Off the Ledge and Back From the Brink
If You Know Someone Who is Potentially Suicidal - Act Now!
Visit helpguide.org for more information. Please review the myths discussed below. People may not ask for our help but that doesn't mean that help can't be provided or isn't needed! We can all become advocates for preventing suicide by being better listeners, not becoming accusatory or blaming them for their behavior. We can become informed in how to talk people off the ledge and to get them the help they need.
Visit mayoclinic.org for more resources. If you feel that someone is actively contemplating suicide, call 911 or call the National Suicide Prevention Hotline at 800-273-TALK (800-273-8255) to speak with a mental health professional. Press 1 if a veteran.
- Take any signs of potential suicide seriously!
- Do not leave the person alone!
- Do not argue with the person or be judgmental.
- Do not be dismissive of his or her feelings in any way.
- Be understanding and supportive.
- Do not promise the person to keep this a secret. The person needs to receive treatment and have the problem addressed.
- Remove drugs or alcohol from a person's possession if possible.
- Remove dangerous items from the person's possession such as knives, guns, etc.
- Speak encouraging about the possibility of things being better. Hope is a powerful elixir.
5 Myths About Suicide
Unfortunately, many people feel that this is a topic that we shouldn't talk about. I encourage everyone to talk about depression and suicide just like we would talk about preventing an infection or thinking of the afflicted person as if they had heart disease. An ounce of prevention is worth a pound of cure as they say. This is one area where we globally should be more aware and more open to understanding causes and prevention. The World Health Organization estimates that 1 million people per year die from suicide.
Myth #1 – If we talk about suicide, it may cause him or her to go through with it! Nothing is further from the truth. Someone who is contemplating suicide feels completely isolated and alone, as if there is no one on the planet who understands them or cares about them being here or not here. Talking about it dispels that thought. By talking about it, it's possible to get them to address or acknowledge their feelings of depression and truly, it could save a life! Encouraging the person to seek help is the best present you can give. Only in addressing it can we hope to prevent it.
Myth #2– Someone who has tried to commit suicide or commits suicide has mental problems. If these people had mental problems, they would have manifest it in some other way. People driven to suicide are simply overwhelmed with their lives and cannot see another way out. They commit suicide as a result of depressive thoughts and out of desperation, feeling there is no other way. The only remedy is to catch someone before they fall or before they jump from the ledge. Understanding depressive illness and feelings of suicidality are the keys that will turn the statistics around and make us all more aware as a society of the darkness some people carry with them. Understanding can be just the light they need to find their way out of the darkness and to see other possibilities.
Myth #3 – If someone wants to kill themselves, they will do it anyway! Not true! We may think of it in a fleeting moment but instantly regret that and change our mind. People are capable of realizing it is a desperate choice based upon seemingly unbearable pain. Sometimes it is simply an impulsive act. People contemplating ending their life need to be shown that there are appropriate alternatives to dealing with pain and frustrations in their own life.
Myth #4 – People who mention killing themselves never carry it out. They're just talking about it for attention. Always err on the side of taking these statements seriously and advising that the person seek help. Get them help if they are too young to get it for themselves. There's a reason that most people say these things, and those statements reflect a level of pain that should be taken as a warning. It would be the same situation as someone telling us they were having chest pains and we ignored them, only to find them dead later of a heart attack. Symptoms are indicative of something and we should all be mindful and take care in how we deal with any kind of pain, emotional or physical.
Myth #5 – People who kill themselves were never interested in getting help. Again, not true. Think of Robin Williams and all that he went through to stay sober. Think of George Michaels and all of his years of despair. A breaking point is exactly that. The person simply cannot see another solution at that moment in time, no matter how many times they have guarded against this moment or how much counseling they have received. It becomes a tragedy because someone was not able to get them the help they needed at that one particular moment or they were not able to ask for help in that moment.
The most important thing we can all do is to be mindful of the signs and symptoms of severe depression and suicidal thoughts and act before it's too late. The saddest thing of all is to have thoughts of "I could have" or "I should have" after the fact.
