A Personal Note On Suicide

A Personal Note On Suicide

***TRIGGER WARNING- This article contains information about suicide which may be upsetting to some people. If you or anyone you know is struggling with thoughts of suicide please call your local suicide hotline or visit http://www.iasp.info/resources/Crisis_Centres/

Suicide sucks. Plan and simple. It always seems to hit us when we least expect it and it always hurts. It doesn’t matter the age, the circumstance. It always feel like a life was taking before its time.

The last half of 2018 has been a helluva time for me. Over the past 6 months I have dealt with the deaths of five people who were either directly or indirectly under my care. One died of an accidental heroin overdose, the other four were suicides by hanging.

I have seen CPR performed heroically and tirelessly, but in vain on two of those deaths and it is an indescribable feeling to see someone I knew, someone I had spoken to earlier that day, laying on the ground motionless. Someone so young (one was in her twenties, the other in her thirties) and so full of life at one point, now lifeless.

Suicide is an unfortunate evil we have to deal with in the mental health field. My current job puts me in the role of dealing with suicidal patients all day long.

I am used to dealing with suicidal patients, even patients who attempt suicide or self-injure, but I am and never will be used to dealing with completed suicides. I take each death personally, even if professionally and ethically my staff and myself did everything we could to prevent it.

Suicide is often an impulsive act. At least one of the suicides appears to have been the result of rage. Suicide is often thought of as anger turned inward.

Suicide sometimes builds overtime and is the result of unbearable psyche pain. Three of the suicides, at least on the surface, appear to have been thought out. One woman was grieving over the loss of her sister and blaming herself for her sisters death. She was filled with depression and guilt she found insufferable. Another man was facing a lengthy prison sentence and decided he would rather die than go back to prison and spent years locked away. He was the only one who left a suicide letter behind. It was obviously something he had given some thought to.

Suicide, as we have seen too often lately, is sometimes the result of bullying, which appears to have been the case in the last suicide and another serious suicide attempt a couple of weeks after that one. Adults in correctional settings who are exposed to bullying are at high risk for suicide.

There weren’t any obvious warning signs that could have prevented any of these deaths. Accept for the accidental heroin overdose, these individuals seemed to have been determined, in those moments, to end their lives. I wish I could have saved them. I wish I could have saved them all. I cried after each of those suicides because I knew those individuals, maybe not terribly intimately, but as close as you can professionally under these circumstances.

I even thought about resigning because I felt like we failed them although multiple internal and external reviews showed that we did not. However, I know that for these five lives lost, there a countless numbers of suicides we have prevented. And that’s what keeps me going. That’s what keeps us all going.

 

 

 

 

