Suicide (oh dear – saying it twice in like 2 seconds is sure to have you quivering in your boots right about now…), is a word which is very rarely said. Which is slightly concerning because it accounts for one of the main causes of death worldwide (Tsirigotis, Grusxczynski, & Tsirigotis-Maniecka, 2014).
When people are broaching the subject it can be quite entertaining. Not the subject, just the way people talk about it. People have a tendency to whisper the word, or use gestures rather than just coming out with it. As if by saying the word suicide (oops… there it is again…) all of a sudden anyone who has had a depressive thought, is going to go ‘right that’s it I’ve had enough’ and off they go to end their life.
Trust me it doesn’t work like that at all.
If someone wants to kill themselves the first time you will know about it is after the attempt. Just by talking about it is not going to tip anyone over the edge.
In fact talking about suicide is definitely something which should be happening on a routine basis.
Suicide is a choice.
It may not be a choice you agree with, but when we get down to it we all have free will and will make whichever choice we believe is the one which will serve us the most.
You often hear suicide spoken about as the ‘cowards way out’. Let’s just stop for a moment and put that into perspective.
Taking your own life is definitely not a cowardly thing to do.
It happens because people feel as though it is the only choice left to them. They cannot see any other way out.
Whilst at a suicide prevention strategy meeting the other day, one individual perked up and said, “We don’t penalise people who take their own life when they have a terminal illness, that’s seen as OK. We often feel sympathy with their choice.”
How true is that?
It’s OK if you have a physically terminal illness, but if you decide to take your own life because of a mental health difficulty you’re penalised?
You’re whispered about.
In the ‘good old days’ you weren’t even allowed to be buried in the churchyard, and doing this meant you were going to hell… So after suffering on Earth you choose to take your life and then are stuck with eternal suffering.
While many people no longer believe this, the reason I bring it up is that it absolutely frames the way we think about people who commit suicide.
Suicide because of mental ill health is like the ultimate taboo subject. When I rock up at events with a banner that shouts ‘A Mental Health Service’ it’s as if there is an invisible barrier… I definitely get some funny looks and some people pretending not to hear what I’m saying and then I start talking about people topping themselves and wow – that is a really quick way to clear the room (and get unfriended on Facebook...)!
[I just want to jump in real quick for anyone who has come across this article and doesn’t really know me. I do not take the subjects of mental ill health, or suicide lightly. I 100% believe we should be supporting people back to full mental health and reducing the stigma attached to both will absolutely help to do this. I try to do my part not just in therapy, but also by talking about such subjects in a ‘real’, un-clinical and relaxed way. Also 14 years ago I almost became a suicide statistic myself so can talk about it from a perspective of someone who battled and in a split second overcame that fate.]
So why is it ok to ‘ease your suffering’ from physical but not mental pain?
Personally I am torn. The psychologist and the healer in me thinks that in both situations there is always hope, if you just find the right person you can ease the pain and live out the precious life you have. The real person in me who has been to a really dark place both physically and mentally understands when you feel like you just don’t want to deal with it anymore. There is the argument that we don’t let our pets suffer when they are struggling and yet we make our family members endure untold pain because we don’t want to let them go.
But back to the mental and physical divide. I truly believe it’s because like with all health issues most people just don’t understand the anguish that goes on behind closed doors when dealing with mental ill health. You can’t see it. You haven’t suffered yourself so you just can’t empathise. We’ve all stubbed our toes, cut our fingers or had headaches, stomach-aches, backache at some point and so when you see someone in a wheelchair, or in a cast you can imagine how they’re feeling.
However, for some reason things like depression have a complete misconception in the real world. Depression is not a ‘bad day’. Depression is not waking up with low energy and snoozing a couple of times. Depression is when the thought of getting out of bed makes you feel ill. If you even manage to get out of bed you have no motivation to eat, get dressed, wash yourself, or do anything. You don’t want to talk to anyone, you don’t want to be near anyone, and you quite simply don’t want to be.
