***TRIGGER WARNING***

This article will tackle active and passive suicide and may not be suitable for sensitive audiences.

In our first article about self-harm, we tackled the subject with as much kindness as the topic would allow. Self-harm is a sensitive subject that had to be tackled to bring it out of the shadows and into the light where we can understand it and perhaps, someday, make it possible to end it.

Suicide is a topic most people would rather sweep under the rug because we are all afraid of the subject. We fear that talking about suicide will cause someone we love to attempt or complete to die by suicide; thus, we ignore it and have made it into a taboo subject.

This article will tackle suicide head-on and speak not only of active suicidal ideation but also a type of death many do not know exists, passive suicide.

The Importance of Discussing Suicide

Suicide is a horrendously tricky topic to broach; however, not talking about it can have tragic results. However, if we do not bring ourselves to talk about suicide, we will not find active and lasting solutions.

Suicide is the tenth leading cause of death in the United States, killing several thousands of people during the COVID19 crisis. That number is growing. The uncertainty, loss of jobs, worry, and social unrest experienced in the U.S. are stealing the hope of men and women alike who cannot see that there is life beyond where they are standing at that moment.

Talking about suicide matters because it can save lives. It can also help lessen the impact of the loss of a precious life, causing ripples of loss to spread throughout families, friends, and the larger community. The loss of one life impacts everyone, and no one is immune from its influence; no matter who you are, suicide has more than likely passed through your mind at least once.

Suppose we offer hope and empowerment to those who feel self-destructive. In that case, an open and honest discussion about suicide must be held and maintained for good.

Risk Factors for Suicide

According to the National Institute of Mental Health, suicide is no discriminator of persons affecting people of all ages, genders, and ethnicities. While suicidal behavior is complex, there is no single cause with many factors contributing to someone deciding to harm themselves. However, most people share specific characteristics, and below is a list of the main risk factors for suicide.

  • Depression or other mental health disorders
  • Substance abuse disorder
  • Some medical conditions
  • Chronic pain
  • A family history of suicide
  • A history of family violence, including physical and sexual abuse
  • Prior suicide attempts
  • Owning and having guns or other firearms in the home
  • Recently receiving a release from prison or jail
  • Being exposed to other’s suicidal behavior, including celebrities

Many people have some of the risk factors but will never attempt suicide, but it is important to note that suicidal behavior is NOT a normal stress response. People who have suicidal thoughts or actions are under a great deal of extreme distress and are not making a harmless bid for your attention.

Someone talking about harming themselves should never, ever be ignored.

A Brief Description of Active and Passive Suicide

Suicidal ideation is the thought and wants to end one’s own life. Active suicidal ideation takes passive thoughts such as, “I don’t want to be here anymore,” and turns them into potentially deadly actions.

The methods of active suicide are as varied as people who pursue it, such as using a weapon, abusing medications, or driving into oncoming traffic.

Passive suicide is just as dangerous as active suicide because the thoughts and behaviors involved are deadly and can lead to active suicide. Passive suicide is when an individual has thoughts of wanting to die but has no active plan to make that happen.

There are many methods of passive suicide, including going to bed and refusing to get up despite weight gain/loss and the possibility of forming blood clots or breathing problems.

Some signs warn if a person is suffering from thoughts of suicide, they may include the following.

  • Anxiety
  • Saying goodbye to relatives and friends
  • Engaging in risky behavior
  • Giving away precious possessions
  • Actively shopping for ways to kill oneself (medications, weapons, drugs)
  • Increasingly moody or angry
  • Frequently talking about death
  • Expressing that they feel hopeless, trapped, and alone
  • Isolating away from family and loved ones
  • Remaining in bed for most of the day to avoid others
  • Refusing to eat food either in secret or with informing others
  • Not taking vital, potentially life-saving medications

It is vital to remember that neither is less deadly or severe than the other if you or someone you love are having active or passive suicidal ideation. Both active and passive suicide require immediate intervention by a mental health professional.

Although traditionally more women attempt to die by suicide than men, males are four times more likely than women to complete the act. The highest rate for completed suicide is among middle-aged men because they vastly choose firearms as their means, with 50.39% of all suicide deaths.

COVID 19 and Completed Suicides

The COVID 19 pandemic is believed (we have no firm evidence yet) to significantly increase the suicide rate in the United States. We won’t know how much until all the data is in.

