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How much do you really know about suicide?


Suicide has long been a skirted word in polite conversation and a taboo topic. Suicidal feelings, thoughts and behaviors come with a host of undesirable companions: judgment and shame and pain and confusion and blame and sorrow (to name a few).


Here’s a truth to know: it’s typical and common that at some point in a human's life, they will have a thought about death as an appealing option to escape their pain.

Life gets hard and moments get hard and of course we would crave relief from that! As humans, our default is to cower away from uncertainty and pain. And sometimes the idea of a permanent and final relief crosses our mind.


Suicidal thoughts do not mean you are crazy.

Suicidal thoughts do not mean you are broken.

Suicidal thoughts DO mean that you are human and that you are in pain.


Suicidal thoughts in us become louder and more frequent if there are many days of pain and emotional turmoil without relief. The many days of pain can stem from all kinds of sources and often come from difficult life situations and events and/or a diagnosable condition like major depression, generalized anxiety, OCD, substance abuse, PTSD, or a personality disorder, etc.


If suicidal thoughts become frequent (not just a fleeting idea) or start to veer towards fantasizing about how to do it or researching methods of death, it’s absolutely time to get help. The whole purpose and function of your brain is to help you stay alive. This is why we run from danger and eat when we’re hungry and sleep when we’re tired and breathe automatically.


Our brains function to send us messages about what is crucial for our survival. So if part of your brain is telling you to kill or hurt yourself, that part of your brain is not functioning as intended. Imagine sitting at a computer that flashes “unplug me now and throw me into the river!” or “smash me to bits with a hammer!” You would know that something was amiss. You might take it to be serviced or check for a glitch in the operating system. You would likely not act on those self-destruct messages that clearly indicated trouble inside the machine.


The challenge is that when we feel suicidal, it's hard to have the awareness that something is amiss. We can start to believe that suicide is a good option. The urges and thoughts about ourself and life can feel so correct and intense. Living may seem so hopeless and desperate that self-destruction does seem like the logical step.

For this reason, it’s crucial to reach out early for support from friends, family, professionals, coworkers, neighbors, an anonymous helpline - wherever you can. And it’s also crucial for all of us to be attentive to warning signs and ways we can provide support to our fellow humans. National Suicide Prevention Week is an annual week-long awareness campaign in the United States, falling on September 6-12 in 2020. And September 10th is World Suicide Prevention Day annually. Suicide is a local and a global concern, because the pain of life touches everyone.


Suicide was the 10th leading cause of death in the US (2018), and the 18th leading cause of death globally (2016). Projections are that the rate of completed suicides for 2020 is greatly increasing right now in this most difficult year we are all stumbling through.


Some additional statistics about suicide in the US, based on 2018 data compiled by the American Foundation for Suicide Prevention:

  • Total Number of US known suicides in 2018: 48,344

  • National suicide rate in 2018 for all ages: 14.2 deaths per 100,000 people

  • North Carolina: 14.4 suicides per every 100,000 people

In 2018 in the US:

  • An average of 1 person every 10.9 minutes killed themselves

  • Suicide was the 2nd leading cause of death for 10-34-year-olds

  • Suicide was the 4th leading cause of death for 35-54-year olds

  • 1 male completed suicide every 13.9 minutes, 1 female every 49.7 minutes

Additional trends in 2018 in the US:

  • There were more than 2 ½ as many suicides (48,344) in the US as there were homicides (18,830).

  • Firearms accounted for 24,432 suicides in 2018 (50.5% of total suicides)

Suicide attempts in 2018 in the US (best estimates for 2018)

  • There was one suicide attempt every 26 seconds.

  • There were 25 suicide attempts for every 1 person who died by suicide.

  • 3 females attempted suicide for every 1 male who attempted.

For every person who died by suicide, 280 people decided not to go through with it. Suicide is preventable and there are always options.


What are the risk factors for suicide?


Below are some of the known trends, which fall along the categories of health, history, and life experiences/situations.

