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Reflections

Suicide: Seeing the Signs and Taking Action

Robin Williams suicide sparked sadness and raised awareness about what the New Yorker calls a “crime of loneliness” (Soloman, 2014). Despite the catchiness of the title, few sufferers would consider suicide a crime. Instead, it seems like the only option in the face of unstoppable pain. To speak of it as a crime or to say its selfish only stigmatizes people deserving respect and needing compassion.
 
Every 40 seconds someone commits suicide in the US. It's risen from the10th most common cause of death in 1999 to the 4th in 2010 (Moore, 2014).  About 1/2 million Americans are taken to the hospital every year because of suicide attempts with 1 in 5 having major depression (Soloman, 2014). This rate continues to escalate especially with “men and women in the middle” (35-64 years old); that of men being 3 times that of women (Moore, ibid).
  
While media, family and friends want reasons, most suicidologists say simplifying isn’t smart. Instead of one stand-out reason, there are complex layers of cause. So speculating whether Williams suicide is about addiction, depression or  Parkinsons is ill-informed. Nor is it respectful to second guess someone’s reasons surrounding such a personal and serious act. Dr. Martin Heisel warns we’ll never have a full understanding of why: “There’s a variety of factors that go into an individual’s death by suicide. It’s never one occurrence, one factor, one consideration. It’s important not to simplify” (Weeks, 2014).
 
As difficult as it is to speak about suicide,  it's important to see the symptoms:  

  • substance abuse and/or an increase in alcohol use
  • purposelessness with no reason reason to live
  • anxiety with trouble sleeping or sleeping too much
  • feeling trapped with no way out
  • hopelessness when looking toward the future
  • withdrawal from family, friends and society
  • risky behaviors that lead to recklessness
  • mood changes
  • escalating anger and even rage
(http://dbhdid.ky.gov/dbh/documents/sp/WarningSigns.pdf


Because its unbearable to believe that someone we love is considering suicide, our tendency is to sweep it under the rug and avoid the subject altogether. But skirting the issue isn’t the best course of action. Instead, says Heisel “speaking about it openly can be the key to helping the person overcome these thoughts” (Weeks, ibid). Offering a bigger sky that sufferers can see themselves against can bring hope. So it’s important to speak up rather than colluding in silence. Name the deed by asking the question: “have you thought about harming yourself?” The very fact that you can name it and sit with persons in a dark place gives them permission to talk freely about their pain. 

Faith becomes important here. Knowing that we’re fully seen and completely accepted by a  Power Greater than ourselves communicates dignity and worth. Seeing ourselves with significance can keep us from the chasm. Remember too that the Christian scriptures witness suicide seven times (Judas, Samson, Abimelech, Ahithophel, Zimri, Saul and his Armor Bearer). While suicide is never seen as a good alternative, the act itself is not singled out as sin. This speaks strongly to withholding personal moral judgement.
 
Alongside faith, evidence based research offers healing options for sufferers. Though untreated mental illness (depression and bipolar disorder) can heighten the risk of suicide, there’s no guarantee that treating the underlying cause will solve the problem. Suicidologists recommend that “suicide [itself] must be the focus of the treatment, identifying the “the unique drivers” for the individual’s suicidal thoughts, feelings and behaviors (Moore, 2014).  

This approach is called CAMS or the Collaborative Approach to Managing Suicide. It’s based on top notch empirical evidence from clinical trials (Jobes, 2009). Jobes, author of a book on this subject (http://www.amazon.com/Managing-Suicidal-Risk-Collaborative-Approach/dp/1593853270), summarizes that this approach combines a strong therapeutic alliance along with collaborating with the client “to assess risk and co-author their suicide specific treatment plan" (Jobes, 2009). While the CAMS approach makes no moral judgement against suicide, it’s an unabashedly preventative treatment designed to eliminate suicide as a means of coping while increasing the reasons for living. 
 
Summarizing, the first step when someone you suspect is struggling with suicide is to take action. Say something, help them find a qualified therapist and accompany them to the referral. Here are some other lifelines:
 
  • Be direct. Talk openly and matter-of-factly about suicide.
  • Be willing to listen. Allow expressions of feelings. Accept the feelings.
  • Be non-judgmental. Don't debate whether suicide is right or wrong, or whether feelings are good or bad. Don't lecture on the value of life.
  • Get involved. Become available. Show interest and support.
  • Don't dare him or her to do it.
  • Don't act shocked. This will put distance between you.
  • Don't be sworn to secrecy. Seek support.
  • Offer hope that alternatives are available but do not offer glib reassurance.
  • Take action. Remove means, such as guns or stockpiled pills.
  • Get help from persons or agencies specializing in crisis intervention and prevention.
http://www.suicidepreventionlifeline.org/gethelp/someone.aspx 

For further information call 1-800-273-HELP. Finally, God is on the side of life and gives us "all things pertaining to life" (2 Peter 1:3). May God grant us wisdom and courage to offer life to others considering death as the only option for unstoppable pain.

Dr. Beverly Weinhold 


References

Heisel, M. (2014, August 14). Quoted by C. Weeks. No easy answers to Robin Williams suicide. The Globe and Mail. 

Jobes, D. (2009, Arg, 14, NR, 1). Suicidologi. Retrieved August 17 from: https://www.med.uio.no/klinmed/forskning/sentre/nssf/tidsskrift/2009/nr1/Jobes.pdf

Jobes, D. (2006). Managing Suicidal Risk: A Collaborative Approach. New York, NY: The Guilford Press. 

Kentucky Cabinet for Health and Family Services. Retrieved August 17, 2014 from: http://chfs.ky.gov/news/Suicide+Prevention+Conference.htm

Moore, M. (2014, Aug. 17). Kentucky a leader in ‘suicide focused’ treatment. Courier Journal. p. H1 & H3. 

National Prevention Suicide Lifeline. Retrieved Aug. 20 from: http://www.suicidepreventionlifeline.org/gethelp/someone.aspx.

Soloman, A. (2014, Aug. 14). “Suicide, a crime of lonliness. New Yorker. Retrieved August 17 from:http://www.newyorker.com/culture/cultural-comment/suicide-crime-loneliness

Weeks, C. (2014, Aug.14). No easy answers to Robin Williams suicide. The Globe and Mail. Retrieved August 18 from:http://www.theglobeandmail.com/life/health-and-fitness/health/no-easy-answers-to-robin-williamss-suicide/article20066580/.
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