According to a paper published in Psychiatry Research, suicide itself is a pandemic and, when added to the pandemic of COVID 19, exasperates the problem. There are six groups of people who are at the highest risk of succumbing to suicide frontline workers, the elderly, the homeless plus migrants, victims of abuse and violence, stigmatized groups, and those in a financial crisis (Banerjee et al., 2020)

While it is impossible to cover every group in this writing, one demographic deserves special attention, frontline workers.

Frontline workers include those at the forefront of tragedy, such as nurses, doctors, and support staff. Frontline workers are the backbone of the United States fight against COVID 19. However, the sickness and death these folks have had to deal with during the pandemic are unprecedented in modern times. Except for the civil war, there have never been so many people dying among the civilian population.

Not only do frontline workers face the fear of catching COVID 19 and becoming statistics themselves, but they must also face the ever-present threat of taking the deadly virus home to their loved ones.

Due to the increased stress and fear frontline workers face, there has been a dramatic increase in hopelessness, guilt, insomnia, and self-blame and a decrease in self-esteem, all of which can be risk factors for suicide.

Suicide responses include surveillance of frontline workers and openly talking about what they are witnessing, how each frontline worker is actually feeling, and open discussion about the danger of suicide for themselves and their coworkers.

Suicide Prevention

Ending the deadly pandemic of suicide has become a number one priority for many cities, states, and the United States government. Too many people are losing their lives because they have no outlet for the intense stress they are feeling.

Ending the scourge of suicide is everyone’s job, and we can all play a part.

Talk about suicide. Don’t be afraid to reach out to a friend who shows signs that they may be thinking about harming themselves.

Know the signs. Knowing the behaviors that exhibit that someone is in deep distress and thinking of dying by suicide is vital in the battle to destroy the enemy of suicide.

Never discount the feelings of those who are suicidal. It may be true that their problems may not seem serious to you; what really matters is how THEY perceive their problems. Listen without judgment to what they are saying and never dismiss their emotions and be there when they express them. Acknowledge your concern and do not dismiss suicidal talk or thinking. Always take suicidal threats seriously and seek help for yourself and them.

Become a good listener. Someone who feels or thinks about suicide needs is someone to hear them and empathize with them. Do not be afraid to ask the hard questions about suicide and openly discuss what your friend or family member should do. Just be there.

Encourage them to get help. While you cannot force another adult to choose to get help, you can firmly but lovingly push them in that direction. Just remember that you are nor were you ever able to control another adult.

Closing Thoughts

It is my hope that this piece speaking frankly about suicide has been a help to you. There are so many things to live for, and bringing self-harm into the open is the best way to heal the wounds that stress can cause and possibly push someone to take desperate measures.

If you feel suicidal or have been having thoughts of self-harm, please, reach out for help today. Your voice is very much needed in this crazy world, and we desperately need you to be part of our lives.

No matter who you are, where you have been, or what you have done, suicide is not the answer as it is a permanent answer to a temporary question.

“Scared and sacred are spelled with the same letters. Awful proceeds from the same root word as awesome. Terrify and terrific. Every negative experience holds the seed of transformation.” ~ Alan Cohen

“Despite the natural belittling of oneself, the doubts, the insecurities, we have to wake up to the realization that we all write our own autobiography, we are the authors of our life story. Realizing that, write a good story with your life and make sure to write yourself as the protagonist. Be the hero of your journey.” ~ Yossi Ghinsberg

References

America’s Health Rankings analysis of CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death files, United Health Foundation, AmericasHealthRankings.org, Accessed 2021.

Banerjee, D., Kosagisharaf, J. R., & Rao, T. S. (2020). ‘The dual pandemic of suicide and COVID-19: A biopsychosocial narrative of risks and prevention. Psychiatry Research, 113577.

Goldsmith, S. K., Pellmar, T. C., Kleinman, A. M., & Bunney, W. E. (2002). Reducing suicide: A national imperative. National Academies Press.

Gunnell D., Appleby L., Arensman E., Hawton K., John A., Kapur N., Khan M., O’Connor R.C., Pirkis J., Caine E.D., Chan L.F. Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry. 2020.

Suicide prevention. National Institute of Mental Health. Retrieved from: https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml

As always, CPTSD Foundation is always here for you if you need to talk or need someone just to listen.

If you are a survivor or someone who loves a survivor and cannot find a therapist who treats complex post-traumatic stress disorder, please contact the 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 about where to look for and find a therapist to help you. Go to the contact us page and send us a note stating you need help, and our staff will respond quickly to your request.

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