The People We Least Suspect
Since the fairly recent deaths of Kate Spade as well as Anthony Bourdain, I've been thinking a lot about what drives people to suicide. I honestly thought my heart would break the day I heard of Robin Williams' death by asphyxiation as I knew instantly that it probably meant he had hung himself. To now hear of two more people who, from all outward appearances, had the world "by the tail" and who chose death by hanging, I'm further saddened and alarmed. I'm frankly a little worried about what that says about the state of mental health in general.
I have a lot of theories about why people are depressed or why some people are more prone to it than others. Yet, there is the great unknown there. Why do some people appear to be able to handle their problems and have all the outward confidence in the world and then inwardly hide their deepest, darkest, most despairing feelings from the world?
Going back to Robin Williams, as he was always and forever my idol, he seemed to have an unlimited store of humor and a way of looking at the world that made me laugh until I cried at times. I don't know when it was or where it was that I read once (many years before he committed suicide) a quote from him stating that he felt "tired." I do think in retrospect that should have been a huge clue to all who knew him that perhaps he was dancing a little too fast and that maybe all that "humor" wasn't really all that was in there. He said that he felt a terrific pressure, an insurmountable obligation or something to that effect, that whenever he was around people, he needed to be "on." There was nothing that he should do or could do but entertain people…and entertain us all he certainly did. I think his wit and his charm oozed from him no matter what he did. It seemed that each and every encounter with him made people better for it. The absurdities of life and the belly-laugh ability he brought to anyone around him made us all feel good. Yet underneath it all, he was feeling tremendous pressure to be the best that he could be and to most of all always be entertaining, no matter how he felt inside. On hearing him admit that the one time, I remember thinking that was a lot of pressure for such a seemingly easy-going "funny guy." Now, it makes me sad to know that he was under that much self-induced pressure. It also rang a bell inside me. Was I capable of doing the same thing or feeling the same way?
Passive versus Active Suicidal Thoughts
According to betterhelp.com, people between the ages of 15 and 35 and those over 65 are at highest risk for having passive suicidal thoughts. These are thoughts that don't have a plan formulated but are just depressive thoughts niggling in the back of one's mind. They would be something along the lines of "It'd be better if I just wasn't here anymore because I wouldn't have to deal with this."
They are nonetheless just as dangerous as active suicidal thoughts because on any given day or in any given situation, a passive thought can turn into an active plan. Depression is a funny animal. It can creep up on you in an instant or it can gradually overcome you moment by moment, leaving you paralyzed and unable to move forward in your life.
Likewise, you can be trolling along placidly in life only to have something hit you so hard you don't know how to get up again. You can then move on from that experience and think you've recovered, only to somehow be dragged under again by another event, much like a riptide in the ocean. Most of us don't really "see" depression coming. We suddenly find ourselves swirling in it and then become aware that we are swimming against the current trying to get out of it.
The most frightening thing about passive suicidal ideation is that it can turn to active intent in an instant. All it needs is a trigger. That looming proverbial last straw can and does send a person to the ledge and causes him or her to finally carry out that passive idea that they had and jump. It's as if a switch were thrown. I believe that it's the loss of hope in all things. It's a feeling that you simply can't go on living as there is too much mental pain.
Society's Impact on Suicidal Thinking
I think the complexity of today's societal makeup and the state of the world are both contributing heavily to a universal state of depression or at the very least, unmitigated levels of anxiety. If most of us aren't depressed on some level over the state of our economy, the very real possibility of death of all human values in our society, and the rising state of fear and violence prevalent all around us, we must already be on medication or be slightly delusional! Every moment of every day, we're bombarded with tragedy and human suffering. We're being blasted with the news of more and more people going rogue and taking the lives of massive crowds of people because of their own mental anguish. We don't feel safe and we don't feel like we can trust anything that was once a reality or a safety net to remain in place.
We can't even be assured that the jobs we have trained for or put our lifetime into in service will stay the same. Many of us don't believe that we'll be financially secure any longer when the price of everything increases and our wages decrease. The adage of working hard paying off has now become a cruel lie to most of us as we realize that the harder we work, the less we seem to get ahead, and the dreams we once had of being able to retire have evaporated. How are any of these things supposed to make people feel?
How is it possible to not become depressed when you can't get a grip on what the world will be like next week let alone next year? Add to that things like worries about climate change, the extinction of species of wildlife, the threat of global conflicts or disease, and we're all are under an incredible amount of stress.
