Prairie View postdoctoral therapist counsels the community on suicide.

Suffering in silence … a poetic notion but a tragic reality for too many.

For people who attempt or complete suicide—who suffer such hopelessness and despair—the decision to take their lives seems rational. Often the situation they are experiencing is temporary, even though they feel the pain will never end.

Families, friends and communities impacted by a completed suicide privately suffer their own pain, shame, guilt and burdens. While the stigma of mental illness and the stigma of suicide seem everlasting, the pain of the survivors of a completed suicide is temporary as well.

Awareness: The key to prevention

The one word at the heart of suicide is suffering. The key to ending suffering is prevention, and the key to prevention is awareness. With knowledge comes understanding, and with understanding come the power to change lives and the compassion to help heal.

The Sedgwick County Health Department, for example, has reported the rate of completed suicides for the county as consistently higher than the national rate every year since 2000 and higher than the state rate since 2005. This is not a problem of the few; it is a problem of your community, your neighbor, maybe your sister or your best friend.

According to the American Association of Suicidology, people with a diagnosis of major depression are at approximately 20 times greater risk for completed suicide than the general population.

Despite this increased risk, thoughts of suicide can affect anyone, especially someone faced with a catastrophic loss or change. These thoughts are not normal, but a sign of great distress. If you recognize these signs in someone you care for, offer to help and direct the person to resources designed to provide guidance.

Warning signs of suicidal thinking
The person considering suicide may:

•  Talk about suicide, death, and/or having no reason to live.
• Withdraw from friends and/or activities.
• Have a recent severe loss or threat of a significant loss (like job or relationship).
•  Experience drastic changes in behavior.
• Lose interest in hobbies, work, school.
• Give away prized possessions.
• Take unnecessary risks.
• Lose interest in personal appearance.
• Increase use of drugs/alcohol.
• Be faced with humiliation or failure.

Treatment helps

Many entities exist to provide help. Despite the availability of resources, the World Health Organization reports less than 25 percent of people with depression receive adequate treatment. Community mental health centers, school counselors, crisis centers, private therapists, family doctors, and religious or spiritual leaders are among the many resources available to help. While there is no perfect or simple solution, treatment can help — but only if used.

People with depression (the diagnosis most commonly linked to suicide) may experience such symptoms as:

• Feelings of sadness.
• Significant changes in weight and/or appetite.
• Loss of energy.
•  Feelings of worthlessness, hopelessness or guilt.
•  An inability to think or focus.

Those with depression have what is often times referred to as the “negative triad” of dysfunctional thinking patterns: 1) negative thoughts of self; 2) negative thoughts of the world; and 3) hopelessness that it will ever improve.

Cognitive behavioral therapy (CBT) is one technique used by therapists for treating depression. CBT focuses on the idea that identifying these negative patterns of thought, testing the evidence used to support the thought, and learning and practicing more positive, realistic self-talk will improve mood and behaviors. This is about taking dysfunctional automatic thoughts and replacing them with healthier thinking patterns.

CBT is only one example of the many ways to treat depression. Feeling comfortable with the approach and the therapist are key to treatment success. In some situations, where the person presents an immediate risk of harm to self, hospitalization is appropriate and necessary. Most hospitalizations are brief and designed to stabilize the patient and regain safety.

Medical professionals such as family doctors or psychiatrists are able to determine if medications would be appropriate for managing symptoms of depression. The array of antidepressants to provide relief is vast and, when appropriately used, can assist many in relieving psychological pain. Through the use of medications, therapy or a combination of medication and therapy, the treatment for depression is effective 60 to 80 percent of the time.

Compassion for survivors 1

Self-preservation is human nature, and suicide violates this fundamental premise. Due to this, survivors of suicide deal with their own stigmatization by society. This alters and interferes with the grief process.

Family and friends who survive may feel rejected by those who want to help but don’t know how to or feel uncomfortable doing so. Loved ones left behind often feel rejected and abandoned by the person who took his life, at times resulting in feelings of anger.

Survivors often show higher levels of guilt, blame and responsibility than those who are mourning other types of loss. Personal discomfort and shame may also lead survivors to lie about the cause of death of their loved ones, bringing forth considerable isolation. This may prevent them from getting the grief support necessary for processing their feelings and meeting their unique needs.

Suffering in silence can create and sustain guilt and identification with the victim. Because suicide bereavement is unique to other mourning experiences, survivors may be at their own risk for suicide.

A continuing cycle

Think back to prevention. Understand the warning signs. Survivors experiencing a sudden or extreme loss, who are shadowed by guilt and shame and who are isolated are at risk for continuing the cycle unless it is interrupted.

Understand that treatment can work. Show compassion for sufferers of depression, survivors of those who complete suicide and anyone who exhibits the warning signs of suicidal thinking.

We, as a community, have the power to show acceptance and empathy for those with mental illness and for families and friends who struggle with this invisible pain. It is time to work to eradicate the stigmatization which only serves to prolong the silent suffering.

Reed is a licensed master’s level psychologist at Prairie View’s west Wichita office. National Suicide Prevention Week is Sept. 7-13.