Staff Perspective: A Conversation About Suicide

Staff Perspective: A Conversation About Suicide

The struggle to understand a friend’s suicide was illustrated for me again recently when a friend posted this on Facebook, “I have no words right now, except pain for finding out that I lost a good friend and amazing soldier to suicide this morning.” Reading through the comments of his post someone mentioned the deceased being free of pain. My friend’s response was, “but what about everyone else’s pain now?” I think that speaks volumes about the heartbreak of suicide. I reached out to my friend, Caleb, to ask his permission to talk about his experience in this blog and he graciously agreed.

In our conversation, Caleb said one thing that was particularly disturbing was that friends had reached to the deceased recently and he seemed fine. This group of friends was left trying to understand where they had failed to see a problem, or why their friend had not confided in them for help. It is so difficult for others to understand the decision to end one’s own life. I could not answer those questions directly, but Caleb and I talked about how suicide risk is fluid and his friend’s risk could fluctuate from day to day.

Caleb understood that his friend had been struggling with chronic pain from an injury and possibly PTSD from deployment. He could see how difficult his friend’s life might have become on a daily basis. But he was heartbroken over the lost of his friend. Caleb told me that, he too, has chronic pain from migraines and “other problems that keep (him) awake at night,” but he struggled to understand “crossing that line between life and death.” Caleb is a man who does have struggles in life, but he also has a very supportive family, a strong relationship with his wife and children, and pours out goodwill and love into the world. He wears his heart on his sleeve, which can leave him bruised from time to time, but he gets a lot of positive support in return. He also has the fundamental belief that through determination and hard work he will overcome what obstacles are in his path and achieve a better future.

For the person contemplating suicide the key needs of social connection and self-efficacy are often perceived as not being met. The word ‘perception’ here is of utmost importance, as illustrated by Caleb’s pain at losing his friend and how much he wished to still be connected to this soldier. He was more than willing to offer social connection and support to his friend before his death, which makes it difficult to understand how the suicidal individual can no longer reach out for that lifeline.

I asked Caleb what he wanted others to know as I was contemplating this blog and he said, “To reach out, as for help. Not to rely on the warning signs before someone will help.” I contemplated this for a bit and what that would look like in practice. I think it means that anyone dwelling in the dark places of their minds and feeling overwhelmed by life’s struggles should seek help rather than carrying on alone. Caleb also meant that friends should reach out before someone has gotten to the point of showing warning signs of suicide. Help someone who doesn’t seem to be in dire need as well as those obviously straining under life’s pressures. This is good advice, especially considering how serious the warning signs for suicide are, and how difficult some of them may be to spot during typical social exchanges. The warning signs of suicide are:

  • *Threats to kill self
  • *Seeking way to kill self
  • *Talking/writing about death, dying, suicide
  • Hopelessness , anger, seeking revenge
  • or engaging in risky activities
  • Feeling trapped
  • Increased alcohol and/or substance use
  • Withdrawal
  • Anxiety, agitation, insomnia/hypersomnia
  • Dramatic mood changes
  • No reason for living; no sense of purpose in life

*Items indication a need for immediate emergency care

Looking at that list of warning signs it becomes clear that you cannot always see these on the phone or just hanging out with a friend. They involve work and the symbolic extending a helping hand to find out the answers. You would not easily know if a friend is feeling hopeless unless you began asking some questions. Likewise, feeling trapped, anxious, or depressed may require some questions to discover if a friend is experiencing them. Maybe we could see reckless behavior or rage, but only if we are often around our friends and loved ones, but many people may express that rage and recklessness when loved ones aren’t near (like while driving, at stores, or bars). And certainly we would not know if a friend or family member has no reason for living or no sense of purpose unless we are asking and carefully observing.

So Caleb is right, don’t wait for the warning signs to become obvious or in that top tier of seeking emergency help. The time for action is now, in our everyday interactions with friends and loved ones. As soon as we get worried or feel the hairs on the back of our necks stand up telling us something is or could be off. Begin asking those questions that will help the warning signs become visible. As Caleb put it, “Keep in touch with one another and keep the bonds together.”

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.

Libby Parins, Psy.D., is the Assistant Director of Civilian Training Programs at the Center for Deployment Psychology (CDP) at Uniformed Services University of the Health Sciences in Bethesda, Maryland.