People who are religious, I suppose, have an easier time of it in some ways. By that I mean that I've noticed the people who cling to religion talk about these bad events as if they actually welcome them. I'm always astounded by statements about how they're so glad that the end is near. All these horrific things that are happening in the world today are just a teaser of the life that's to come for those who believe. The misfortunes and tribulations of the world are giving them the silent message that soon their troubles will be over and they will move on to a better place. I suppose it would be a great solution if all of us could believe in that. Unfortunately for me, it's always seemed like a fairy tale. As hard as I have tried to believe and put off my doubts, to look on any form of salvation as a fix-all for the state of our world today, or a cure for depression, I haven't been able to do that. I still believe the words of my grandmother, spoken often, which were..."God helps those who help themselves." Yet how on earth are we to help fix all these problems and how on earth are we to dig out from under this oppressive stress and anxiety?
I've read a lot about how our society has built-in flip switches for many of our anxieties and fears. I think that the possibility of hair triggers in society increases day to day. An example of one such trigger that leads to a behavior would be our nationwide problem with obesity. I've read articles about the fact that we have so many restaurants and places where people can eat or get food that it has now engendered a propensity for morbid obesity in our country to an alarming degree. In previous decades, we had less restaurants and grocery stores, very few take-out places and very limited choices when it came to eating out or just getting food. Today, we no longer have to "wait" to feed our hunger as we are bombarded with opportunity after opportunity to feed ourselves, source upon source stacked upon the other. Experts say this is a highly abnormal exposure and for some people, it simply can't be turned off. People feel that they must "top off the engine" at every opportunity. This results in a perpetual cycle of imagined hunger and eating. The more they do it, the less time in between meals their hunger isn't present. The trigger to eat is ever present. This becomes overwhelming for someone who is trying with all their might to lose weight.
The World Around Us
The lack of polite behavior and caring in society along with the rise in violent crimes has also led to severe levels of anxiety. People don't trust that their homes are safe. People don't trust that their children are safe at the bus stop or in our schools. We all live at high levels of anxiety in today's world. It feels like we can't move about in our day-to-day life without being literally "on top of" other people. Our freeways are teeming masses of people all going somewhere, all in a rush, many becoming angry at the slightest delay or error on the part of another driver.
We rarely want to communicate with others even in passing someone on the street or in a store. It seems that making eye contact with someone is not the current vogue. How many of us whiz past a vehicle on the side of the road or freeway and what is our only thought? "I'm sure they have a cell phone and they'll get help. I'm in a hurry!" Or we would rather drive past than take a chance and stop lest it not be safe.
Everyone seems suspicious of others. We have to lock our doors, our cars, and stand with our children at bus stops lest they be abducted or exposed to the mentally challenged or criminals in our neighborhoods. We can't trust the people next door as they could or might be sex offenders or felons. We worry about sending our children to public school in case a shooting occurs. We worry about attending a music concert or the movies. We aren't even safe going to a Trader Joe's!
There is so much uncertainty in our day-to-day lives that it generates fear and anxiety, which in turn tends to wear people down. This creates a feeding ground for feelings of depression. What's the point? Why do we get up and even try to make a living or try to have a normal life? We worry that no matter how careful we are, something bad can happen in an instant...like someone entering a store and opening fire on innocent people. Or walking into a school and killing our children. Who wouldn't be depressed on some level living in such a world?
The fight or flight response is triggered by many of the scenarios above. Constant exposure to this response and lack of a release from anxiety can lead to extreme levels of anxiety and depression. Added to that the fact that most of us cannot afford to live in a dwelling that isn't right on top of someone else, we have multiple setups for anxiety and deprivation of our sense of peace and tranquility. No matter where we go in the world, we seem to be sandwiched in like sardines.
Our neighborhoods seem to be shrinking in terms of space rather than expanding. Homes built literally on top of each other make us feel that our privacy is invaded. We have to monitor our children and our pets so that no conflicts arise. It begins to feel like we're all living in boxes and cages.
In short, we never get a chance to relax. For most city dwellers, this high state of anxiety keeps our bodies hormonally charged and of course throws off our sense of well-being. It can be a natural slide from a high state of alert to depressive lows.
