• The Trauma-Informed Newsletter
• Daily Encouragement Texts

All our services are reasonably priced, and some are even free. So, to gain more insight into how complex post-traumatic stress disorder is altering your life and how you can overcome it, sign-up, we will be glad to help you. If you cannot afford to pay, go to www.cptsdfoundation.org/scholarship to apply for aid. We only wish to serve you.

References

Centers for Disease Control and Prevention. Increase in Suicide Mortality in the United States, 1999-2018. Retrieved from: https://www.cdc.gov/nchs/products/databriefs/db362.htm