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Understanding suicide– Saving lives by breaking the taboo

Julia HUANG, Psychotherapist

Recent news of the deaths of two celebrities, Anthony Bourdain and Kate Spade, has left many of us in a state of shock and sorrow. Continuous reports grab our attention, yet there are still many people outside the spotlight that struggle silently in a dark corner. Can potential suicide be identified early and prevented? What are some effective ways to help those at risk?

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Let’s take a look at some common questions and see the insights that Julia and Sharon have provided.

Question one:

Would talking about suicide with a suicidal person increase the probability of them actually doing it?

Answer:

No. Talking about suicide is a sign of seeking help. Although it is a natural tendency for people to avoid talking about death, just a tiny hint of rejection and avoidance can turn someone away, while you might be the last person they could ask for help, or to stop their suicidal plan. So if you notice someone saying things like “life is meaningless” or “the world is better off without me,” go ahead and ask what they have in mind, and ask if they have thought about killing themselves. Your action sends a message that they can talk to you about this difficult topic.

Question Two:

Is it true that only people who suffer from mental illnesses (ie. depression/substance abuse) commit suicide?

Answer:

No. According to Anne Schuchat, the Principal Deputy

Director of the CDC, more than half of people (54%) who die by suicide do not have a known mental health condition. In fact, people who are experiencing a great deal of stress or experiencing the sudden loss of a loved one may be at increased risk for suicide.

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Question Three:

If mental illness is not the biggest  reason behind suicide, what exactly causes suicide?

Answer:

Suicide is not caused by a single factor. In fact, suicide occurs in response to multiple biological, psychological, interpersonal, environmental, and societal influences that interact with one another, often over time. Factors that may contribute to suicide include:

  • Relationship problem (42%)
  • Problematic substance use (28%)
  • Crisis in the past or upcoming two weeks (29%)
  • Criminal legal problem (9%)
  • Physical health problem (22%)
  • Loss of housing (4%)
  • Job/Financial problem (16%)

All of the above factors can lead to a huge amount of psychological pain. When such pain accumulates over time, the person might hide feelings from others, creating a façade, like “everything is normal.” During the façade stage, they could live within a state of two realities: on one hand, they can appear to be a successful, well-rounded person in society; on the other hand, they are suffering from unbearable pain in an internal world that no one can see. Eventually, hopelessness and isolation can make the person feel like death is the only way to end the pain.

Question Four:

Is suicide an accidental behavior or is it preventable?

Answer:

Suicide is preventable. Around 80-90% of people who commit suicide will reveal their plan to people around them before proceeding. There are many people who are able to heal after recovering from a suicide attempt, and move on to healthy lives. We can learn the signs of suicide, how to respond, and where to access help.

Below are the 12 warning signs of suicide:

  • Feeling like a burden
  • Being isolated
  • Increased anxiety
  • Feeling trapped or in unbearable pain
  • Increased substance use
  • Looking for a way to access lethal means
  • Increased anger or rage
  • Extreme mood swings
  • Expressing hopelessness
  • Sleeping too little or too much
  • Talking or posting about wanting to die
  • Making plans for suicide

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Question Five:

What should we do if someone around us is suicidal?

Answer:

  1. Ask questions directly and unambiguously if you think someone may be considering taking their own life. Acknowledge the trust it takes for this person to share these thoughts with you.
  2. Validate the feeling of wanting to die without accepting that this will be the outcome.
  3.  Ask if there is a plan. The risk is higher if there is a plan. For an urgent case, sign a non-suicidal contract with them, and list names and phone numbers they can call if they become suicidal
  4. Reduce access to lethal means for those at risk. Try to keep them safe and be there with them. Take them to a mental health professional for further assessment as soon as possible.

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Life is a mixture of ups and downs. Everyone faces stress from time to time. For most people who are in a suicidal trance, they seek a solution for their unbearable psychological or physical pain. Finding a way to stop the pain is very different from killing oneself. If we can work together to help the person discover hope, and let them know that there are ways to resolve the pain, then suicide can be prevented and they can recover from this hopeless state.

By being a good listener, taking a nonjudgmental stance, and having a compassionate heart, you can help to save a life.

If help is needed, in Shanghai it can be provided for example by:

Departments of Mental Health of United Family Shanghai Area hospitals and clinics, appointments need to be made, Tel 4006 393 900

Shanghai United Family Hospital Emergency Room, Tel (021)2216 3999

Shanghai Mental Health Center for inpatient treatment, Tel (021)64387250.

Lifeline Shanghai, a telephone hotline for people of the English speaking community in crisis, available daily from 10 a.m. to 10 p.m. (021) 6279 8990