Freedom of spirit and mind seem to have taken flight in today's society. Is it any wonder then that many of us do feel that blanket of depression wrapping around us? That feeling of what next? What else can possibly go wrong? Why am I here? Where is all of this heading? Even if the believers are right about this being the end of all things as we know it, how much worse will it get?
My Own Experience
My aunt suffered from mental illness. Later in life, she became agoraphobic but when I was growing up, I remember her being this totally gregarious and impulsive person. She drove too fast, smoked too many cigarettes, and was always loud and flamboyant, in manner and in dress. She also seemed a bit "abnormal" even from a child's perspective. I found myself worrying a lot when I was around her as there was something niggling away at me that anything could happen, whatever "anything" was. She wasn't violent like her mother who suffered from some form of schizophrenia, but there was just something "off" and I sensed it.
When I was about 8 or 9, we got a call from my uncle who she had been staying with. Supposedly, out of the blue, she had become depressed and swallowed several bottles of pills including a bottle of aspirin. She was unconscious. After a lengthy hospitalization, she was able to recover, but she was never quite the same after that. She was sent to a state mental facility where she stayed for many years, finally being released permanently when I was a teenager.
We brought her to visit us a couple of times during her confinement, but unfortunately, something always happened to drive her over the edge and back to the hospital. She would go into some kind of delirious state, screaming and yelling, even throwing herself onto the hood of our car one time. The hospital would have to be called and she would be taken away back to the facility. I still remember the arguments between my mother, my grandmother and my aunt and wonder now if those somehow triggered her regressions.
Eventually, they did ECT treatments on her, which may have helped. I've always wondered what her diagnosis actually was. There was obviously very deep depression there or some kind of mental illness going on in the background. When she did exit the facility and resume living on her own, she never worked again and she was always different in terms of being on lots of medications and not being able to handle much in real life. She was no longer her same personality and seemed very muted.
For myself, having suffered through a childhood of severe physical abuse as well as emotional and verbal abuse, I felt the blanket of depression settling on my shoulders several times in my life. I was one of the lucky ones who realized it for what it was though...a reaction to things in my life that were just too hard for me to cope with. I had many challenges later on in my life as well and moments when I was afraid those demons were going to catch up with me, but again, through counseling, I was able to see the gifts that I was given, the other options I had in my rich life, and I was able to overcome the depressive feelings and bounce back.
Why Does Depression Take Hold?
If we read different books or visit websites, we can find an abundant amount of reasons why depression happens and depression to the point of suicide. Here are just some of the most common reasons.
- Abuse. That was what started my journey with episodes of depression. It can come in the form of sexual, physical or emotional abuse. It can be short in duration that starts a trigger of depressive thoughts, or it can be ongoing over many years. All of us seem to possess the capacity to handle abusive situations differently. I often think of the survivors of the Holocaust and how they could possibly have endured their abuse. Some did better than others obviously. I always say that abuse on any level is the gift that keeps on giving. It's hard to block from your mind and you can fall victim to its lure mentally when you least expect it. I remember seeing the movie Good Will Hunting and sobbing ever afterward during the movie when Robin Williams told Matt Damon the simple words "It's not your fault." That freed something in me but sent me hurtling backward to my own abusive situation. Obviously, the key in dealing with depression that stems from abuse is to learn to address those losses and to acknowledge that there may be leftover scars. A scar can become painful in just the right circumstances when touched.
- Conflicts, stresses of life. Losing a job or experiencing bankruptcy can end up sending someone into a depression. Having a falling out with a family member or a friend can send us into a downward spiral. No one truly welcomes conflict. It's a moment where what we thought we knew before isn't quite so anymore and we have to regroup and readjust our thinking to move on. Sometimes that isn't always possible for us. If we've trusted someone and they betray that trust especially, it can turn into a self-deprecating atmosphere where we may blame ourselves for not seeing things as they truly were or for trusting the wrong person. In order to stop the cycle of depression, we have to reach acceptance of circumstances or things for what they are rather than as we would have them be, which is not always an easy task. When people do things that we do not expect, it's a hard pill to swallow. Self-blame keeps us in pain and depression, while learning to accept the situation and move on takes it away.
