September marks Suicide Prevention Month, a time dedicated to raising awareness, offering support, and paying closer attention to our own mental well-being and that of those around us. This month is about shifting public perception, spreading hope, and sharing vital information with those affected by suicide. It’s important to remember that suicidal thoughts, like mental health conditions, can affect anyone – regardless of age, gender, or background.

We all stand to benefit from open, honest conversations about mental health and suicide. Just one heartfelt conversation can make a world of difference, potentially changing or even saving a life. We never truly know what someone else is going through, and sometimes, simply asking how they’re feeling can be the first step towards healing.

 

Understanding Suicidal Thoughts

When someone is experiencing suicidal thoughts, they are often consumed by intense pain and the belief that things will never improve. In this state, it can feel like there is no other way to escape their suffering. These feelings of hopelessness are pervasive, and they cloud the person's ability to see alternatives or seek help. It's important to remember that people who are suicidal don't necessarily want to die—they want their pain to stop. By helping them understand that their situation is temporary and that support is available, we can offer a lifeline in moments of crisis.

 

"Suicide does not just occur in high-income countries but is a global phenomenon in all regions of the world. In fact, close to three quarters (73%) of global suicides occurred in low- and middle-income countries in 2021." – WHO

 

These are some key facts taken from World Health Organisation’s website:

• More than 720 000 people die due to suicide every year.

• Suicide is the third leading cause of death among 15–29-year-olds.

• Seventy-three per cent of global suicides occur in low- and middle-income countries.

• The reasons for suicide are multi-faceted, influenced by social, cultural, biological, psychological, and environmental factors present across the life-course.

• For every suicide there are many more people who attempt suicide. A prior suicide attempt is an important risk factor for suicide in the general population.

 

WHO also notes that, there is a clear connection between suicide and mental health conditions, especially depression and alcohol use disorders, in wealthier countries. Previous suicide attempts also increase the risk. However, many suicides are impulsive and occur during moments of crisis when someone is unable to cope with intense life pressures like financial struggles, relationship issues, or ongoing pain and illness.

Experiencing conflict, disasters, violence, abuse, or loss, along with feeling isolated, are also linked to suicidal behavior. Certain vulnerable groups, such as refugees, migrants, Indigenous peoples, LGBTIQ+ individuals, and prisoners, face higher suicide rates due to discrimination and marginalization.

 

What Suicidal Thoughts Feel Like

When someone is having suicidal thoughts, they might feel trapped, hopeless, or like they’re a burden to others. It’s like being stuck in a dark tunnel with no light at the end. These thoughts can be constant or come in waves, and they can make it hard to think clearly about other options. People in this state of mind often feel isolated, even if they’re surrounded by others, and they might think that no one understands what they’re going through.

That’s why it’s so important to reach out if you think someone is struggling. Sometimes, just knowing that someone cares can help break that sense of isolation and give them a reason to keep going.

 

What Leads to Suicide?

There’s no single cause of suicide. It’s usually a mix of emotional, psychological, and life challenges piling up. Mental health issues like depression, anxiety, or bipolar disorder can increase the risk, especially if they go untreated. But it’s important to remember that many people dealing with these struggles don’t attempt suicide, which shows that other factors often come into play:

 

• Trauma or abuse: Past experiences of trauma, such as physical or emotional abuse, can significantly heighten a person’s vulnerability to suicidal thoughts.

• Loss and grief: The death of a loved one, a divorce, job loss, or even the end of a significant relationship can drive someone to feel like they have no future or purpose.

• Isolation: Feeling disconnected or unsupported can exacerbate feelings of hopelessness.

• Chronic pain or illness: Ongoing physical pain or a debilitating illness, especially when combined with other stressors, can lead people to consider suicide as an escape.

• Substance abuse: The use of drugs or alcohol often lowers inhibitions and can amplify feelings of despair, making a person more likely to act on suicidal impulses.

 

The Myths of Suicide

The stigma around suicide prevents people who are considering or have attempted suicide from seeking the support they need. Suicide is still seen as a taboo in many culture, people avoid talking about the seriousness of how wide it is and sadly the suicide prevention remains under-addressed. As a result, only a limited number of countries have prioritized suicide prevention in their healthcare systems, with just 38 nations reporting a national suicide prevention strategy in place.

 

"Attention-Seeking"

One of the most harmful misconceptions about suicide is that people who talk about it are simply seeking attention. In reality, verbal expressions of suicidal thoughts are often a cry for help. Many individuals who are struggling don't know how to ask for support in a way that feels safe or productive. By dismissing their feelings, we risk missing crucial opportunities for intervention.

 

"Talking About Suicide Puts the Idea in Someone’s Head."

