Suicide is complicated. So is prevention

I was 11 years old when I first thought about killing myself.

For more than a decade since then, I have struggled to overcome regular suicidal thoughts.

These thoughts and feelings can be triggered by some of the smallest things — breaking a cup, being rejected by a potential employer — things that could upset anyone can send me into a full-blown spiral. It’s one of the many things I struggle with as someone with bipolar disorder.

It can feel like I’m being choked by a black cloak. Sometimes the feelings can pass as quickly as they arose; sometimes the darkness lasts longer.

The coverage of mental health issues — like suicide prevention — was cathartic for me.

In 2020, 45,979 people died by suicide in the United States Centers for Disease Control and Prevention. It is now considered the 10th leading cause of death in the nation and the second leading cause of death for people between the ages of 15 and 24, according to the National Institute of Mental Health. Just last year, Surgeon General Vivek H. Murthy issued a public health advisory in response to rising suicide rates among adolescents.

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But suicides are just the tip of the iceberg, according to Anthony Wood, the company’s interim CEO and chief operating officerAmerican Assn. of suicideology (AAS), one of the oldest suicide prevention organizations in the United StatesAssociation data show that 1.2 million people have attempted suicide in 2019. The number of those who think about it but don’t follow it is immeasurable.

what’s moreData from survivors of suicide attemptsshow that nearly half of those who attempt it thought about it for less than 20 minutes. A quarter of them thought about it for less than five minutes.

According to Wood, suicide is linked to a number of causes: mental illness, life stressors — and just wanting to stop the pain someone is experiencing. The reasons someone dies by suicide are as unique as they are – making prevention and prediction a model, not a science.

Suicide prevention campaigns have been around for decades. Messages such as “Know the signs” and “Suicide is preventable” are intended to inspire hope with the aim of reducing the suicide rate.

However, there is disagreement about their usefulness. Understanding suicide is complicated; such is prevention.

The AAS was one of the first organizations to collect data from survivors and create what we know as “the Signs”. The idea, Wood said, was that if AAS could define warning signs like other diseases, doctors and other caregivers could better assess a person’s risk.

But Wood says the association’s signs were never meant to be used on an individual basis outside of a clinical setting — by people trying to help friends and loved ones.

according to dr Doreen Marshall, vice president for missionary engagement at theAmerican Foundation for Suicide Prevention,There is no way to predict when or if someone will die by suicide. What we do Knowledge comes from conversations with those who have tried and survived and survivors of suicide losses.

Some people become experts at hiding their pain, Marshall said, but there are people who offer clues that they are considering suicide. They’re not quite as specific or clear as prevention messages might suggest, she said, but certain behaviors can be cause for concern.

The three buckets — speech, behavior, mood — according to Marshall, are what most experts use to identify suicidality individually. Hearing someone say they want to end their life, seeing them increase drug use, withdrawing – these are some of the most common signs.

If you recognize some of these behaviors in someone, or are concerned about someone’s mental wellbeing, there are things you can do to help.

Don’t be afraid to be direct. Some people may believe that mentioning the word “suicide” can trigger but if you’re afraid someone is thinking of killing themselves, there’s no time to wait. Ask him directly, “Are you thinking of killing yourself?” Holz said. Most of the time, he continued, that person feels a sense of relief that someone is seeing their pain.

“It never hurts to show that you care about a person,” Shari Sinwelski, vice president of crisis care at Didi Hirsch, told Psychiatric Services. And no matter how you ask it, if the answer is yes, then it’s time to act.

Resources for suicide prevention and crisis counseling

If you or someone you know is struggling with suicidal thoughts, seek help from a professional and call 9-8-8. The first nationwide three-digit mental health emergency hotline, 988, in the United States will connect callers with trained mental health counselors. In the US and Canada, text “HOME” to 741741 to reach the crisis text line.

Calling 988 or other hotline is probably the quickest way to reach someone trained in suicide intervention. In the long run, helping that person establish a long-term mental health support system is key to saving their life.

There is anationwide shortage of mental health professionals, so it may take longer to get help than you hope. In this case you can searchSupport groups or other free resourcesfor the people.

People who end their lives are often judged by how they died, not how they lived, said Ronnie Walker, founder and chief executive officer ofAlliance of Hope, a nonprofit organization that supports survivors of suicide loss. “Yet there were so many extraordinary people who got to a point where, for whatever reason, they took action to end their lives,” she said.

Like Wood, Walker says survivors can suffer.

At times, survivors may experience a complicated grief defined by the continued disruption of the healing process, like a wound that is never allowed to heal.according to M. Katherine Shear, Marion E. Kenworthy, Professor of Psychiatry at the Columbia School of Social Work and the Vagelos College of Physicians and Surgeons.

Suicide prevention campaigns are important, but many survivors find they amplify their feelings of guilt, Walker said, especially during Suicide Prevention Month.

Sinwelski says it’s just as important for survivors to build their support networks.

Reach out to others who have lost someone to suicide. Because of its complexity, the grieving process can best be understood by those who go through it themselves.

In the end, every story is unique.

Most people would never guess that I thought about killing myself. I don’t fit The Signs model. Also has no one I’ve lost.

And that’s why it’s so important to continue these conversations.

Suicide is a fact of life. But in many cases it can be prevented. And it’s not about knowing the signs, it’s about changing the way we think about dying by suicide.

There is help out there. Get in touch if you or someone you know is having trouble.

Dialing 988 directs callers to the National Suicide Prevention Lifeline, available throughout the United States. The Lifeline currently serves TTY users either through their preferred relay service or by dialing 711 then 1-800-273-8255. Suicide is complicated. So is prevention

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