Free Byte: Depresion and Suicide

Welcome to a very sobering and somber edition of BETHEA'S BYTE: FREE BYTE.  Kurt Cobain.  Robin Williams.  Mindy McCreedy.  Tony Scott.  Jovan Belcher.  Kate Spade. Anthony Bourdain.  These are just a few CELEBRITY names that have committed suicide.  If they are susceptible, that means we can be too.  I'm not saying this to be funny.  This is fact.  The facts we don't know is what circumstances led up to these people (famous or not) to taking their own lives.  More importantly, when we find out what the circumstances are, the question is how do we help them.

Now as I write this piece, I have an admission to make.  It's hard, but I make this to help drive the conversation.  While I was in Junior High School (middle school to most of you guys), I was bullied.  I was bullied to the point where I had considered suicide.  I had a good teacher, and a praying mother with an extreme way to get me out of it.  Trust me when I say that I experienced the right way and the wrong way of handling this.  The right way was that teacher talking to me, telling me that I had a lot to live for.  She told me about how not to let bullies get to me.  To me, looking back, this was the right way to handle it.  Then I remembered that she called my mother.  That evening, I experienced THE WRONG WAY to handle suicidal thinking.  I'm in my room doing homework and my mom (R.I.P.) came in with this vase and she scared me, yelling, "You wanna kill yourself?  Here, let me help ya."  Effective, yes.  Worse to handle suicide and thoughts of it, absolutely!

So, now that I gave you a glimpse into my life, here are some sobering facts and figures.

A study done by the American Foundation for Suicide Prevention in 2014 stated that suicide was the 10th leading cause of death in the U.S., imposing a cost of $51 billion to the US annually.  Other additional facts showed by the study were:

1. The annual age-adjusted suicide rate is 13.26 per 100,000 individuals.
   
2. Men die by suicide 3.5x more often than women.
   
3. Women attempt suicide 2x more often than men.
   
4. On average, there are 121 suicides per day.
   
5. White males accounted for 7 of 10 suicides in 2015.
   
6. A firearm is used in almost 50% of all suicides.
   
7. The rate of suicide is highest in middle age—white men in particular.
   

 These are sobering facts.
Here are four common misconceptions regarding suicide:

"People who talk about it won't do it."

Suicide threats should always be taken seriously. The truth is that few individuals are single-minded in their decision to kill themselves; many are asking for help even as they contemplate suicide.

"People who really want to kill themselves are beyond help."

Fortunately, this is not the case. Suicidal impulses may be intense but short-lived. The majority of individuals who are suicidal even for extended periods recover and can benefit from treatment.

"Suicide is a purely personal decision."

This argument is sometimes used to justify a "hands-off" attitude. It is a misconception, because suicide doesn't just affect the person who dies; it affects others also.

"Asking about suicide can put the idea in someone's mind."

Research proves that asking someone about suicide will not "put the idea in their head." In fact, many people having suicidal thoughts often feel relieved when someone asks. Suicidal individuals are engaged in a private struggle with thoughts of death. Talking about the possibility of suicide can alleviate the loneliness of the struggle and can be a first step in obtaining help.

Reports of Kate Spade’s suicide and struggle with depression have transformed her from symbol of polished prep to a blunt reminder that suffering affects all types. Three days later we woke to the news that another beloved figured, Anthony Bourdain, had taken his life.

These two tragedies have inspired hundreds to tweet some version of the same message: Mental illness is nothing to be ashamed of.

But deep in the comment threads, some have also been debating a more uncomfortable question: What do you do when a friend is depressed for such a long time that you’ve started to feel that that nothing you can do will make a difference, and your empathy reserves are tapped out? There are no easy answers. But here are some tips from experts:

Don’t underestimate the power of showing up
You may not feel that your presence is wanted. But just being by the side of someone who is depressed, and reminding her that she is special to you, is important to ensuring that she does not feel alone, said Dr. Norman Rosenthal, a clinical professor of psychiatry at Georgetown University School of Medicine.

If she acknowledges she’s depressed, that’s a good sign, said Dr. Rosenthal. He recalled the story of a patient who stopped feeling suicidal after telling people he was close to how he was feeling.

“When you shine the light on the shame, it gets better,” Dr. Rosenthal said.

Don’t try to cheer him up or offer advice
Your brother has an enviable job and two lovely children. He’s still ridiculously handsome even though he hasn’t gone to the gym for six months. It’s tempting to want to remind him of all these good things.