  • Mental health conditions like depression, substance abuse, bipolar, schizophrenia, etc.

  • Serious physical health conditions including chronic pain, traumatic brain injury, loss of physical functioning or disfigurement.

  • Childhood abuse, neglect or trauma.

  • Prolonged stress, like racism, poverty, harassment, bullying, relationship problems, unemployment, incarceration.

  • Personality traits of aggression, emotional dysregulation, impulsivity.

  • Lack of (or poor) relationships and supports.

  • Lack of quality connections with others.

  • Stressful life events, like rejection, divorce/breakup, financial crisis, death of a loved one, and other major life transitions, traumas or losses.

  • Exposure to another person’s suicide, or to sensationalized accounts of suicide in media.

  • Previous suicide attempts or self-harm behaviors.

  • Family history of suicide.

  • Easy access to lethal means including firearms and drugs for overdose.


What are the warning signs for suicide?


Most people send signals either intentionally or unintentionally before they kill themselves. Keep an eye out for changes in behavior and words and mood.

  • If a person talks (or jokes regularly) about: killing themselves, feeling hopeless, having no reason to live, being a burden or disappointment to others, feeling trapped or without options, feeling unbearable physical or emotional pain.

  • Behaviors that may signal risk, especially if related to a painful event, loss or change:

-- Drinking alcohol more or using substances more

-- Looking for a way to die, such as searching online for methods or taking in various media about death/suicide

-- Withdrawing from activities they used to enjoy or participate in

-- Canceling plans or not responding to communication

-- Isolating from family, friends, coworkers, online communities

-- Sleeping too much or staying up very late with little sleep each day

-- Communicating “goodbye” messages to people or talking in ways that sound like a final farewell

-- Giving away special or meaningful possessions, including pets

-- Actions that are aggressive, risky or display a “screw it all, who cares” attitude

-- Lethargy, fatigue, being disheveled, neglecting hygiene and basic needs

  • People who are considering suicide may appear: depressed, extremely anxious about their safety or future, disinterested in life or anything at all, consistently irritable, agitated or angry at the world, ashamed of themselves, distraught or constantly crying


Sometimes shortly before a person takes their life, there will be a calm resoluteness about them, as if they feel lighter because they have decided to end their pain and are hopeful about that relief. This can be a tricky time because loved ones may feel some reassurance that the person “finally seems better!” when in fact their improved demeanor means that death could be imminent.


Most people who are contemplating suicide feel incredibly alone with their problems. The burdens feel too large to shoulder and solutions are simply invisible. With meaningful and consistent support from others, it is possible for hope to grow and for options to be visible once again.

There are many terrific resources online to find support for yourself or to give you tools to help someone you are concerned about. A handful are listed down below.


If you are reading this and feeling suicidal right now, please feel this:


You matter.

You are lovable just as you are.

Your life and what you bring to this world is valuable.

You are not alone no matter how isolated you might feel right now.


Please reach out for help.


National Suicide Prevention Lifeline https://suicidepreventionlifeline.org/ 800-273-8255 (TALK) or simply text TALK to 741741 for support via text. The Lifeline provides 24/7, free and confidential support for people in distress, as well as prevention and crisis resources loved ones.


American Foundation for Suicide Prevention https://afsp.org/get-help

Plethora of suicide prevention resources including this Self-care Infographic


International Association for Suicide Prevention (IASP) https://www.iasp.info/resources/Crisis_Centres/

Sources of help across the globe.


Suicide Stop, International Help Center https://www.suicidestop.com/call_a_hotline.html

Compilation of global suicide hotlines and other suicide prevention resources.


National Alliance on Mental Illness (NAMI) https://www.nami.org/Your-Journey

Immense online and local resources for those living with mental health concerns and those who care about them.



Data sources: National Institute of Mental Health, Center for Disease Control, American Foundation for Suicide Prevention, World Health Organization

© 2017 Heather M. McKenzie, Therapist LCMHC PLLC

(919) 744-8335

heather@mckenziecounseling.org

all areas of North Carolina, United States​