Those Left Behind: The Aftermath of Suicide

young-women-comfortingEarly yesterday morning I got a call from the Health Services Administrator (HSA) at the jail informing me that a nurse had committed suicide overnight.
It was a shock because I knew this nurse and had just saw her two days earlier. The HSA wanted me to come in and help break the news to the other medical staff and offer support to those who needed it.
I prepared myself for that, but what I wasn’t prepared for was getting a call from her grieving fiancé who of course was having a very difficult time dealing with the tragedy.
He had spoken to her before she committed suicide, through text messaging. She had texted him a picture of a bunch of pills, but she had done that before and he thought it was an attention seeking, manipulation game and so he ignored it.
Now that she is gone he is blaming himself.
The night shift nurses, the ones that worked closes with her took it the hardest. Especially one young nurse who had grown attached to her. She broke down and sobbed continuously. She kept talking about how strange it was going to be to come to work and not see her there.
This woman also left behind two young children.
It is estimated that each suicide affects at least six people, including family, close friends, co-workers and neighbors.
After a loved one has committed suicide, it’s not uncommon for those affected by their death to start falling apart from the intense grief and the fruitless search for the answer “why?”.
The people left behind to deal with the impact of suicide often find themselves so emotionally devastated that it’s hard to move forward.
This feelings often include:
  • Shock– most people experience shock or a sense of emotional and physical numbness as the first reaction to learning someone they care about has committed suicide. It’s the mind and bodies natural way of trying to slow things down until it can try to make sense of what happened.
  • Anger– people often feel anger, either directly or indirectly. They may be angry at the person who committed suicide, angry at themselves for not being able to prevent it, or angry at the persons therapist for not being able to “cure” the person.
  • Guilt– Loved ones, in an attempt to find answers to why a person killed themselves often ruminate on signs they may have missed. They may blame themselves for not expressing love, for being too distant, for not believing the person when they said they were depressed for the 1ooth time. The “what ifs” can go on and on.
  • Fear– Once someone has committed suicide, it’s not uncommon for family members to become afraid that they will lose someone else to suicide or that even they themselves could possibly commit suicide.
  • Relief– It’s also not uncommon for family and friends to feel a sense of relief, especially if the individual suffered from chronic mental or physical illness (i.e, intense pain) or even if they person had been on a long, steady decline of self-destructive behaviors such as drug addiction.
  • Depression– While it’s natural to go through grief when you’ve lost someone close to you, it’s not uncommon for grief to turn into depression if that loved one took their own life. The person may experience sleep disturbance, lose of appetite and loss of energy.  This can translate into feelings of life being worthless and losing joy in things one once found enjoyable.
In normal grief, all of these feelings will start to ease up overtime, it only becomes concerning when they remain very intense and do not seem to improve with time.
For people affected by an individuals suicide, it’s important that they:
  • Stay Close to family and friends– having a good support system is important to keep an individual from isolating themselves and ruminating on the suicide, especially in the first 6 months. The person may not feel like being around others and may not be ready to talk about their feelings, but they still need to have supportive contact.
  • Give children special attention– Children especially may have a hard time coping with a loved ones suicide. They need special attention so that they can express their emotions and talk them out. They need to know that grief is a normal process and need the adults in their lives to model healthy grieving for them, including open communication, sharing feelings and reminding them that they are loved and supported.
  • Be aware of special occasions– holidays, birthdays, anniversaries, etc., can all be very stressful times.People may need extra support or checking up on.
It takes time to heal from the loss of a loved one, especially when that person has committed suicide. While the pain may feel like it’s never going to go away, it will get better. Having the support of loved ones will help with that process.
Remember to express love for the person that was lost, love for the family and friends that are still here and and love for yourself.

Helping Someone Who Has Lost Someone To Suicide

Helping Someone Who Has Lost Someone To Suicide

Earlier this week I was called to talk to a juvenile who had witnessed her boyfriend shoot himself the night before. He didn’t make it. She was obviously upset and making her way through the various stages of grief, but what was most pronounced were denial and anger. She is only 15 and he was 18. His life already over. Her life changed forever. As I listened to her talk, first with disbelief, then with anger at herself for not stopping him, then anger at him for leaving her, until she finally broke down in uncontrollable sobbing before returning back to anger and guilt directed towards herself.

Sadly, during my career I have dealt with a lot of death, but suicides always present their own unique set of challenges. People who have lost someone to suicide often not only feel the grief and tremendous loss that comes along with death in general, but they often also feel guilty that someone they knew decided that whatever they were going through was too much to bear.

A couple of years ago in an auditorium filled with crying high school students, teachers, and parents, after a popular student athlete killed himself, what I heard most was people blaming themselves for not recognizing signs that weren’t there. While sometimes suicides come with warnings, often they are very abrupt.

The irrevocable pain the loved ones of someone who committed suicide feel can cause them to become an emotional and mental wreck. Those of us looking in from the outside often want to help, but are unsure how.

You don’t have to be trained as a mental health professional (trust me, often times all the training in the world doesn’t make it easier), but here are some ways you help someone you know who has lost someone to suicide.

Let them come to you.

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As part of the Crisis team I had to go to several schools over the course of five years after a student had committed suicide. I would walk into a school I didn’t know and come face to face with distraught students, teachers, and parents I didn’t know. It is scary. The best thing I did was to be there and let those who wanted to talk come to me. If I saw that someone was obviously very upset I would go to them, hand them a tissue, sit next to them, and wait for them to open up to me. It always worked.