Depression is when your brain is telling you you’re worthless, you have nothing to offer, you have no friends, you are fat, you are ugly, and the world would be better off without you in it. Depression is when you can’t switch this off. Depression is when you don’t even know it’s happening in the first place.
Depression is different things to different people but ultimately you feel less than everyone else around you.
Why then is suicide because of depression not OK when suicide because of physical pain is OK?
Both individuals are suffering.
Both individuals believe there is no other choice, that there is no other way out.
Having a mental health difficulty is one of the strongest predictors of a suicide attempt (Hoertel, et al., 2015), and we know that mental health services in the UK are on their knees which means it’s up to us to get off our bums and start leading the way.
So here’s what you can do right now to let someone know it’s OK to think about suicide, it’s OK to talk about suicide and ultimately it’s OK if that’s what they choose to do (please understand I am not actively encouraging anyone to take their own life).
By talking about it you are giving someone the opportunity to talk to you about what’s going on.
This single thing will enable you to support them to make a different choice if this is what they wish.
Remember my mini soapbox about depression? The other thing depression does is it stops people from problem-solving, it stops people from being able to see the good and the positive.
By openly talking about depression you will be able to show them these things.
You will be able to help them with their housing problem, advise them on where to get debt help, support them move jobs, lift them up when their marriage is breaking down… and protect them from being trapped in a world so dark that the only option on their radar is nothingness.
People who commit suicide do so over real world problems and having any mental health difficulty on top of these real life problems significantly increases the risk of suicide regardless of gender (Hoertel, et al., 2015).
Please don’t be afraid to use the word suicide. It does not make people do it. The scientific research shows the exact opposite. The more we talk about it the less likely it is to happen, even when someone is struggling with clinical depression (King, Strunk, & Sorter, 2011).
In 2014 there were 6122 deaths by suicide in the UK (4630 males and 1492 females), with the highest rates occurring between 45 - 59 years of age for both genders (ONS, 2016). It’s important to address the gender disparity because on the surface it looks as though men are more likely to commit suicide. While this is technically true these statistics only take into account those which are ‘successful’. Having a clear understanding of attempts would in my mind even this out more. Women are more likely to use poisoning (e.g., overdose), whereas men tend to use more instantaneous methods. Only by tracking and recording the attempts alongside the actual deaths will we be able to get a clear picture.
So as an employer, an employee, a friend, a family member or just a random person on the street here’s my message to you:
Saturday 10th September is World Suicide Prevention Day so this is your opportunity to get out there and just stop being afraid to use the word. Even if you’re not quite there yet with the idea of asking people if they’re struggling themselves, you can at least raise the awareness of all the different places, people, and organisations who they can talk to.
The International Association of Suicide Awareness can be found on Facebook https://www.facebook.com/IASPinfo and they are getting people to light a candle in a window at 8pm on the 10th.
If you live in Telford, Big Red’s House CiC will be holding an awareness day in the Alive Gallery in the Town Centre go in, have a coffee, pick up some leaflets, and find out what you can do to help.
Hoertel, N., Franco, S., Oquendo, M., Kerridge, B., Limosin, F., & Blanco, C. (2015). Mental disorders and risk of suicide attempt: a national prospective study. Molecular Psychiatry, 718-726.
King, K. A., Strunk, C. M., & Sorter, M. T. (2011). Preliminary Effectiveness of Surviving the Teens® Suicide Prevention and Depression Awareness Program on Adolescents’ Suicidality and Self-Efﬁcacy in Performing Help-Seeking Behaviors. Journal of School Health, 581-590.
Office For National Statistics. (2016, February). Suicide in the United Kingdom, 2014 Registrations. Retrieved from Office For National Statistics: http://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/suicidesintheunitedkingdomreferencetables
Tsirigotis, K., Grusxczynski, W., & Tsirigotis-Maniecka, M. (2014). Gender Differentiation in Indirect Self-Destructiveness and Suicide Attempt Methods (Gender, Indirect Self-Destructiveness, and Suicide Attempts). Psychiatric Quaterley, 197-2018.