'They Had It All': Five Major Misconceptions About Suicide

Lipi Roy, MD, MPH

Contributor

Healthcare

I write about medicine, addiction, social justice...& some COVID-1

While an entire textbook can be written about suicide, I’d like to share five common misconceptions.

1. “People who take their lives are weak-willed.” As a society, we continue to stigmatize people with suicidal thoughts or who have died by suicide. Socially discrediting someone during their darkest moments deepens their feelings of hopelessness. Many, though not all, experience depression which is a “brain disorder, not a choice, and affects people without regard for looks, wealth or fame,” according to Candida Fink, a psychiatrist in Westchester, NY. The World Health Organization reports ~800,000 suicide deaths worldwide each year. Breaking down the taboo of suicide and mental illness is key in prevention and treatment.
2. “It mostly affects people who are really struggling – poor, unemployed, homeless.” Suicide does not discriminate. According to the Centers for Disease Control and Prevention (CDC), suicide rates have increased by 30% nationwide since 1999. While depression was a known diagnosis in ~50% of cases, many other factors play a role. Financial strain, health issues, and stress at home and work were all contributing factors. Suicide is the 10th leading cause of death in the U.S. and one of only three on the rise (drug overdose and Alzheimer’s disease are the other two). Risk factors include prior suicide attempt, personal or family history of substance use or mental illness, chronic pain, family violence and guns at home.
3. “Suicide affects everyone equally.” This is a bit of a trick. While suicide does impact people from all walks of life – across races, nationalities, religions, professions – some groups are disproportionately affected. Select at-risk groups (per CDC, NIMH):
• Men are more likely to die by suicide, but women are more likely to attempt suicide
• American Indians and Alaska Natives have the highest rate of suicide; non-Hispanic whites are 2nd
• 8.6% of students in Grades 9-12 reported at least one suicide attempt in the past 12 months; girls attempted twice as often as boys (11.6% vs. 5.5%), highest among Hispanic girls (15%) vs non-Hispanic white girls (9.8%; per 2015 Youth Risk Behaviors Survey)
• 29% of lesbian, gay or bisexual youth attempted suicide at least once in the past year vs. 6% of heterosexual youth (CDC); suicide rates are highest among transgender individuals (41% vs 4.6% among the general public; per American Foundation for Suicide Prevention (AFSP)
• According to the Department of Veterans Affairs (VA), ~20 veterans die by suicide daily; 7,400 vets took their lives in 2014 (or 18% of all suicides in the U.S.). Suicide prevention, along with opioid safety, remain top concerns at the VA.
• Physicians have the highest suicide rate among any professional group, with ~400 doctors taking their lives annually in the U.S. In New York City, two doctors and a 4th-year medical student died by suicide in the past five months
4. 4“There’s nothing I can do to prevent a suicide.” – When a person takes his or her life, the people left behind often feel a sense of helplessness, even guilt. When my aunt died, my mother and other relatives felt they should have known; “we could have prevented her death.” As difficult as it might be to accept, no one else can be blamed for a loved one’s death by suicide. However, we can all take key steps. The National Institute of Mental Health (NIMH) recommends the following:

• Ask: “Are you thinking about killing yourself?” Not easy, but studies show that asking does NOT increase the risk or suicide or suicidal thoughts.
• Be present: Listen to your colleague or loved one. Observe their body language.
• Safety: Minimize a suicidal individual’s access to lethal items (e.g. guns, knives, razor blades, stockpiled pills) or places (bridge, highway). Again, not always simple, but removing access to dangerous weapons/locations can be lifesaving. Of note, firearms are the most common method of suicide (with or without mental health issues; source: CDC), accounting for 51% of all suicides in 2016 (AFSP).
• Connection: Stay in touch with someone after a crisis or recent hospital release. Suicide deaths decrease when we follow up.
5. “I have nowhere to go.” The sense of hopelessness can be profoundly overwhelming. If you or a loved one needs help, please call the National Suicide Prevention Lifeline 1-800-273-TALK (8255) where trained counselors are available 24/7, seven days a week. Other numbers to save in your smartphone: a close friend or relative; the Crisis Text Line, 741741; and the local police department. National Alliance of Mental Illness (NAMI), Substance Abuse and Mental Health Services Administration (SAMHSA), NIMH and Zero Suicide also offer excellent free online resources.

When I reflect on this past week, I am overcome with many emotions: sadness, confusion, loss. But I also remind myself to replace my biases patience, kindness and sincerity. I think we can all listen, without judgement, to our colleague who’s going through a divorce; our uncle who’s depressed about his wife’s dementia; our neighbor who wears a turban and smells “like curry.” Ask yourself, “What can I say or do to ease someone’s burden?” Our gestures needn’t be grand. Smile at fellow passengers on the subway. Hold a door open. Offer to carry a stranger’s grocery bag.

And if YOU are feeling helpless, alone and/or have thoughts of hurting yourself, please know that you are NOT ALONE. I promise you, someone will listen. Reach out to someone you know and trust, or to a trained professional. Your life has VALUE.