- Death or loss of someone or something treasured. I can attest to this particular trigger for depression readily. I don't think I've experienced such a profound sadness as I have had in losing my beloved dog, Griffin. He was simply the most wonderful dog I've ever had and I've had at least 15! He was enchanting and loving as well as comic relief every day that we had him. It just was surreal the way that he was diagnosed and died so quickly. To date, it's taken me almost 3 years to even begin to partially get over this loss. In the beginning, I honestly did not know how I would heal or if I could bear it. Only through research and a lot of self-healing have I been able to recover at all from this loss. I know he was "just a dog" but in my mind, he was my therapy dog that I didn't know I had. It can also be the loss of something else though, such as a job, a home, a friend or even something you loved to do. Grief is a funny thing. We all grieve in different ways and for different time periods. The most important thing with grief is learning why it's bothering us so much and then to find constructive ways to try and grieve our losses that do involve moving on. It can feel like trudging through mud but it is possible to grieve and still heal.
- Changes in life situation. Moving to a new place, having to change jobs, getting a divorce, even retiring can all impact us in psychological ways. Suddenly, nothing is the same as it used to be. We have to do something different than what we had done before. While sometimes that can be a new challenge and spark interest or renewed energy, sometimes it can be downright frightening or depressing. When I lost my online teaching job due to being laid off, I was in a panic state. I didn't know what I would do for the extra income we needed, and my husband was already retired. I had to come up with another plan and another direction in which to steer my life and income possibilities. It wasn't easy but I resolved to go back to transcribing, which is physically extremely demanding for someone the older you are, but luckily, I was able to make the transition. It was not easy though and I found many days where I've gotten very discouraged over this turn of events. While I love my job, it's extremely physically demanding and having done it for over 4 decades, I wonder daily how long I will be able to maintain this type of job. I did decide that a day at a time was the best way to approach this particular chapter in my life and that seems to help make it manageable. What I do today, I may do tomorrow or who knows...I may not be able to do tomorrow. I will face that when tomorrow comes. I have learned that worrying about it today will only send me to the dark side and that is somewhere I would prefer to avoid.
- Serious illness or loss of abilities. The older we get, of course, the more we can have go wrong with us, the more we have to take stock and look at what we are capable of doing and what we aren't capable of doing. That can be a bitter pill to swallow so to speak. While we should always be "grateful" for all that we have and what we can do in life, that can be easier said than done. As they say, sometimes the mind is willing but the flesh is weak. It takes a strong personal attitude to realize that we can only do what we can do and be satisfied with that. Depression can occur when we begin to mourn our past capacities (physical or mental). We survive when we can adopt acceptance of what we are today.
- Genetic causes. Things such as bipolar depression or major depressive disorders are medical conditions that are presumed to have a genetic basis. Even disorders like obsessive-compulsive disorder can be terrifically disabling and cause havoc in someone's life. In my aunt's case, I don't think she had any choice or even in my grandmother's case. These were disorders caused by either a genetic cause or perhaps a severe environmental exposure. Unfortunately, I'll never know. I've had friends or remote family members over the years who have suffered from bipolar disorder that could only be treated with medication (as well as counseling), and they have survived!
- Medications. Some medications do have the side effect of causing depressive symptoms. We have only to watch drug commercials to hear all the warnings there. Of course, someone who's experiencing emotional side effects like depression would not want to be on that particular medication but the conundrum there is realizing that it's happening to the individual and why. Sometimes, we only see the end result and put the equation together...such as someone taking an antidepressant that actually increases suicidal thoughts rather than preventing them. It isn't always possible to realize it until it's too late. The red flags might have been there but seeing them in time is the key.
- Substance abuse. Depressive disorders are said to occur in about 30% of people who abuse substances. That's not unusual since substance use changes brain cells and how they function. Withdrawal or coming down from substance use is usually the inciting event because the body craves more of the substance. Overcoming substance abuse can be challenging at the very least, and then treating depression that occurs as a result of it even more challenging as the individual misses the feelings that they experienced while using. Realizing the reason for substance abuse is key of course. Was it an aid to handling inner pain and dealing with feelings of anxiety or even depression? Strangely, using a substance only makes the symptoms we are running away from worse in the final analysis.
