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Please Don't Kill Yourself: An Open Letter from A Psychiatrist

Updated on March 14, 2013

According to the American Foundation for Suicide Prevention ( suicide is currently the 10th leading cause of death in the United States. It is the 4th leading cause of death in people ages 18 to 65 years of age. And every 14 minutes another person dies by suicide. In 2010 there were 38,364 deaths by suicide in the United states. By contrast there were 14,478 deaths by homicide the same year. Over 90% of people who commit suicide have a mental illness that could be treated. They don’t have to die.

What someone who dies by suicide doesn’t see is the incredible hole his death leaves behind in the hearts of people who knew him. She doesn’t see the horrific pain in the eyes of the people who she has left behind. I see those things, because I work with the family members and friends who survive. I see those things because I’ve been the person who survived, both professionally and personally.

I am writing this today after we learned a staff member at my hospital killed himself last night. This is a person who was liked and respected by his colleagues. Many people have reacted with disbelief. One person said “I just spoke with him last week and we laughed.” Another person suggested that it was more likely he had been killed by someone else than that he took his own life. People are crying in the hallways and gathering in offices to comfort each other. I imagine that this person had no idea about the pain he would cause. I imagine he only was able to think about and feel his own pain.

We take a mandatory suicide prevention course every year in my workplace. We talk about signs of distress and how to ask someone. We don’t have a course on what to do when someone looks fine and there aren’t any obvious signs of problems. I don’t know if anyone asked this person if he was thinking of killing himself. I don’t think anyone had a reason to think to ask the question.

As a psychiatrist, suicide is the enemy I fight. Suicide and homicide are the two worst outcomes of mental illness, and of the two suicide is by far the more common. I have had to come to grips with the fact that I can’t stop anyone from killing himself. I can do my best to be present, to hear what someone is saying and offer them both help and hope. But I can’t prevent suicide. I can only ask – please don’t kill yourself. Please get help. Let yourself ask for help. You are not alone. Please believe that things can get better, that illness can be treated and problems overcome.


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    • Rose Anne Karesh profile imageAUTHOR

      Rose Anne Karesh 

      5 years ago from Virginia

      Hi krillco, thanks for commenting. I would love to read your material when it is ready, I hope you publish it. So many people struggle with those issues of meaningless and aloneness.

    • krillco profile image

      William E Krill Jr 

      5 years ago from Hollidaysburg, PA

      Amen. It's hard to know you have thrown a lifeline and the person drowning cast it aside. It think a major source of no-indication-of-trouble suicide is often located in individuals with an acute sense of existential depression rather than the DSM depressions. I am working on material and approaches to this issue, directed at helping those of us with existential depression to learn methods of coping with it, living with it, and finding joy and purpose in life despite it.


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