Not only is that unlikely to boost his mood, it could backfire by reinforcing his sense that you just don’t get it, said Megan Devine, a psychotherapist and the author of “It’s O.K. That You’re Not O.K.”

“Your job as a support person is not to cheer people up. It’s to acknowledge that it sucks right now, and their pain exists,” she said.

Instead of upbeat rebuttals about why it’s not so bad, she recommended trying something like, “It sounds like life is really overwhelming for you right now.”

If you want to say something positive, focus on highlighting what he means to you, Dr. Rosenthal advised. And though offering suggestions for how to improve his life will be tempting, simply listening is better.

It’s O.K. to ask if she is having suicidal thoughts
Lots of people struggle with depression without ever considering suicide. But depression is often a factor.

Although you may worry that asking, “Are you thinking about killing yourself?” will insult someone you’re trying to help — or worse, encourage her to go in that direction — experts say the opposite is true.

“It’s important to know you can’t trigger suicidal thinking just by asking about it,”  said Allen Doederlein, the executive vice president of external affairs at the Depression and Bipolar Support Alliance.

If the answer is yes, it’s crucial that you calmly ask when and how; it’s much easier to help prevent a friend from hurting herself if you know the specifics.

Take any mention of death seriously
Even when a person with depression casually mentions death or suicide, it’s important to ask follow-up questions. If the answers don’t leave you feeling confident that a depressed person is safe, experts advised involving a professional as soon as possible. If this person is seeing a psychiatrist or therapist, get him or her on the phone.

If that’s not an option, have the person you’re worried about call a suicide prevention line, such as a 1-800-273-TALK, or take her to the hospital emergency room; say aloud that this is what one does when a loved one’s life is in danger.

In some cases, calling 911 may be the best option. If you do, ask for a crisis intervention team, Mr. Doederlein urged.

But remember that interactions with law enforcement can vary wildly, depending on race and socio-economic background. In cases where you’re concerned that calling police could put a  person in danger, try to come up with an alternate plan in advance.

Make getting to that first appointment as easy as possible
You alone cannot fix this problem, no matter how patient and loving you are. A severely depressed friend needs professional assistance from a psychologist, psychiatrist, social worker or another medical professional.

Yeah, you know. You’ve told your boyfriend this, but it’s been months — or maybe even years — and he still has not set anything up.

“You can’t control someone else’s recovery,” said Kimberly Williams, president and chief executive of the Mental Health Association of New York City. But you can try to make getting to that first appointment as easy as possible.

That might mean sitting next to your friend as he calls to make the appointment, finding counseling that he can afford, or even going with him that first time, if you’re comfortable with it.

What if you’re not sure whether you should start with a therapist or a psychiatrist, or whether you’ve found the perfect person? Ask around for recommendations, and know that one practitioner may ultimately lead to another.

But don’t overthink it. The key initially is just getting a professional involved so you are not the only person managing this situation. (That said, if that first appointment seems really unhelpful, trust your instincts and find someone else.)

Take care of yourself and set boundaries
When the thoughtful and kind people we’ve loved for years are depressed, they may also become uncharacteristically mean and self-centered. It’s exhausting, painful and hard to know how to respond when they pick fights or send nasty texts.

“You don’t have to attend every argument you are invited to,” Ms. Devine said.

Still, just because someone is depressed is not a reason to let their abusive behavior slide. Set clear boundaries with straightforward language such as, “It sounds like you’re in a lot of pain right now. But you can’t call me names.”

Similarly you may find that your friend’s demands on your time are starting to sabotage  other relationships or your job. You’re not going to be able to help if you’re not in a good place yourself.

It’s O.K. not to be available 24-7, but try to be explicit about when you can and cannot help. One way to do this, Ms. Devine advised, is to say: “I know you’ve been really struggling a lot, and I really want to be here for you. There are times that I physically can’t do that.”

Then come up with a contingency plan and kindly push her to stick with it. Coming up with a consistent schedule for when you’ll see each other every week can be helpful to you both.

Remember, people do recover from depression
It can be hard when you’re in the middle of the storm with a depressed friend to remember that there was a time before, and hopefully an after, this miserable state. But it’s essential to remind yourself — and the person you’re trying to help — that people do emerge from depression. Because they do.

I have seen it.  Every single one of the experts quoted here has seen it, too. But it will take patience and time.

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources.

Thanks for reading... and thanks for caring.

Until Next Time...