Symptoms to Watch For
All of us get "down in the dumps" from time to time. Most often, someone who is contemplating suicide, either passively or actively, has had symptoms for some time. This can be for a matter of weeks or even longer. Usually, they will have many or all of these symptoms, not just one or two. We should be aware of these patterns, in ourselves or those we care about.
- Not wanting to participate in things enjoyed before
- Unfinished projects, diminished work or school performance
- Nonparticipation with family or friends
- Substance or medication use
- Inability to concentrate
- Loss of interest in favorite things/giving away these things
- Sad or unhappy
- Irritable or easily frustrated
- Lack of confidence
- Overwhelmed by smallest things
- Disappointed in themselves
- Self-deprecating or self-loathing
- Significant weight gain
- Significant weight loss
- Headaches or muscle pains
- Sleeping too much or too little
- Constant imagined or real illness
- Loss of appetite
- Excessive laughing or crying
Self-Thoughts or Expressions
- "Life isn't worth living."
- "People would be better off without me here."
- "My life is a total failure."
- "I'm a loser. Nothing ever goes right for me."
- "I'll never get better. I'm worthless."
The Final Straw
Mental health professionals analyze those who attempt suicide and those who complete suicide every day. There's a lot of evidence in some people's opinion that points toward the assumption that the persons who complete suicide have a greater sense of burden than those who attempt it and fail.
People who have a plan and actually carry through with it have come to the conclusion that they are willing to endure physical pain and the consequences of their choice in order to escape what they feel is just too much to handle.
Some reports say that suicide by hanging is chosen because of the almost "guaranteed" certainty of death. The success rate is as high as greater than 70%. We could extrapolate that the person deciding upon this method is definitely not sending out a warning or hoping to have someone pick up on a cry for help. They are completely and ultimately serious in their thought that they simply cannot go on the way they currently feel and the only way out for them is to end it.
How do people on the outside help people who are struggling with thoughts of self-harm? In my case, I generally knew when I was reaching toxic levels of depression and since I had so much depending on me and such a robust life to live for, I always had a great motive for pulling myself back from the ledge if I got depressed. I knew enough from my research to know it wasn't truly my fault and I was letting something overtake me. I could read the signs and symptoms and always knew when to get help. Unfortunately, that doesn't always occur for people and one or more of the triggers we have talked about so far just send the final message and the person gives up. We have to be good self-monitors of depressive feelings, and/or we need the people around us (family and friends) to have our backs so to speak and be aware of the signs of depression.
Staying Off the Ledge
Obviously, the best way to stay off the ledge is to take good care to not get to that point of despair. For many of us, that's easier said than done. Sometimes, life just sneaks up on us and we don't realize that we are in the pit until we find ourselves looking up trying to figure out how to get ourselves back up to solid ground.
Call a hotline if you feel despondent or are feeling overwhelmed by life in general. We all feel that way at some point in time. However, if the feelings are not ones that come and go, treatment will be needed of some kind, whether it's therapy or counseling or medication. In rare cases, a short-term hospitalization can also help put a life back into perspective before something regretable occurs.
Know that you are not alone. There are millions of us who have struggled with depressive feelings and fought our way back. For me, the key has been knowing my own self-worth and knowing that I make a difference in being here. Life may be extremely hard at times and in those times, sadness can be a byproduct of that. However, telling someone about your feelings and seeking help in any form is not weakness. It is strength at its very best. It's you saying "I want to live and I want to be happy." Healing is possible if we can address the reasons for our depression and the reasons we think it might be simpler to go out on the ledge in the first place.
All of the experiences we have in life are the sum total of who we are and what we "grow up" to be. I feel that I'm still a work in progress. It isn't over yet. I have many more experiences to own and many more triumphs and tragedies to embrace. We can't see what's coming but we can learn to deal with it all. Life is for living and all we can individually do is try and do that the best way we know how while causing no harm to others.
We can also lessen the burden for others simply by being ourselves but trying to think of a broader picture. How we react to the world around us has a lot to do with our own self-esteem. If we give of ourselves and try to as well be kind to ourselves, forgiving our own frailties and those of others, we make the world better by being in it. That is the theory that I'm sticking with. I know I matter and that the world I live in is better for my presence in it. That is enough for me and I pray it is for you as well.
© 2018 Audrey Kirchner