suicide ideation

Suicide. Let’s talk about it!

The World Health Organization (WHO) says that more than 700,000 people die due to suicide every year and it’s the fourth leading cause of death in 15 to 19 year-olds. While many suicides happen on impulse as an attempt to escape emotional pain, abuse, or seemingly insurmountable problems, the most vulnerable groups are people who experience discrimination due to sexual preference, as well as migrants, refugees and indigenous persons.

Why suicide?

Suicide might be described as an attempt to escape suffering that has become hopelessly unbearable. Intense feelings of self-loathing and hopelessness can shut a suicidal person down to the point that they feel they can no longer reach out to get help, making death their only option. However, most suicidal people are deeply conflicted when it comes to ending their own lives. They deeply wish there was an alternative to suicide, but for whatever reason, they just can see what that might be.

What can be done?

“In order to be a good clinician, I have found that in addition to a strict adherence to the code of ethics, a duty of care, and empathy, I must be fearless when it comes to talking about sex, money, death, and suicidal ideation,” explains Dr. Jenny Holland, Sonoma County psychologist.

“I think it is essential that we have the ability and opportunity to explore our thoughts, feelings and ideas. Such as what it means to feel like, that we might be better off dead, or that the world might be better off without us. Exploring what it feels like to think, talk and even to fantasize about it can be the first step in diffusing what could be a very bad choice. It is important to have a safe place to talk about suicide and the feelings associated with that idea.”

The WHO says that “the stigma, particularly surrounding mental disorders and suicide, means many people thinking of taking their own life or who have attempted suicide are not seeking help and therefore are not getting the help they need. The prevention of suicide has not been adequately addressed due to a lack of awareness of suicide as a major public health problem and the taboo in many societies to openly discuss it.”

“Obviously, a line is drawn if it goes beyond simply thinking and exploring. If there is a plan, and if there are means to carry out the plan, then an intervention outside the treatment room must be made. Understandably, this causes people to feel hesitant about bringing up the topic at all. For fear of being seen as ‘crazy’ or feeling out of control. But really, people just need to be able to talk about it, to talk about being able to do it, having free will, having the choice, to talk about wanting to do it, sometimes to talk about even how they might do it- so they don’t have to act it out.”

The warning signs

Suicidal individuals usually give warning signs of their intentions. The trick is to recognize these warning signs and know how to respond when they happen. Alert friends, family members, teachers and even co-workers can play an important part in suicide prevention by listening objectively, pointing out the alternatives, showing care and concern, and even getting a doctor or psychologist involved.

Major warning signs for suicide can include talking about killing or harming oneself, writing about death or dying, and most importantly attempting to find anything that could be used facilitate a suicide attempt, such as poison, weapons, and drugs. The importance of these kinds of signals are even more serious in someone who suffers from a mood disorder such as depression or bipolar disorder, is alcohol dependent, has previously attempted suicide, or has a family history of suicide.

Studies have found that hopelessness is a strong predictor of suicide. People who feel hopeless may talk about “unbearable” feelings and say that they have nothing to look forward to, that the world is a hopeless place for them. Dramatic mood swings or sudden personality changes can also be warning signs. A suicidal person may also lose interest in day-to-day activities, neglect their appearance, and have extreme changes in diet or sleeping habits.

“These situations require some fierceness and some fearlessness,” says Dr. Holland. “Sometimes even I am afraid to ask. But I know that I must ask. Every session, every patient. Because talking about suicide and talking about wanting to die by suicide saves lives.”

Suicidal thoughts are scary. If you are feeling like you’ve had enough, but you’re afraid to tell anyone for fear of being seen as crazy, or misunderstood, it is time to talk about it. Or if you know someone who is struggling, and you are afraid that you’ll say the wrong thing, know that there is help available. Taking the risk and talking openly can save a life. Don’t put it off! Reach out today.

Article sources: World Health Organization, The HelpGuide


Dr. Jenny Holland, PsyD

Dr. Holland is a psychotherapist practicing in Sonoma County California, providing cutting edge, integrative and evidence-based mental health care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss, and caring for a parent or loved one during a health crisis or decline.

In-person and Online Video Counseling Services are now available. Short-term sessions, single sessions or ongoing support to meet your needs. Contact Dr. Holland to schedule an appointment at 707-479-2946.