As a friend, try to normalize things. Let the moment be as natural as possible. When they are ready, they will talk as long as you are there.

Remember the good times.

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This is a lesson I learned from watching other, more seasoned mental health professionals during those crisis moments. While acknowledging the tragedy of what happened is important, it can be just as important and powerful to help them remember the good times they had with the person they lost. While this may seem counter-intuitive, I’ve seen it work miracles in helping someone stop reflecting on death and to start celebrating someone’s life. I’ve seen people go from sobbing to laughing and from being unable to process the tragedy to opening up completely. So, when they are ready, encourage them remember and talk about happy memories about the person.

Ask good questions.

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The young lady I spoke to earlier this week said what most people who lost someone to suicide say at some point; “I don’t understand why he did this.” Naturally I wanted to help her process that, but I knew it was more important that I resist that urge and get her to talk about herself.

It’s important to avoid statements like, “I’m sure you did everything you could”, but instead ask questions like, “Tell me what have you been thinking?”, “What was it like the last few times you were together?”, “What did you see?” These questions allow the person to open up as slowly and as much as they want to.

In the case of the young girl I spoke with earlier in the week, the last question was a big one because she had witnessed the suicide and it allowed us to process that entire scene at her own pace.

Be there, be mindful.

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When someone experiences such a tragedy, often they are inconsolable. That is one of the few things that bothers me about getting sudden calls to talk to someone when they have just lost a loved one. I know that generally, with everything so raw, there’s not much I can say that is going to make them feel better in that moment.

What I do, and what you can do as well, is just be there. I sit with them and make myself available. I allow them to cry or to say nothing if they don’t want to. As a friend, you can do the same. You can put your arm around them, hug them, or just be there as a source of comfort. That can be more powerful than trying to find the right words to say.

Find the balance between intrusion and distance.

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It is common after someone has lost someone that they will want to be alone so that they can figure out their own emotions and thoughts. You can give someone mental space while still remaining physically present.

What that means is, you can be in the same room with the person, but allow them silence if that is what they want. Allow them some space if that is what they need. You can even be in another room and remind them that you are there for them if they need you.

Offer practical help.

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After an incredible loss, the person suffering will need help if they realize it or not. After my father died I spent countless days not eating, not showering, and only wanting to sleep. I didn’t even realize I was doing those things, I just remember that my life felt upside down.

Allow the person to go through the natural grief and mourning process, but also offer to help do things to make this time in their lives a little more manageable.

For instance, go grocery shopping for them, pick up the kids, and remind them to eat, to shower, or even ask them how you can be helpful. They may not know that they need help or even have the awareness to be thankful for the help you give them, but trust me, it will help them make it through the darkness.

Allow them to problem solve on their own.

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Eventually, the person will ask more of the tough questions about why the person did what they did and what they could have or should have done. Try not to get caught up in problem solving for them, but allow them to work through that themselves. You can be there for them by asking intelligent questions like; “What thoughts did you have when the suicide first happened?” What thoughts do you have now?” But allow them to reflect and figure that out on their own so that they can put it in perspective for themselves.

Suicide is a tragedy and people who have suffered such an extreme lost need good friends to help see them through it.

What We Can Learn From The Dying

dying-wife-istockI’ve read a lot of books and information about death, grief and suicide. Those books have been both some of the most depressing and uplifting books I have ever read. Some of the most interesting books have been on people who were terminally ill like a book written by Bronnie Ware called The Five Regrets of the Dying.

We can learn a lot from the regrets of the  dying as regrets can give us insight if we look at them as things we can change so that hopefully we won’t have the same regrets. Here we’ll talk about the top five regrets of the dying as mentioned in The Five Regret.

