A Therapist's Thoughts on Suicide Prevention

Michael Driscoll, LPC

 

 

 

 

 

 

 

 

 

 

 

 

 

2020.  Ah, what a year.  It feels like Murphy’s Law has been in full force.  In the midst of a global pandemic of historical proportions, our nation has faced increasing political turmoil, competing ideologies locked in civil conflict, an economic downturn not seen since the Great Depression and, of course, murder hornets.  As we do our best to get through these societal and environmental challenges, we must not lose sight that suicide remains the tenth leading cause of death in the United States - seventh in Colorado.  Given the recent and long-term problems faced by our country, this issue may be more prevalent than ever. 

Suicide is a difficult topic to discuss and often related to a mental health issue such as Major Depressive Disorder, unbearable mental anguish and pain.  Depression is a disease like any other.  It can occur with sudden rapid shifts in a person’s life or with a prolonged chronic health condition lasting months or years.  No one chooses to develop a disease, but we attempt to deal with it in the best ways we can.  Depression is no different. People with depression respond well to social connectedness and conversations supported by empathetic understanding.  Loneliness and isolation are common precursors to depression symptoms. 

In an article “The Social Cure” published in Scientific American, one study of some 1400 people indicated that loneliness was often a big predictor of depression, occurring in about one in four older adults.  On the flip side however, depression and anxiety plummeted the more social connectedness the person felt, such as engaging in multiple group activities.  Even better, it didn’t matter what kind of groups the person was involved in … could be sports, birdwatching, painting, behavioral health groups, or just about anything.  The more groups and social connectedness, the better the participants felt.  This speaks strongly to the power of social connection and its healing impact on depression, loneliness, and suicidal thinking.

We need to talk

As friends, co-workers, family-members and as a community, we need to start having weekly, if not daily, conversations with each other about suicide if we are ever to move the needle on suicide prevention and intervention.  We must break through the stigma and discomfort of discussing this topic with others.  The journey out of suicidal thinking can be greatly assisted by a caring person or a group of acquaintances.  Offering a gentle, non-judgmental curiosity to the conversation, as well as just thirty minutes of empathetic listening, can go a long way.  It’s okay to ask even when there is no indication of suicidal thoughts, because contrary to common opinion, asking will not place the idea in their head and will open the door to future conversations.  Starting the conversation is easier than you think.

Try to remain relatively quiet, calm, and non-judgmental for approximately ten minutes, only repeating back what you heard them say in your own words.  Do this several times to help convey that you understand.  It’s critical for the person to feel heard, understood, and validated, as this provides a release for them.  Recommend contact with their therapist, family/friends, or crisis services if indicated, and identify two coping skills they can use to calm down and wait out the ideations, as suicidal thoughts are time limited and usually pass.  Help them to identify their reasons for living, and who would be impacted by their death.  Call 911 or drive them to your nearest behavioral health crisis location if they cannot be safe on their own.  You might not be able to change their mind, and remember the decision is ultimately not yours.  A person must decide to help themselves in a moment of crisis. 

We need to listen

As the listener, reactions to suicidal discussions can feel overwhelming, anxiety producing, and difficult to sit with.  The best advice that I can give is to remain calm and take deep breaths, signaling that it is okay to talk about this subject.  Becoming comfortable with this subject will take time and practice.  Understand there is a significant difference between suicidal thoughts and imminent risk.  If we can help them identify their coping skills for triggers and occurrences of suicidal thoughts, then they take a step toward early intervention, resiliency building and resources at their disposal as well as strengthen their crisis prevention skills for imminent risk.  Finally, as a helper, please do not make the mistake of taking responsibility for someone else’s decision.  Ultimately the individual must make a choice.  Outcomes will vary in all situations. 

Thankfully, around ninety-five percent of suicide survivors report later in life they are glad they lived and that someone was there to listen to them and provide support when it was needed.  They remembered they are never truly alone if they ask for help.  Most survivors have common themes in describing their experience, whether they were interrupted by other persons or lived through the experience, and that is they are incredibly grateful for their connection with another human being during their darkest moments.  Many in this state of mind wished that a stranger on the street had asked them how they were doing.  The innate human need and desire for social connection is powerful - equally incredibly healing and potentially very damaging.  One human connection at the right moment in space and time can alter the life path of an individual forever.  How will you choose to act in that moment?

Finally, many of the previously mentioned issues can generate huge disruptions to people’s lives, creating shifting circumstances suddenly and dramatically, so be on the lookout.  Sadly, suicide is never fully predictable, but the least we can do is ask and check in with our friends, family, and co-workers.  Hindsight provides us data regarding the precursors and indicators of suicidal behavior, so we know what to watch for in people.  Take a few moments right now to research the common symptoms of suicidal behavior, as it just might be that you are in the right place at the right time one day.  If someone you know has had a major life change recently, it doesn’t hurt to ask them how they are doing, and if recent changes have led to recent suicidal thoughts.  And plug 1-844-493-8255 (Colorado Crisis Services) into your phone.

