Suicide

Suicides are always up at this time of year. Note: This is not about planned suicide as a way out of an illness. I'm talking about unexpected suicides.

Some of you have had a beloved family member or friend commit suicide, and it's never easy to live with. Just as people are all different, reasons for suicide are, too. That means that we are left with a big Scooby-Doo-sized shrug whenever someone asks us "why?"

However, the vast majority of cases are due to some form of depression. Many of the ones I encounter had just started their meds, but hadn't waited for them to kick in yet. And what depresses one person won't depress another.

I have heard of 4 suicides this month in just my circles alone (one of them is the son-in-law of a very close friend) and Tony Dungy's son is the most famous one currently.

To deal with suicides honestly, and in the hopes of preventing future ones, we need to also dig deeper and develop some strategies. But to do so, we must know the reasons, and what to look for.

For one thing, it is incumbent upon us to tell our children that there may be a time they consider suicide. If they do, they must tell us or seek counseling immediately so that they can get help. Although this is an uncomfortable topic, it's just as important to discuss this with our kids as it is important to discuss illegal drug use with them.

We also need to impress our kids that suicide is the coward's way out. I realize it sounds harsh, but the reason that suicide is committed is that it's usually seen as the "easy way out". So, kids need to be taught that their problems will never be greater than what others have faced and that there are always solutions. Most of the time it's simple: they're in mental pain, and don't want to deal with the pain any more. Well, pain is something that goes away. But suicide doesn't.

Another way to deal with suicide is to impress upon them a greater fear of the unknown. What if the Catholics are right, and suicides go straight to hell? I'm not Catholic, but I'd hate to stake the future of my soul on that doctrinal position!

Many suicides are also committed in the hopes that it will permanently scar someone: "I'll show him! I'll kill myself! He'll always regret he went back to Sue!" The problem is that it scars the innocent, but the guilty move on easily enough. After all, they lacked enough conscience to do it in the first place, didn't they? So kids need to realize that it's a poor tool of revenge. In fact, it often makes it even easier for the person they're trying to punish: "Yeah, she killed herself. It just shows how mentally unbalanced she was!" So, the best revenge is living well. And, sugar in the gas tank.

What are the signs of suicide? Oh boy is that a toughie. The suicide that hit close to home recently was typical in that no one had a clue until it was too late. He had been remarkably cheery, and seemed to be finally handling his depression and recent divorce. But the reason he was cheery was because he had made up his mind to do it, and was at peace with that decision. This is quite common. But perhaps if he'd heard some of Auntie Saur's tough talk, it might have made him think twice. Instead, he is leaving two teenagers behind and has injured other innocents on both sides of the family.

Of course if a loved one mentions suicide, it is important to never take it lightly, even if he laughs it off later. It is better to become the pushy relative who insists on counseling, than the one that is the pall bearer. And never hesitate to ask if they're having thoughts of suicide.

If the person is acutely suicidal, make sure that they are under 24-hour surveillance.

Don't take the burden on yourself. If the person asks you to keep a confidence, this is one of those cases where you cannot. You must get them professional help, STAT.

As I mentioned before, depression is almost always there, which is why counseling is highly recommended even when treating depression with meds. If the person suffering depression is not getting help, you need to find out what sort of an idiot he has for a doctor. No. I mean, you need to make sure he gets the help. But calling his doctor an idiot would be truthful.

Conditions Associated With Increased Risk of Suicide

1. Death or terminal illness of relative or friend.
2. Divorce, separation, broken relationship, stress on family.
3. Loss of health (real or imaginary).
4. Loss of job, home, money, status, self-esteem, personal security.
5. Alcohol or drug abuse.
6. Depression. In the young depression may be masked by hyperactivity or acting out behavior. In the elderly it may be incorrectly attributed to the natural effects of aging. Depression that seems to quickly disappear for no apparent reason is cause for concern. The early stages of recovery from depression can be a high risk period. Recent studies have associated anxiety disorders with increased risk for attempted suicide.
7. Emotional and behavioral changes associated with suicide
8. Overwhelming Pain: pain that threatens to exceed the person's pain coping capacities. Suicidal feelings are often the result of longstanding problems that have been exacerbated by recent precipitating events. The precipitating factors may be new pain or the loss of pain coping resources.
9. Hopelessness: the feeling that the pain will continue or get worse; things will never get better.
10. Powerlessness: the feeling that one's resources for reducing pain are exhausted.
11. Feelings of worthlessness, shame, guilt, self-hatred, “no one cares”.
12. Fears of losing control, harming self or others.
13. Personality becomes sad, withdrawn, tired, apathetic, anxious, irritable, or prone to angry outbursts.
14. Declining performance in school, work, or other activities. (Occasionally the reverse: someone who volunteers for extra duties because they need to fill up their time.)
15. Social isolation; or association with a group that has different moral standards than those of the family.
16. Declining interest in sex, friends, or activities previously enjoyed.
17. Neglect of personal welfare, deteriorating physical appearance.
18. Alterations in either direction in sleeping or eating habits. (Particularly in the elderly) Self-starvation, dietary mismanagement, disobeying medical instructions.
19. Difficult times: holidays, anniversaries, and the first week after discharge from a hospital; just before and after diagnosis of a major illness; just before and during disciplinary proceedings. Undocumented status adds to the stress of a crisis.

Suicidal Behavior

1. Previous suicide attempts, “mini-attempts”.
2. Explicit statements of suicidal ideation or feelings.
3. Development of suicidal plan, acquiring the means, “rehearsal” behavior, setting a time for the attempt.
4. Self-inflicted injuries, such as cuts, burns, or head banging.
5. Reckless behavior. (Besides suicide, other leading causes of death among young people in New York City are homicide, accidents, drug overdose, and AIDS.)
6. Unexplained accidents among children and the elderly.
7. Making out a will or giving away favorite possessions.
8. Inappropriately saying goodbye.
9. Verbal behavior that is ambiguous or indirect: “I'm going away on a real long trip.”, “You won't have to worry about me anymore.”, “I want to go to sleep and never wake up.”, “I'm so depressed, I just can't go on.”, “Does God punish suicides?”, “Voices are telling me to do bad things.”
10. Requests for euthanasia information, inappropriate joking, stories or essays on morbid themes.