Suicide awareness: what to know
Child and Adult Psychiatrist Dr. Domenick Sportelli helps us understand suicide and suicidal thoughts and how better to help any loved ones who may be struggling with suicide ideation.
Suicide is a very real thing and a very dangerous thing, obviously. And we deal with this all the time
in the field of behavioral health. And people often ask, why would somebody ever want to harm themselves?
Understanding this a little bit better might help us approach these individuals in a better way and even treat them better.
So why would somebody even think about harming themselves? Well, first and foremost, it might be escape from a discomfort or a circumstance or a situation.
Another reason might be that they're trying to escape feelings, that they're very, very depressed or very, very anxious.
So in most cases, it's an escape. In a lot of cases, suicide feels to the individual
that it's the only solution that they can come to get rid of these uncomfortable emotions
and circumstances in their lives. Another reason why somebody might consider hurting themselves is physical pain. Sometimes we see people that have
significant chronic pain in their lives, and they can't control it. And it leads them to think down the lines of self-injury
or suicide. So another thing to address as well is, what is it about the potential increase in suicide
lately? And we've identified some things in research. One is that there still is a mental health stigma.
So people do still, unfortunately, perceive mental illness-- whether it's depression or anxiety or something
like bipolar disorder-- they still think, wow, there's something wrong with me that's a character flaw. I shouldn't be experiencing this.
No one will understand this. I can't talk to anybody about this. So there's still that stigma. And what that does, it sets up an environment where they
don't feel understood, they feel isolated, they feel alone, and they feel as though they cannot get help.
So that's one reason why we think that suicide rates are as prevalent as they are.
A couple of other thoughts are individuals that have access to lethal means can absolutely increase the suicide rate.
Economic circumstances-- when we go through economic turmoil, this can absolutely bump the suicide rate.
We've recently gone through a pandemic with a lot of isolation, which contributed to a lot of mood disorders. So we know that for sure.
Social isolation, as I just said-- with the pandemic that was a big one. Substance use is on the rise.
We know that the opioid epidemic is an incredibly dangerous circumstance, at least in the United States right now.
And that will also drive up the potential for self-harm, self-injury, and suicide. When children experience something
called adverse childhood experiences like trauma and neglect, abuse, they have a higher likelihood of hurting themselves as well.
So in the case of society and socioeconomics, if kids are having a hard time, well, then that generation
might have a hard time down the line as well. So we look at what's called adverse childhood experiences. Media influence is a big one.
Now media is everywhere. And we have access to so much information now. And there is something called suicide contagion, where
if people or kids or adolescents or even adults, for that matter, see people harming themselves,
maybe even see people that they looked up to such as role models mentors or famous individuals that engaged in self-injury, there could potentially be what
we call a suicide contagion. So we want to pay attention to that as well. And unfortunately, with the rise of social media,
there is a rise in what we call cyberbullying. And this is especially challenging because it's really hard for children and adolescents
and even adults to escape bullying and criticism and harassment.
So it makes it very, very hard. And unfortunately, a lot of these individuals think that the only escape is to harm themselves and engage
in suicidal behavior. So when we're thinking about this-- and I deal with this in the emergency departments quite
often, unfortunately-- if you feel that someone might be feeling depressed or sad or suicidal, there
are a couple of things that you can do to help them. And I think most importantly, let them know that you care and that they're not alone, because I'm telling you
right now, probably a large reason why they feel the way they feel is because they feel isolated and misunderstood. So that will go a long way.
When you do this, you want to do it in a non-judgmental way and a non-critical way. Reassure the individual that what they're going through
is not permanent. In psychiatry, we have an old cliche saying. And it says that suicide is a permanent solution
to a temporary problem. And when you're in the midst of a storm, sometimes it's really, really hard to see your way out.
So you need someone else who can see past that storm to guide you through that storm and get you to the sunlight on the other side.
And that's a really, really important thing to think about when you're helping somebody that's going through something like this. You know, what I find is-- and people are afraid to do this.
And research has proven otherwise. And I think this is a very important point. People fear that if I talk about suicide with my kids
or with someone that might be feeling suicidal or depressed, that that is going to contribute to their suicidal behavior.
Well, that has been proven wrong. So actually, awareness and discussing suicidal thoughts and feelings with someone that you think
might be experiencing these things has more of a likelihood to help them than to hurt them. So you're very unlikely going to do more harm by talking
to somebody about this. Now I understand that a lot of you out there are not behavioral health professionals. But what I will tell you are some things that don't help.
And you know, it's very common for us in the non-medical community or non-behavioral health community
to think that we could just say, hey, cheer up. You'll be fine. People that are going through a major depressive episode, that
will make them feel more misunderstood and more isolated. So things that you want to avoid is saying things like hey, cheer up, you'll be fine.
Being dismissive of it can be a little challenging for somebody. Just changing the subject and not really engaging it
can be hard for the individual that's suffering with this. Even sometimes just trying to give advice
the way you would handle it sometimes isn't the best way to do it. Asking them directly, are you feeling suicidal?
Don't be afraid to ask someone directly, are you feeling like you want to end your life? Do you have suicidal thoughts?
Are you feeling suicidal? Do you have a plan to hurt yourself? We know in research that by asking these direct questions,
you're more likely to engage in a productive conversation that can get this individual help. Some do's and don'ts, some understanding of suicidality
and why it's been happening and why it takes place, and how to approach it-- but I'm going to say this as a medical
doc, as a behavioral health specialist. The way that I look at suicide intention or suicidal thinking, that is the heart attack
if I was a cardiologist, meaning, that's an emergency. So if somebody that you love or care about or know
is experiencing suicidal thinking, it's an emergency. It's time to call 911. It's time to intervene.
And it's time to get them help. So hopefully, this makes a little bit more sense about such an incredibly challenging topic. [AUDIO LOGO]
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