  1. I wish I’d had the courage to live a life true to myself, not the life others expected of me: Many of us live lives that are inauthentic to who we really are and what we really want. It’s hard not to when we have been bombarded since birth by our parents and later by society about who we should be and what we should want, even when it contradicts our true desires. Even more disturbing is that many of us have been so brainwashed that we don’t even know when we are living inauthentic and think that the thoughts and goals that have been inserted inside of our minds by culture, society and family, are really our own when in fact they may be keeping us from living authentically. Something we can work on is recognizing this and attempting to live a life that is more inline with our true desires and goals.
  2. I wish I hadn’t worked so hard: We are taught that we are supposed to work hard and as a matter of fact, many people enjoy working hard, but many use working hard to escape dealing with other issues or work hard because it is what is expected of them. However, most people who are dying wished they would have spent more time doing things that nourished them, such as hobbies or spending time with friends and family, instead of working and collecting material items that now serve them little to no purpose. Sometimes we must work hard in order to pay the bills and “free time” doesn’t seem like an option, but we still have to find the time to do things that will serve us better spiritually.
  3. I wish I had the courage to express my feelings: How many times do we hold our tongues and not say the things we really want to say to family, friends, etc? We end up becoming passive and not assertive in order to save face or avoid a potential argument. Furthermore, a lot of people have trouble expressing love and affection and miss out on opportunities to let others know how they truly feel about them. In order for us to live a life with less regrets, we have to live a more authentic life where we are not only in touch with our true feelings,  but are able to express them.
  4. I wish I had stayed in touch with my friends: It’s easy with the pressures of life and how fast paced  things can be, to lose touch with our friends, but having healthy, nurturing relationships adds to the overall happiness and quality of life. Maybe today you can find a way to start re-connecting with good and healthy people that will help bring joy to your life.
  5. I wish I had let myself be happier: In the book Five Regrets of the Dying, most people didn’t realize until they were dying that happiness is a choice. Sure things happen to us, many that are out of our control, but we still choose how to deal with that situation and how we will let it affect us. We can start becoming more aware and make more  conscious decisions about how to deal and respond to those situations instead of allowing them to bring us down, make us angry or throw us for a loop.

The good thing about other peoples mistakes and regrets is that we can learn from them and hopefully not end up having the same regrets. We can all start today by looking over this list and incorporating our own so that we can live a happier, more authentic life.

Robin Williams: Depression, Bipolar Disorder, Substance abuse And Suicide

robin-williams7878It’s hard for many people to understand how someone can be “successful”, and “wealthy” and still be miserable and end up committing suicide, but mental illness and substance abuse doesn’t care about socio-economic status.

There are countless examples of wealthy and famous celebrities who have taken their lives in the face of mental illness and/or addiction. 

Still, many are shocked that someone so funny and loved as Robin Williams, age 63, who’s been battling bipolar disorder, severe depression, drug abuse and alcoholism for a large part of his life, would end up taking his own life. 

For anyone who has ever felt the pain of severe depression knows that once it has a grip on them, it’s almost like being covered in darkness where they can’t see past their failures, no matter how successful they are.

The only thing that they see, hear and think about are their missed opportunities, mistakes and what seems like the bleakness of the future. It doesn’t matter if they are happily married, have accomplished many goals, all they see are their failures. They forget all of their successes and things they should be proud of and just become consumed with feelings of worthlessness, shame and guilt.

When in a deep depression, suicidal thoughts may creep in and become overwhelming to the point where the person feels like they are a burden to the world, especially those close to them. They feel like their spouses, children and friends would be better off without them. Their view of reality becomes severely distorted.

In Robin Williams case, he was married, had children, had a long successful career, was loved by millions, yet he battled addiction, bipolar disorder and depression. At some point in the midst of his depression, the thoughts of being worthless and a burden became overwhelming. 

It also speaks to the point that depression and suicide doesn’t go away at a certain point of wealthiness or happiness. It’s a disease.

Robin Williams is no different than anyone else who suffers from a severe mental illness. About 90% of people who commit suicide have an undiagnosed, untreated or undertreated mental illness. 

Robin Williams was also in the demographic of those highly at risk of suicide which are white, middle aged men with health problems. Robin Williams had been suffering from a heart condition and it’s possible that the thought of losing control of his life, his quality of life or losing his life in general to a physical illness, increased his risk of suicide. 

