Monday, June 11, 2018

The Mystery and Tragedy of Suicide

No one can see completely into the heart, the mind and the pain of another, no matter how close one is to a person.

Sadly, too many people shock those they love by ending their own lives. In 2016, more than 45,000 Americans committed suicide. Behind each one of those statistics, there is a tragic end to a life with ripples of grief, anguish and guilt impacting family members and friends for years to come.

The recent deaths of celebrities Kate Spade and Anthony Bourdain have heightened public awareness of a problem that has been increasing in recent years, with suicides up 25 percent since the turn of the century.

Some experts attribute this rise in deaths to a variety of factors: the decline of the middle class and diminishing prospects of attaining the American Dream, the opioid crisis, and people more likely than before to view suicide as an alternative to living with painful life events.

But suicide is more complicated and mysterious than that. There can be tremendous pain even in the absence of deprivation or drug-altered reality. Professional success, wealth and fame obviously offer little, if any, protection from the despair that can cause a person to end his or her life.

However, many of those who attempt or who commit suicide, have a diagnosed or diagnosable mental illness. This may be a major depression, anxiety or bipolar disorder. It may be the result of living with the pain of a chronic condition like Borderline Personality Disorder. Being in treatment with a mental health professional can decrease the risk of suicide. Being in a loving, supportive marriage can also be a protective factor. But neither is an absolute guarantee that a loved one won't end his or her life.

What can you do if someone you love appears to be deeply depressed and/or suicidal?

  • Be aware of common signs and symptoms: If a person is increasingly isolated from friends and family, is immobilized by depression, starts giving away prized possessions or talking of hopelessness or even mentioning ending it all, be alert. There is no truth to the saying that those who talk about suicide never do it. Mentioning suicide, even supposedly in gest, is a reason for concern. It can be a cry for help.
  • Listen to instead of disputing their feelings. Hopelessness can seem irrational when you look at the reality of a person's life. But it's important to listen to their point of view and let him or her know that you understand that, right now, he or she is feeling overwhelmed. Focus on helping this person feel heard and loved and not so alone. A loving touch, a willingness to sit with the pain and to listen, is a much better deterrent than arguing that this person has a great life that is well worth living. That may be so. But at the moment, he or she can't see that. If you can help him to feel less alone in the world, it may be easier for him to take the first step away from self-destruction.
  • If a loved one has been deeply depressed but is starting to seem better, be hopeful but stay vigilant. Someone in the depths of depression may not have the energy to complete a suicide. But as the depression begins to lift, they may have a lethal combination of renewed energy with continuing feelings of hopelessness.
  • When a loved one talks of depression and despair, gently ask about suicidal thoughts. Bringing this up is not likely to trigger action on their part, but may give you some clue about risk. Someone who has thought of suicide, particularly if he or she has a method in mind, may be at increased risk of suicide.
  • Urge your loved one to get immediate help: from a mental health professional, from the family doctor or, in a crisis, from a suicide prevention hotline. If he or she declines help and appears to be at risk, take matters into your own hands. Call 911 and ask for a crisis intervention unit. Take him or her to a hospital emergency room. If this depression and suicidal ideation is new and doesn't appear to be happening for any discernible reason, enlist the help of your family doctor in testing for a variety of physical conditions that can trigger depression. Make an emergency appointment with a mental health professional. If your loved one is already in therapy, encourage him or her to call his therapist immediately. If the person refuses, notify the therapist yourself so that he or she can contact the depressed person. Or call or encourage your loved one to call: The National Suicide Prevention Hotline number: 1-800-273-TALK (8255).
In some instances, however, there is no warning and no chance to intervene. You're blindsided by a loved one's suicide -- and your life changes forever.

You're likely to have a bewildering array of feelings: guilt that you weren't able to prevent it, anger at your loved one for giving up on life, loneliness in your profound and ongoing grief and, sometimes, feeling judged by others who make thoughtless comments or otherwise indicate that the suicide of a family member must mean that something was the matter with your family, with your parenting, with your marriage.

How do you begin to deal with this?

  • Know that as strong as your love has been, the feelings and circumstances that led to a loved one's suicide can overwhelm all that.  When someone is in the grip of a major depression or a depressive cycle of bi-polar disorder, your love for him and his love for you may not be enough to save him. When a person is feeling so hopeless or his thinking is so affected by substance use or abuse, and he or she has a plan or immediate means to follow through with a suicide, there may be nothing you can do to prevent it.
  • Realize that this death may always be a tragic mystery.  You may never know or understand why this happened. Some people go to great lengths both to plan a suicide and to keep those they love most, those most likely to interfere with their plans, unaware of their intentions. Some suicides are impulsive and come without any warning. In the wake of a loved one's suicide, you may find yourself desperately looking back: Were there clues you missed? Something you could have done? It's quite possible that there were none. Not knowing why is a part of the ongoing anguish of a loved one's suicide.
  • Don't fall into a pattern of blaming yourself. Even if the suicide victim left a trail of blame or others in the family are quick to point to you, don't accept the blame. This is much easier said than done, of course. Seek counseling or crisis group help in the wake of this tragedy. Living with the reality of a loved one's untimely death is painful enough. Don't pile further punishment on yourself. The person who committed suicide did this to himself for reasons that you may never know or understand. You did the best you could at the time for and with this person. 
  • Seek out a therapy group for bereaved family members. Or perhaps someone you know who has also lost a loved one to suicide. The special understanding that these others may have of your feelings and situation can help you feel less alone in your grief.
  • Know that healing is a relative term.  With time, the grief may be less intense, but it will always be with you. And you may find that it comes and goes in waves -- perhaps heightened at certain times like birthdays, holidays, or the anniversary of the death or simply triggered by a memory. With time and with help from those you love and, perhaps, from a mental health professional, you can live and function with your pain, knowing that, to varying degrees, it will always be there.
  • Reach out to help others in the wake of your tragedy.  Try to increase understanding of mental illness and/or suicide by participation in support groups, presentations through your church or community centers or volunteering with local organizations focused on suicide prevention. This isn't for everyone. But some people find new meaning and purpose in such activities, particularly if these can help to prevent other families from losing loved ones to suicide or comfort those who have experienced such a terrible loss.
  • Celebrate the person as well as grieving his or her death.  An important way to integrate this tragedy into your life and go on is to remember the person you've lost with love, with sweet memories, funny stories, tender comments. It's important that the person you've lost doesn't become a taboo topic or that thinking of him or her invariably brings up feelings of grief or anger. Let love back into your life. Allow all of the wonderful memories to return to you. Remember with others not how she died, but how she lived. Talk about what, in life, made him so special. Sometimes these moments will bring tears. But, in time, there will be smiles, even laughter, as you look back on this person with love, remembering someone who brought not only pain but also so many blessings to your life.