Nov. 19th, 2015

sweetmusic_27: A biohazard symbol (biohazard)
Five Uncomfortable Truths About Suicidality

Every year, I post on this topic.  Every year, I want to make mental issues and suicide a little more visible, a little more normal, if only around my little corner of the internet.

Suicide is the act of taking one's own life, and suicidality - the tendency toward or risk of suicide - is an illness like any other. Some people have this sickness temporarily, others fight it their whole lives. In my family, it's hereditary. All too often, it's fatal. It takes over your mind and body and you die from it. When that happens, as a society, we tend not to talk about it too much. It’s a very quiet killer, rendered quieter by stigma, taboo, awkwardness, and misconceptions.

1. It has happened to someone you know.  Around 20-24 percent of adolescents age 12-17 report suicidal ideation.  If you know five people, that means someone you know seriously considered suicide.  It's the eleventh leading cause of death in the United States, and tenth in 2013.  You likely know someone who has lost a loved one to suicide.  People just don't mention it.  We've been taught that it's inappropriate to air dirty laundry, and mental health is dirty laundry.  But 18.5% of adults have a mental illness currently or within the past year, and around 90% of people who commit suicide have a mental illness.

2.  It's not like they show it on TV.  We are often shown someone whose life falls apart, who gets deeply sad, and then winds up clinging to some outcropping on the twentieth floor, crying and being talked down by someone right next to them.

It's not  always a big dramatic realization, or someone whose life has fallen apart.  It's different for everyone, certainly, but many of those affected by depression to the point of suicidality talk about how numb they feel, about how difficult, how not-worth-it things seem.  Yes, some experience a traumatic event - my grandfather, for instance, lost his business and shot himself - and that pain or loss overshadows everything.  But for some, suicidal ideation is more of a constant, a background hum that may get louder or softer, but doesn't go away for months or years.

It doesn't usually happen on the ledge of a building, either.  In 2013, 51.5% of suicide deaths were by firearm, 24.5% by suffocation/hanging, and 16.1% by poison.  Jumping gets lumped into the remaining eight percent.

On TV, the person in crisis gets talked down, and then everything is fine for them forever.  Meanwhile, in the real world, about 20% of people who commit suicide have made a previous attempt.  Mental issues don't just go away in the length of a forty-two minute episode of a drama show.  Therapy, coping strategies, and medication take time and work.

3.  Kids get suicidal.  Not just teens - even three-year-olds experience suicidal thoughts and make attempts.  This is a difficult and painful truth, but ignoring and dismissing it because it causes us discomfort means that suicidal youth are less likely to be taken seriously.  There is research on the subject going back years and years.  It is real.  Suicidal children know what they are doing and generally even the young ones, like the preschoolers in the 1984 Rosenthal and Rosenthal study linked above, understand the permanence of death.

4. There are big differences between self-medicating, self-harm, and suicidality.  They can be related, but when we can't talk about any of them openly, we can't untangle the differences.

Lots of people self-medicate in one form or another.  People will use what substances are available to them, and they will use what gives them results, from the socially innocuous caffeine, sugar, tobacco, and alcohol all the way up to heroin and oxycodone, or any other drug.  People who are hurting will seek out things that help them feel better.  People using drugs in dangerous ways may be suicidal, or they may just be willing to accept the risks to start to feel better in a desperate situation.

Self-harm often gets confused with suicidality, because cutting can look like attempted wrist-slashing, or because jokes about emo kids have become pervasive, or simply because we have a taboo against self-harm.  But it can be a way of self-soothing that is found all across our primate family.  Monkeys under stress, in pain, or with a history of trauma self-bite in ways very similar to humans who self-harm, and show reduced heart-rate and better coping.  The urge to self-harm is a very basic part of us that is more complicated than just being a warning sign.

These behaviors may be related to suicidality, and may be methods of self-treating depression or other mental issues, but they're not the same thing; our unwillingness to talk about any of those three topics because they fall under the shameful umbrella of "hurting yourself" isn't helping.

5. You can do something about it.  This is possibly the most uncomfortable truth of all.  There's knowing facts and figures, and then there's internalizing that information and acting upon it in a way that challenges us to face stigma and taboo.  That's huge, and it's scary.  But there are ways to help.  Talking about suicide does not cause someone to be suicidal. If you're worried about someone, it is safe to bring up the topic of suicide.  If someone brings up the topic of suicide with you, you have already done the right thing. All you need to do next is take a deep breath and let that person talk.  "Suicide" is a scary word, but talking about it doesn't kill you, and being ready to listen might help someone live.

Every time you share this post or other information on suicide, you help to fight the stigma, break the taboo, and dispel the myths. Feel free to link back to this. Feel free to comment here with other links and resources and stories. Feel free to talk to me about suicide. Feel free to comment anonymously on this post (trolling and hate speech will be deleted).

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