More than 38,000 Americans commit suicide each year and while depression can last a life time, suicidal thoughts are usually temporary and the act of suicide itself is often impulsive. If we can deter someone from committing suicide they usually will move on from the desire to kill themselves even though the depression continues. 

According to the American Association of Suicidology:

  • 39,518 people died by suicide in the U.S. (2011)
  • 108.3 per day
  • 1 person every 13.3 minutes
  • 3.6 male deaths for each female death by suicide

Comparison to other highly publicized causes of death per year:

  • Homicide 16,238
  • Prostate Cancer 32,050
  • Motor Vehicle Accidents 35,303
  • Suicide 39,518
  • Breast Cancer 39,520

By age:

  • Middle age (45-64 years): 18.6 per 100,000,
  • Elderly: 15.3 per 100,000

*Teens (15-24) is 11 per 100,000*

*The rate for middle aged has been increasing and surpassed the rate for elderly a few years ago*

If you are anyone you know is suffering from suicidal thoughts, the national suicide prevention lifeline can be reached at 1-800-273-8255 or http://www.suicidepreventionlifeline.org

Young Stars Bright Futures Cut Short By Suicide

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Lee Thompson

I have been a fan of Lee Thompson since my college days when I would find myself watching The Famous Jett Jackson on the Disney channel despite it being meant for teens between the ages of 12 and 16.  After all, here was an African-American movie star/spy who lived with his father and grandmother and got into various adventurous with his friends, how could I not find that interesting?

Lee also starred in the movie Friday Night Lights and was in Akeelah and The Bee .

Tragically however, Lee, who was currently starring in TNTs police drama Rizzoli & Isles, committed suicide on August 19th. He was just 29 years old.

I personally was shocked by the news of his death because he was a fairly low key actor. I never heard about him getting into trouble with the law, abusing drugs or alcohol or even much about him having any mental or emotional instability. I always assumed he was just doing fine and that is the danger when it comes to suicide.

As I have stated before, I have done a lot of crisis counseling in the aftermath of people who have committed suicide and often the words I hear from family members and friends is that they thought the person was doing just fine and their suicide came as a huge shock.

And this is where some of the stigma that surrounds mental illness comes into play. According to sources, Lee may have been battling depression quietly for a long time. Some are saying that he really changed once he started practicing an African religion called Yoruba, but it’s very likely that in an attempt to ease his depression, he sought refuge in religion and when that failed to lighten his depression, he unfortunately thought his only alternative was death.

Sources say that his mom was worried about him because many of his friends that lived in Los Angeles with him had moved and that he was surrounded mostly by “industry types” and not real friends. If this is true, definitely having a lack of a support system/network increases the chances of someone with suicidal thoughts to actually act on them.

Apparently Lee was close to his mother and sister, but probably out of pride and/or shame (stigma even), never told them about his depression or at least about how bad it really was. Many times men feel weak for feeling depressed and will hold it in and take their lives without anyone knowing how long they had been suffering.

His coworkers on the set of the show Rizzoli & Isles got suspicious when he didn’t show up for work and sent an officer to his house to check on him and that is where he was found dead. Jackson didn’t leave behind a suicide note, but sources say that he took his life with a gun.

This comes right after reality television star Gia Allemand (who was also 29) of Bachelor and Maxim modeling fame committed suicide by hanging herself with a vacuum cleaner cord two hours after her NBA boyfriend Ryan Anderson told her that he didn’t love her any more on August 12th.

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Gia

According to Gia’s father, she had a long history struggling with dealing with rejection when it came to friends and boyfriends.

Honestly I didn’t know much about Gia until this happened. I remember getting ready for work when it came on the morning news show and I paused to listen to the story. It’s troubling to me when anyone who commits suicide, but it’s especially painful when people who are in the spot light commit suicide because that often sends a message to their fans and others that it’s okay to end your life if you think there is no other solution.

There are ALWAYS other solutions.

Unfortunately when you are in the middle of a deep depression or a mental/emotional/psychological break down, it’s easy to imagine that life will never get better, that it will never be as you want it to be and that death is an easy escape.