Some resources:

www.NAMI.org  National Alliance on Mental Illness

https://coloradocrisisservices.org/   Colorado Crisis Services

https://suicidepreventionlifeline.org/    Suicide Prevention Lifeline

Denver based therapist Michael Driscoll is a Licensed Professional Counselor and Supervisor of Staff for the Thornton Outpatient Therapy team of Community Reach Center.  He has been working in the field of mental health for over 16 years, has been an outpatient therapist for more than 10 years and specializes in the treatment of PTSD, Major Depression, Bipolar and Schizophrenia disorders.  Michael is a certified EMDR therapist, a facilitator for Assessing and Managing Suicide Risk (AMSR) trainings and is the lead for Community Reach Center’s Suicide Prevention Committee. 

 

Postpartum Depression and Suicide in New Mothers

Although being a new mother can be a wonderful experience, it can also be mentally, emotionally and physically exhausting. In some cases, the stresses associated with motherhood, and other factors, can cause a woman to experience what is known as postpartum depression (PPD). Also called postnatal depression, this is a serious mental health condition that can lead a mother to attempt or complete suicide. Consequently, it’s important that mothers and those around them understand what PPD is, and if they observe signs of it, seek help, including suicide prevention assistance if necessary.

Causes of Postpartum Depression

There is no one cause of PPD. Experts believe it results from a combination of physical and emotional factors. New mothers tend to experience a number of physical challenges ranging from pain and discomfort produced by the birthing process to dealing with intense sleep deprivation. The result tends to be exhaustion, which can be a contributor to PPD. Hormones are believed to play a role in the condition as well. Following childbirth, a woman’s estrogen and progesterone levels drop rapidly. This results in chemical changes in the brain that can produce mood swings.

While PPD is not fully understood, there are identified risk factors, including:

  • Symptoms of depression in the past, whether associated with childbirth or not
  • Depression or mental illness in other family members
  • Alcohol or drug abuse
  • Troubling life events during pregnancy or soon after giving birth (e.g., domestic violence, personal illness, death of a loved one, relocation, job loss)
  • Difficult or premature delivery
  • Health problems with the baby
  • Lack of assistance and/or emotional support in caring for the baby
  • Uncertainty about being a parent (whether the pregnancy was planned or not)
  • But, one thing is clear: PPD does not result from anything a woman does or fails to do.

Postpartum Depression Symptoms

Postpartum depression should not be confused with the “baby blues,” which affect up to 80 percent of new mothers and leave them feeling tired and sad. Baby blues involve mild symptoms and resolve in a week or two. PPD is a serious mental illness that the National Institute of Mental Health describes as having these symptoms:

  • Feeling sad, hopeless, empty or overwhelmed
  • Crying more often than usual or for no apparent reason
  • Worrying or feeling overly anxious
  • Feeling moody, irritable or restless
  • Oversleeping or being unable to sleep even when her baby is asleep
  • Having trouble concentrating, remembering details and making decisions
  • Experiencing anger or rage
  • Losing interest in activities that are usually enjoyable
  • Suffering from physical aches and pains, including frequent headaches, stomach problems and muscle pain
  • Eating too little or too much
  • Withdrawing from or avoiding friends and family
  • Having trouble bonding or forming an emotional attachment with her baby
  • Persistently doubting her ability to care for her baby
  • Thinking about harming herself or her baby
  • PPD typically develops between a week and a month after delivery, and only a healthcare professional can diagnose it. So, it is important that new mothers or their loved ones seek help if the condition is suspected. And, as with any form of depression, it is critical that family members and healthcare providers take suicide prevention steps if needed.

Treating PPD

Postpartum depression can be treated with different forms of counseling (also called talk therapy) including cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). It can also be addressed with antidepressant medication. And, the two types of treatment can be used together. A woman’s healthcare provider determines the proper approach based on her individual situation.

Don’t Suffer in Silence

Too often women feel pressured by the expectation that motherhood will be a “joyous” experience and consequently don’t feel comfortable taking action when symptoms of postpartum depression appear. The fact is, PPD is common and very treatable. If you or someone you know is experiencing it, seek help promptly. And if you feel the urge to harm yourself or your baby, call 911 or a suicide prevention hotline like the Colorado Crisis Services at 1-844-493-TALK(8255) immediately. You will receive caring, compassionate support and assistance. If you have a non-urgent desire to talk with someone about how you are feeling after childbirth, contact us online at communityreachcenter.org or by phone at 303-853-3500 Monday through Friday, 8 a.m. to 5 p.m. We have centers in the northside Denver metro area of Adams County including the cities of Thornton, Westminster, Northglenn, Commerce City and Brighton.