World Suicide Prevention day is on September 10. I decided to take the opportunity to shed a different light on this tragic topic by explaining how a person struggling with suicidal thoughts feels. Often, they are branded as “selfish” and “weak” by people fortunate enough to have never experienced despair so profound that choosing to die is the only mechanism of relief that someone can think of. What I hope to convey is that the stigmatizing of people who have considered or have attempted suicide is at best unhelpful and hurtful and actually quite dangerous as someone struggling with suicidal ideation is unlikely to reach for help out of shame.
As always, we will begin by looking at the global numbers of affected people to shatter the myth that suicidal ideation is “rare” and “unnatural”. According to the World Health Organization (WHO), more than 720,000 people die annually from suicide. This is the number of people who actually succeed. It is by no means indicative of those whose attempts did not result in death as that number is much higher. This is a clear indication that suicidal ideation is not rare at all. The WHO also goes on to explain that many suicides are impulsive acts in moments of total crisis when the person cannot handle life stressors anymore. Men have historically succeeded in killing themselves at much higher rates than women in part because society does not provide them with safe spaces to experience or express their emotions. I delved into the statistics and reasons behind this in greater detail in my post And Patriarchy Shall Oppress Us All, (YES, Including Men).
What we in mental health have known for decades is that someone struggling with suicidal thoughts is often someone feeling hopeless. The saying “live in hope so you don’t die in despair” actually makes this point. When someone no longer has hope that things in their life can improve, that they have the ability to hold on and overcome, they become hopeless. This is the biggest indicator that this person is heading towards considering suicide as an option to end their suffering. They are literally dying in despair.
When I was an intern many years ago, I had encountered people in the kind of crisis that they were at imminent risk of completing suicide. (In Canada, suicide is not a criminal act so we do not say “committed suicide”). I had instances where I had to call crisis intervention teams to stop someone from taking their life and had even had a suicide attempt happen in my office right in front of me. As terrifying and traumatizing as that was for me, it paled in comparison to what it was like for the person who was trying to end their life. Sitting in the presence of that kind of pain deepened my empathy more than anything else. I realized that the person felt safe enough to tell me that they intended to end their life and that in doing so, the part of them that wanted to live was making a last-ditch effort to stop them from dying. Often, before they get to that level of crisis, they are tentative in telling me that they are struggling with suicidal thoughts for fear of me, (their non-judgmental therapist), judging them. It is at that point that I share my own struggles with past suicidal thoughts which opens the door for a full discussion about how they feel and a sense of relief on their part at being understood. It is there that therapeutic work can happen as the stigma they walked into the room with disappears in the presence of someone who has been there herself.
Although not everyone experiences their suicidal thoughts or the lead up to them the same way, I have observed some common elements. THIS is how someone who is considering suicide may be experiencing the world:
1. They are in so much pain psychologically and physically, (as the human brain does not distinguish between physical and emotional pain so it manifests as body pain), that there is nothing that they have tried that has eased their pain at all. They often are facing very intense problems that they cannot think, act, pray, meditate or self-care their way out of. Issues like chronic pain, terminal illness, complete financial ruin, homelessness, substance misuse etc. are the kinds of issues that come to mind.
2. Because all the things they tried to stop their pain have failed, they believe that THEY are the problem and they have failed. This leads to the feeling that they are inherently defective and therefore, useless and worthless leading to hopelessness. How can one have hope that things will change when everything that one has tried has not changed anything?
3. They feel ashamed to tell anyone that they are feeling this way because they will be branded as “attention seeking”, “weak”, “selfish”, “dramatic” or anything else that serves the psychological comfort of the person they are being vulnerable enough to tell rather than recognizing the seriousness of the situation.
4. They may be masking their distress very well since there is the expectation that people should just soldier on no matter what. As several celebrity suicides have shown us, a suicidal person may be presenting as very normal or even jovial. This is a mask that is eventually too heavy to put on.
5. At some point, the person realizes that the only time they are not in pain is when they are asleep. Death is the ultimate sleep.
Imagine how you would feel if the only relief you have from what you are dealing with is when you are literally unconscious. Can you see how that seems like the most welcome state you can experience when all you feel is 24/7 distress? If we equate being dead with being asleep, it means that the person never has to awaken to the horror of their reality ever again. To someone who feels they have nothing to live for, this is a very appealing thought. If that thought has enough time to take root, there is not empathy, connection and support from others and there are mechanisms to end one’s life available, it is not far-fetched a thought that the world is better off without them anyway. Can you see how to someone in that fragile state, being called selfish or attention seeking can be the last straw in pushing them over the edge into ending their life?
I hope that we can start to empathize with people who are really struggling and try to decentre ourselves when faced with another person’s pain. What is helpful is providing enough safety for each other as human beings where someone can tell us they are struggling to stay alive and that we meet them with compassion, concern and love rather than judgement and stigma.
If you or someone you know is struggling with suicidal ideation, please seek emergency services at the following places:
British Columbia - https://www.healthlinkbc.ca/mental-health-substance-use/resources/crisis-line-association-bc
Jamaica - https://jis.gov.jm/information/get-the-facts/goj-support-for-the-mentally-ill-in-crisis-situations/
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