Today’s Guest Blogger tackles the sensitive topic of suicide and the myths surrounding it. Thanks for your expert handling of the issue. Written by Joeylittle, a freelance artist and teacher.
Conversations about suicide are underscored by a deep, foreboding stigma. Unfortunately, this creates an atmosphere of secrecy and fear around a subject that can only be addressed if it is discussed. Individuals struggling with suicidal thoughts are often desperate to speak with someone who will listen without judgement, but the topic is so prohibitively shrouded in complicated social opinions and emotional reactivity that being heard in this way may feel like an impossibility. In this article, we will take a look at some of the myths surrounding suicidal ideation.
Definition: Suicidal ideation (literally, suicidal thoughts) are considered to be either active or passive; however, clinicians will agree that there is no clear line that separates the two. Passive suicidal ideation is generally defined as having the desire to die, but not necessarily knowing or possessing a means/plan/timetable to that end. Passive ideation can turn into active ideation very quickly. Active suicidal ideation occurs when an individual has a clear plan and the intent/means to execute it. This state is commonly referred to as ‘suicidal’. For the purposes of this article, we will primarily be addressing passive suicidal ideation.
MYTH: If I talk about it, I’ll be hospitalized
“I don’t want to go to the hospital” is a sentiment shared by many. The truth is, most of the time you will not be hospitalized for having and revealing suicidal thoughts. Most people will contemplate killing themselves at some point in their lives, even if only to dismiss it. In suicidality, there is a difference between thinking (wanting) and planning/preparing/doing. Wanting to kill yourself indicates that you are in profound amounts of psychological pain.
When you are talking about your suicidal thoughts with a trained clinician, they will ask you questions that are designed to assess how immediate your thoughts are and whether or not you are far enough along in your thinking to have escalated to the point of planning and/or doing. Even within planning, there are shades of grey. Believing that you would shoot yourself is less dangerous when you don’t have access to a gun, for example. It’s important that you answer questions honestly and not try and work out for yourself how advanced your suicidality is.
MYTH: They won’t believe me
“Nobody takes me seriously” is the typical counterpoint to the above. People often don’t know how to describe how badly they feel, and after gathering the enormous amount of strength it takes simply to call for emergency services, may find themselves hurt, angry and afraid when they are not hospitalized on the basis of their thoughts. It’s important to remember that, in a suicidal state, you are always doing the right thing by letting a trained clinician evaluate you, and if they determine that your ideation is currently passive enough to be stable, they are not rejecting you: they are keeping you from having an unnecessarily intense experience, and they are also ensuring there is room for people who are less able to manage their thoughts.
The sad truth is, hospitals are overcrowded, and locked psychiatric wards can be very frightening places. A clinician is not going to put you into a locked ward for your own protection unless you are in immediate need of that protection. You may actually be at your personal ‘bottom’, the lowest point you’ve known, but if you don’t have a plan with a timeline and access to your intended method, they are likely to give you some coping skills, make a follow-up plan, set a safety contract and release you.
Unfortunately, being told to go home can create a profound feeling of rejection, causing the suicidal individual to act out their thoughts by making a parasuicidal attempt, also known as a ‘suicidal gesture’.
Definition: Parasuicide occurs when an individual makes a deliberate attempt at self-harm that does not result in death. Usually, the subconscious intent is not to die, but to get help; however, the parasuicidal person will not recognize their actions as such. They often fully believe, in that moment, that they are choosing to die. Parasuicide is far from harmless. These attempts, which often involve combinations of pills and alcohol, cutting, or placing themselves in harm’s way (reckless driving or laying on train tracks are some examples) can move out of the individual’s control very quickly, resulting in long-term disability, organ failure and death.
So, why aren’t they called ‘suicide attempts’? The individual is ultimately looking for help, not death. Parasuicidal behavior is always dangerous, and it must be taken seriously. If you are in possession of methods that you think you might use to kill yourself, if you became desperate enough, you must remove your own access to those means for your own safety. If you cannot, then that is important information for you to share with the crisis worker you are speaking with.
MYTH: People who talk about suicide are just looking for attention
There’s no “just” about it: people who share their suicidal thoughts are seeking help. Remove the word ‘just’, replace attention with ‘help’ and you have a fact: people who talk about suicide are looking for help. There is no shame in seeking help. You don’t have to be actively intending to kill yourself in order to seek help with your suicidal thoughts; you are in despair and deserve to be helped to some relief.
MYTH: Talking about it will make it real
Because suicidal thoughts are kept secret, they build up an enormous pressure in the mind of the person holding onto them. Talking about them won’t make them real; instead, talking will release some of the pressure. Talking helps. Not-talking hurts. The best use of a crisis line is to have someone to share these thoughts with. No hotline is going to relieve all of your pain. They exist to help you release some of the pressure of that suicidal secret.
Yes, when you first start to talk about it, you may feel like the floodgates have opened; that’s very common. Just keep talking, until you start to feel the pressure subside. Your goal is to get to a place where you can understand that you aren’t going to do something to hurt yourself right now. You have a new plan — to contact your doctor and get some more long-term help.
MYTH: Being put into the hospital/being put on drugs is the worst thing that could happen to me
No: succeeding at suicide is the worst thing that could happen, because then, you’re all out of chances to recover. Hospitals can be intense, and psychiatric wards will have individuals who are suffering from all varieties of mental illness. For people with post traumatic stress disorder (PTSD), this can be terrifying – even re-traumatizing. In light of this, if you are aware that you are having suicidal thoughts, bring those thoughts to your therapist, psychiatrist or primary care physician before you’ve allowed them to fester long enough to land you in the emergency room.
A planned intake is far less disorienting than an emergency hold.
If you are in doubt that you can keep yourself safe, share those thoughts with a clinician who knows you sometime during the daylight hours, before they get the better of you. The hospital is not the worst thing that can happen to you. And, if the short-term suggestion is to begin some form of medication, remember that you do have an illness, and you may need help right now in keeping the worst of it at bay, so you can do the real work of recovery. Medication isn’t forever, and hospitalization isn’t forever. Suicide is forever.
There is no proof that talking about suicide leads to greater suicidal thinking or that it encourages suicide attempts. On the contrary, there is preliminary research showing that self-disclosure of suicidal ideation can lead to faster recovery and help prevent suicides from succeeding. Individuals who have survived trauma are statistically much more likely to consider suicide and are therefore at greater risk.
The significant presence of isolation symptoms in those diagnosed with PTSD only intensifies that risk; the more one isolates, the less likely they are to want to talk to anyone about the darkest thoughts they may be living with. Hopefully, having a better awareness of what the truths are will allow more sufferers to get past their fear of what may happen and instead take action to self-disclose so that the worst – suicide – doesn’t happen.
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