“Can I see another’s woe,
And not be in sorrow too?
Can I see another’s grief,
And not seek for kind relief?”
— William Blake, “On Another’s Sorrow”
The theme of this month’s #1000Speak post is acceptance. I’m not sure if I’ve quite managed it this month. I began the piece that follows only a couple of days after the suicide that precipitated it. It was weighing on my mind, for the impact to my daughter and her friends, and because it brought back mixed emotions for friends that I’ve lost over the years. I think that, perhaps more than any other type of death, suicide bears down on those left behind with a stream of mixed emotions, including anger and guilt, in a way that an accident or an illness doesn’t. It brings out our empathy (too late), and our guilt (we should have been prevented it). But of course, it really has nothing to do with us. And we almost certainly could not have fixed anything. Despair and loneliness come from within – and any of us can be alone and isolated even when we are surrounded by people who love us and care about us. Depression is not rational. Because of that, all of the self-compassion in the world still may not be enough to prevent a suicide. But for those that are left behind, the beginning of the Serenity Prayer variant has strong value even for the non-religious:
“God grant me the serenity to accept the things I cannot change, the strength to change the things I can, and the wisdom to know the difference”
When we see the signs of depression, of loneliness in a crowd, of suicidal thoughts, we should try to act where we can although those means may be limited. It’s a very human, and somewhat narcissistic, quality to blame ourselves for missing something, or not doing enough, but compassion for ourselves includes the need to understand that, sometimes, there may not be enough love, or support, that we can provide, and although we can suggest venues for obtaining help, we cannot force another adult to do anything that they choose not to do (with minors, there are parents and, if necessary, state agencies that can be notified, but we need to be prepared for the possibility that there, too, our best efforts may fall short). Compassion compels us to act, and with our friends suffering from depression, acting sometimes times requires a friendship-risking level of action – especially among adolescents, but in the end, regardless of the outcome, we need to accept that we’ve done all that we could, and that we can’t help someone else if they have already placed themselves beyond our reach.
On Friday, June 26, a former classmate of my daughter’s passed away. She was only 21 years old, and it was a suicide. Because she’d gone on to school in another state, as a few other friends had, the kids had all drifted apart over the past couple of years, so no one here knew what her situation was.
Bright, articulate, artistic, and creative – she should have been looking forward to a future full of promise, but inside her mind, that was not the world she saw. Of course I can’t know for sure what was on her mind, no one really can, but that seems to be where depression often leaves one – devoid of hope, unable to see any bright spots on the horizon. Adolescents and young adults are particularly susceptible because even when they’ve sought help, the medications used often include suicidal thoughts as a side effect.
The friend my daughter remembered, and the one that I saw in the photos that friends and family shared, was happy and full of life, and, as I write this, my daughter is, understandably, unsure how she feels – grief is like that, and suicide seems to magnify it. Useless though it is, the only advice I could give was to keep in mind that depression is a medical condition, and suicide is not rational. Funny advice coming from me – I’d written a paper in college positing that, in fact, suicide could be rational. And of course it can be. When facing a terminal illness, for example. But not as a by-product of depression. And I understand from first-hand experience how difficult it can be to move past the anger stage of grief when the death was a suicide. Even knowing how not rational those misfiring neurons leave a clinically depressed person, our rational-minded, non-suicidal, selves want to make it make sense. And it doesn’t because it can’t. But that knowledge doesn’t stop us from wanting to help when someone we know is depressed. And it doesn’t stop us from feeling that we should have been able to have done something to prevent the suicide.
The statistics, though, are terrifying. Suicide is the second leading cause of death in the 10 – 24 age group. It is the 10th across all age groups (higher than homicide). This infographic from The American Foundation for Suicide Prevention lays the reality out in stark detail:
Current estimates are that 90% of those attempting suicide are suffering from an underlying mental illness such as depression, bipolar depression, or schizophrenia. Sometimes these illnesses were diagnosed, or left untreated, and sometimes the medication used for treatment increases the risk of suicide (this, too, is of particular concerns in adolescents, where antidepressant medications often increase suicide risk). But because suicide is complicated, the underlying mental health issue is rarely the sole cause – other life events come into play – but the underlying illness interferes with the sufferer’s resiliency, and/or with their ability to think rationally about their situation, or to seek appropriate help.
But what can we, the friends and relatives of those at risk of suicide, do?
First, recognize the warning signs, and understand that the presence of multiple signs is an indicator of greater risk. And the people who talk about committing suicide are not less likely to commit suicide than those who don’t – that common belief is simply not true. The more common warning signs are:
- If a person talks about killing themselves, or of having no reason to live.
- If they feel that they are trapped in their current situation, or that they are a burden to others.
- If they have begun abusing alcohol or drugs, or have increased their use of intoxicating substances, or if they have otherwise begun to act recklessly.
- If they have begun withdrawing from normal activities, and avoiding family and friends, or begun contacting people to say goodbye.
- If they are acting more aggressive, hostile, or anxious than normal.
Next, when you recognize one or more warning sign in others, encourage them to seek help by walking into a hospital emergency room, or urgent care center, or by contacting a suicide prevention hotline, such as the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
It is important to note that these options are equally applicable if you recognize any of the warning signs in yourself.
And then remind yourself that a suicide attempt, whether successful or not, is not cowardly, it isn’t ‘being dramatic’, it isn’t spiteful. It is an outgrowth of severe internal pain and anguish. It is tragic. And someone who survived an attempt needs care, support and understanding.
The Centers for Disease Control has also produced a useful information sheet of suicide causes and prevention, which can be found here.
“On the death of a friend, we should consider that the fates through confidence have devolved on us the task of a double living, that we have henceforth to fulfill the promise of our friend’s life also, in our own, to the world.”
― Henry David Thoreau