Suicide is a permanent decision to a temporary problem is a popular saying, but unfortunately suicidal people ususally believe that their problem is indeed permanent even when it’s not.

**If you or someone you know needs help, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)**

Mindy McCready: Addiction, Mental Illness And Suicide

1358256839_mindy-mccready-articleSuicide is such a tragic occurrence in life, something that always surprises me a little, even when it’s expected, such as in the case of Chris Domer.

Even more shocking are the instances when it’s not expected, even if the person has had a troubling past, such as Mindy McCready.

Mindy McCready was a 37 year old country music star who apparently committed suicide this past Sunday afternoon by shooting herself in the head on her front porch. Besides being a country music star, more importantly, McCready was the mother of two boys, including a ten month old infant.

It’s hard to imagine the stress/circumstances that would cause a mother of two to want to take her own life, so I thought it would be a good idea to examine some of the stressors McCready was under.

Recently, her fiance and the father of her ten month old infant, record producer David Wilson died of an apparent suicide. This tragedy in itself could have been enough to push McCready into a suicidal state. Here is the father of her infant child, now dead, someone she had planned to spend the rest of her life with, and now he’s abandoned her.

On top of that, whenever someone close to someone commits suicide (and often they don’t even have to be that close personally), it makes it easier for that person to think about and even commit suicide themselves if they are already in a fragile state. That’s why having a family member who has committed suicide makes a person more at risk for committing suicide and why communities and schools often experience clusters of suicide after someone in that community or school has killed themselves. Perhaps the death of her infant’s baby’s father made it easier for McCready to end her own life.

On top of that traumatic experience, McCready also suffered from addiction and mental illness, both of which increases a persons likelihood of attempting suicide.

McCready had two previous suicide attempts in 2005, including attempting to overdose on drugs and alcohol. She was found unconscious in her hotel room and hospitalized. Then later that September while pregnant with her first son, she attempted suicide again by overdosing on anti-depressants. In 2008 McCready was also treated for an apparent suicide attempt after slashing her wrists. She was hospitalized at least once more after an overdose, or what may have been a bad reaction to some Darvocet apparently given to her by her mother.

Her battle with addiction and mental illness was often public. She appeared on Celebrity Rehab with Dr. Drew Pinsky and on The View. She spoke with Dr. Drew about the stigma she felt from the media and her fans about being in rehab, a topic he discussed on CNN after her suicide:

“Her biggest fear was the stigma of doing so and what people would think if she, God forbid, took care of herself. And this to me is the most distressing part of this story. She is a lovely woman, we have lost her, and it didn’t have to go down like this.”

McCready was also dealing with an ongoing custody battle that was often nasty and very public. Her ex-husband who is her first son’s father, Billy McKnight, wanted primary custody of their son and filed motions in court to have McCready submit to drug and alcohol testing and also undergo a psychological evaluation.

Despite her struggles with addiction, mental illness and an often rocky personal life, McCready still tried to remain positive. On her fan page in January 2012 she wrote:

“I haven’t had a hit in almost a decade. I’ve spent my fortune, tarnished my public view and made myself the brunt of punch line after punch line. I’ve been beaten, sued, robbed, arrested, jailed, and evicted. But I’m still here. With a handful of people that I know and trust, a revived determination, and both middle fingers up in the air, I’m ready. I’ve been here before. I’m a fighter. I’m down, but I’ll never be out.”

Perhaps the death of her infant’s father, a man she called (after his dead), her soulmate and life partner, was the final straw that broke the fighter in her. They both apparently killed themselves by shooting themselves in the head.

It could have been her addiction. After all, she had left treatment for substance abuse early and was reluctant to re-enter treatment due to the stigma she had faced in the media and with fans.

Chances are, it was a combination of everything: addiction, mental illness, dealing with the recent death of her fiance, a custody battle and having an overall bleak outlook on her future.

Suicide is a permanent solution to a usually temporary problem.

It hurts when we lose anyone to suicide and addiction and it’s sad that we have lost yet another bright star. Like Dr. Drew said, it didn’t have to go down like this.