A lot of people avoid bringing up suicide because they’re afraid it’ll make things worse, but research shows that’s not true. Asking someone directly if they’re thinking about suicide won’t push them toward it—it can actually give them a chance to open up and talk about their feelings. This can be the first step in getting them the help they need.

 

"Only Certain Types of People Consider Suicide."

Suicide doesn’t fit a mold—it can affect anyone, no matter their background, age, or social status. We often hear that only people who are deeply depressed or facing huge life problems consider suicide, but that’s not always the case. Even people who seem like they have it all together might be quietly struggling. That’s why it’s so important to be kind and check in on each other, even if everything seems fine on the surface.

 

"Suicide Happens Without Warning."

While some suicides may seem to come out of nowhere, most people show warning signs beforehand, even if they’re subtle. It might be through things they say, like "I can’t take this anymore" or "I just want it all to stop," or changes in behavior, like withdrawing from people or giving away things they care about. Sometimes, they might suddenly seem calm or at peace after a long period of struggling, which can be a sign they've made the decision to end their life. Paying attention to these clues can help you step in early.

 

Warning Signs

There are several warning signs that someone may be at risk of suicide. Recognizing these can help us intervene before it's too late. These include:

• Talking about death or suicide: Comments like "I wish I wasn't here" or "I want to end it all" should always be taken seriously.

• Withdrawal from social connections: A person may start isolating themselves from friends and family or lose interest in activities they once enjoyed.

• Changes in mood or behavior: Extreme mood swings, irritability, or calmness after a period of depression could indicate that the person has made a decision to end their life.

• Giving away possessions: This behavior may suggest that the person is preparing for their absence.

• Self-destructive actions: Reckless behavior, increased use of drugs or alcohol, or other forms of self-harm can be warning signs.

 

Did you know that there are ways to feel better and get the help you, or someone you know, need? 

While talking about our feelings is incredibly important, there are also effective, evidence-based treatments available for those at risk.

 

Here are some options that have been shown to help:

1. Cognitive Behavioral Therapy (CBT). This type of therapy helps people recognize and change harmful thought patterns, teaching them healthier ways to handle stress and cope with suicidal thoughts. It’s like having a toolkit for navigating tough moments and thinking differently about the challenges you face.

2. Dialectical Behavior Therapy (DBT). It is especially helpful for people who struggle with intense emotions, like those with borderline personality disorder. This therapy teaches skills to manage emotions, improve relationships, and reduce self-destructive behaviors, making it a valuable resource for both teens and adults.

3. Brief Intervention Strategies. Simple, yet effective. Creating a safety plan or crisis response plan can make a big difference. These personalized plans outline specific steps to take when suicidal thoughts arise, providing a clear path to safety. Staying connected with and following up on those at risk also plays a vital role in reducing future suicide attempts.

4. Collaborative Care. This approach involves a team of health professionals working together to support someone’s mental health journey. A behavioral health care manager, primary care provider, and mental health specialists all collaborate to develop a personalized treatment plan. Collaborative care has been shown to effectively treat depression and lower the risk of suicidal thoughts.

 

These are just some of the many treatments available to help people who are struggling. It’s important to remember that you’re not alone, and help is within reach. While some people may face barriers like financial constraints, stigma, or limited access to services, reaching out for support can be a critical step toward healing. If you’re experiencing suicidal thoughts, seeking professional help can make all the difference – you deserve to feel better, and you don’t have to go through this alone.

 

How can we get involved and help others that are struggling?

Family and friends are often the first to notice when something isn’t quite right. When it’s possible to recognize the warning signs of suicide, they can play a crucial role in helping a loved one find the support they need. If someone tells you they are thinking about suicide, it’s important not to leave them alone and not to promise to keep their thoughts a secret. Your support and understanding can be lifesaving.  Remember, you don’t have to have all the answers or be perfect. Just being there, showing that you care, and helping them take small steps can make a world of difference. Your kindness and support can be a light in someone’s darkest moments.

 

Here are some ways to show your support and be there for someone who is struggling:

• Listen without judgment. Let them know you’re there, that you’re listening, and that you’re taking them seriously. Sometimes, just having someone who will listen without judgment can be really helpful.

• Express your support. Reassure them that you care, and let them know you’re there to help in any way you can. Even small gestures, like checking in regularly or just sitting with them, can provide comfort.

• Encourage open and honest conversations. Create a safe space for them to share their thoughts and feelings. Ask gentle questions about how they’re feeling, how long they’ve been feeling this way, and what they’re struggling with. Show genuine curiosity and interest in the details, and avoid trying to “fix” things immediately –sometimes, they just need to be heard.

