Can you predict who will take their life?
We cannot predict who is going to die by suicide. Most people who experience or exhibit warning signs don’t take their lives. There are many risk factors, but there is a lack of specificity in those risk factors. Many people get depressed or go through periods of hopelessness. For statistical reasons having to do with the relative infrequency of suicide and lack of specificity of any risk factor or group of risk factors related to suicidal behavior, it makes it impossible to predict who will die by suicide.
There is no blood test. There is no brain scan. There is no psychological test that can tell us if and when an individual will engage in suicidal behavior. We look for triggers and warning signs that have been associated with suicide risk in vulnerable individuals because it makes common sense to do so and can save lives. But in the end, we don’t know what is in the mind of that person who ultimately decides to take their own life. We don’t know that final thought because it’s never available to us. Because of that, there’s a certain degree of humility that I think all of us who work with people who struggle with suicidal feelings have to accept and understand.
Is there still a stigma around mental illness and suicide?
I think it’s getting better very slowly, but it is still a huge problem. Efforts of organizations like the National Alliance on Mental Illness are making an impact, and public figures coming out and sharing their mental health struggles helps too. But I think that the stigma remains a problem, particularly in some communities more than others. When there are cultural prohibitions or consequences to having a mental illness or getting treated for one, it makes it that much more difficult to access care.
Struggling with depression, anxiety, or having thoughts of suicide is not uncommon, yet many people seem to distance themselves from it — perhaps because it’s not the way that people want to see themselves. The sense of emotional well-being is so closely connected to who you are in the world. It’s different than if you have pneumonia or diabetes, if something happens to you — somehow the idea of mental illness isn’t viewed the same way, perhaps because it’s so closely aligned with a sense of self and identity — even though these are brain diseases.
How can people who have lost someone to suicide cope?
Be aware of your feelings and understand and accept the fact that you are going to have very strong feelings about what happened. That’s normal and appropriate, and you will need support. The extent of that support may be limited or may be extensive in terms of getting into therapy.
There is no constructive role for guilt or self-blame — there has already been one casualty, and we need not create any more. Feelings of guilt, loss, anger, and, of course, tremendous sadness are all natural feelings that can be dealt with and understood in the context of the circumstance.
If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741.