• Ask directly about suicide. If you have concerns that someone might be thinking about suicide, trust your instincts and ask them directly. Talking about suicide won’t plant the idea in their head, instead, it shows them that you care and that they’re not invisible.

• Help them connect to professional support. Offer to help them find a mental health professional, support group, or helpline. Sometimes, they might not be ready to seek professional help, so be patient and continue to gently encourage them.

• Offer practical help. Simple acts like helping with daily tasks, providing a ride to appointments, or assisting with finding resources can ease their burden and show that you’re there in tangible ways.

• Check in regularly. Follow up and check in regularly, even if it’s just a quick message to let them know you’re thinking of them. Consistent contact can remind them that they are not alone.

• Respect their pace. Healing takes time, and everyone moves at their own pace. Be patient, avoid pushing too hard, and respect their boundaries while still offering your support.

• Educate yourself about suicide prevention. Learning more about mental health, warning signs, and ways to help can better equip you to support those in need. The more informed you are, the more effective you can offer help.

 

And to end on a happier note: Recovery Is Possible

 

Recovery from suicidal thoughts and attempts is absolutely possible, and many people go on to live happy, fulfilling lives after hitting a low point. While it can feel impossible in the moment, with the right support—like therapy, medication, and a strong network of friends and family—things can and do get better.

 

"Nine out of ten people who attempt suicide and survive will not go on to die by suicide at a later date. This has been well-established in the suicidology literature. A literature review (Owens 2002) summarized 90 studies that have followed over time people who have made suicide attempts that resulted in medical care. Approximately 7% (range: 5-11%) of attempters eventually died by suicide, approximately 23% reattempted non-fatally, and 70% had no further attempts.

Even studies that focused on medically serious attempts–such as people who jumped in front of a train (O’Donnell 1994)–and studies that followed attempters for many decades found similarly low suicide completion rates. At least one study, published after the 90-study review, found a slightly higher completion rate. This was a 37-year follow-up of self-poisoners in Finland that found an eventual completion rate of 13% (Suominen 2004)." - Attempters’ Longterm Survival (HSHP Harvard T.H. Chan | School of Public Health Website)

 

The key is to reach out for help.

Recovery takes time, but it’s important to remember that even when life feels overwhelming, there are resources and people who want to help you heal. With support, hope can be restored, and brighter days can be ahead. There are people who once experienced the same hardships and feelings as you do that are no longer carry the burden of suicidal thoughts. You are not alone and to remind that we would like to share an example of online support from last month that might bring a smile to your face: On August 18, an artist named Crumb (as @cuptoast on Twitter) shared a comic panel that can be intrepreted as their reflection of personal struggle with thoughts surrounding death and life. Following the first panel, they shared another one as a thank you for the supportive comments they received, saying "we will keep going together". Through art, through conversations... Help and support are always available.

 

References

National Institute of Mental Health (n.d.). Frequently Asked Questions About Suicide. Retrieved from (September 9th, 2024): https://www.nimh.nih.gov/health/publications/suicide-faq#part_6084

National Alliance on Mental Illness (n.d). Suicide Prevention Month. https://www.nami.org/get-involved/awareness-events/suicide-prevention-month/#download-the-toolkit

National Alliance on Mental Illness (2024). NAMI Suicide Prevention Month 2024. Retrieved from (September 9th, 2024): https://www.nami.org/wp-content/uploads/2024/08/NAMI_SuicidePreventionMonth_Toolkit_2024.pdf?utm_source=website&utm_medium=landingpage&utm_campaign=SPM_2024

Harmer, Bonnie, et al. “Suicidal Ideation.” PubMed, StatPearls Publishing, Retrieved from  (20 April 2024):  www.ncbi.nlm.nih.gov/books/NBK565877/.

Harvard School of Public Health. “Attempters’ Longterm Survival.” Means Matter, Retrieved from (11 September 2012): www.hsph.harvard.edu/means-matter/means-matter/survival/. 

Robertson, G. (December 14th, 2022). How to Help Yourself and Others with Suicidal Ideation. National Alliance on Mental Illness. Retrieved from (September 9th, 2024): https://www.nami.org/988/how-to-help-yourself-and-others-with-suicidal-ideation/

Siadat, S. et al (2024). Technology-based suicide prevention: An umbrella review. Journal of Research in Medical Sciences, 29(1). Retrieved from (September 9th, 2024): https://journals.lww.com/jrms/fulltext/2024/07110/technology_based_suicide_prevention__an_umbrella.28.aspx?context=latestarticles

World Health Organization (August 29th, 2024). Suicide. Retrieved from (September 9th, 2024): https://www.who.int/news-room/fact-sheets/detail/suicide