I remember like it was yesterday as I recounted the details over and over again in my mind…

I had just attended the most uplifting service at the African American House on campus to celebrate the life of Martin Luther King and was driving home from such a spectacularly full and rich event. The evening soon turned to tragedy. After more than 10 missed calls from my baby sister, I knew something was terribly wrong.

So with that, I returned my sister’s call. “Awnnie, what are you doing? I have been trying to get in contact with you,” my sister was sobbing.

I could hardly understand her. She asked me to pull over and I quickly obliged, given the seriousness in her voice. Honestly, in the back of my mind, I knew he had finally done it.

Are you there?” my baby sister asked.

I was wrapped up in my own thoughts and had temporarily drowned out my sister’s cries, “Paul killed himself early this morning. His body is with police now!

 

This event changed me for eternity

This event has changed me for eternity. My own blood, my baby cousin that I watched grow up, talked on the phone with, and hung out with in NYC, had just ended his own life; he committed suicide.

Shortly after the days passed, I heard so much from family and friends about Paul’s death. Many refused to believe that he indeed ended his own life. Rejecting the notion of suicide altogether, they created alternate explanations and conspiracies of how Paul “was killed.” Some even stated suicide could not possibly explain Paul’s death because Black people don’t kill themselves. In some Black communities, there is this notion or belief that suicide affects rich, white folk—not Black people who have access to friends, family, and religion.

Through Paul’s death, what I began to realize more and more is that, as a collective unit, there was an overwhelming sense of guilt. Had we failed him as a family? Is there more that could have been done? Did we ignore or turn a blind eye to the warning signs? After all, I WAS a psychiatry resident at one of the most prestigious universities in the country.  If I couldn’t have helped him, who could have? There was A LOT of guilt to go around, myself included.

Since that time, I really tried to understand suicide in more depth, in respect to what families and friends can do. I’ve come to the conclusion that the answer is in providing education. Yes, suicide is tragic, but what is even more tragic is ignoring the signs and symptoms of those suffering, and not providing help when possible. Paying attention to the signs and clues of those suffering, family and friends can intervene and provide different solutions and resources in a variety of ways.

 

What we know about suicide

Suicide is a major public health concern, affecting over 41,000 in the U.S., and is the 10th leading cause of death overall (afsp.org). Suicide does not discriminate among racial or ethnicities, but rather affects all people, regardless of race, age, or gender. Non-Hispanic whites have the highest rates of suicide, however, multiple studies have shown people from certain ethnic minority backgrounds, like American Indians/Alaska Natives, actually endorse suicidal ideation (thinking) at higher rates than others (cdc.gov).

Knowing the risks factors for suicide and understanding those at higher risks are paramount. The main risk factors for suicide include people with:

  • Depression or other mental illnesses
  • Substance use
  • Family history of a mental illness or substance use
  • A prior suicide attempt
  • Family history of suicide
  • History of trauma or abuse
  • Having a gun in the home
  • Male gender
  • Advanced age

Oftentimes, friends and family that are closest to the suicidal person are in the best position to appreciate the risk factor and to spot warning signs. Research demonstrates that 70% of people who commit suicide tell someone about their plan or give some warning beforehand (psychcentral.com). Some warning signs to look out for include statements such as:

  • I’d be better off dead
  • Life isn’t worth it anymore
  • People would be better off with me
  • There is no way out
  • I’m such a burden
  • Life is too difficult

Other warning signs include changes in normal behavior patterns. Sometimes, people who contemplate suicide will plan ahead and complete or revise a will. Others may hoard prescription pills in preparation for an overdose. Other concerning signs are:

  • Increase in drug or alcohol use
  • Withdrawal from friends and family
  • Withdrawal from regular activities
  • Increased isolation
  • Failure to take care of self

 

What you can do

If someone you know is expressing concerning sentiments or exhibiting the behaviors listed above, you can ABSOLUTELY be an advocate for getting help. When helping a suicidal person, it’s always important to be non-judgmental, offer hope, and refer to treatment immediately. Mental illness is treatable, and many people who commit suicide often have a treatable mental disorder. You can refer the person to a mental health specialist, like a counselor, therapist, or psychiatrist. Another potentially life-saving tool is giving the person the National Suicide Prevention Lifeline 1-800-273-TALK (8255), which is available 24 hours, 7 days a week.

No matter what you do, just remember that suicide is often preventable and that treatment can help. By simply knowing the risks, paying attention to the warning signs, and not being afraid to act, you can help your loved ones receive the treatment they need and deserve.  It takes a lot of courage to help someone who is suicidal, but your help could potentially be life-saving.

Helping someone with suicide:

Make a safety plan: Help your loved one make a plan when suicidal thoughts arise, such as having a contact person or being with others during a stressful time (e.g., anniversary, birthday, death, traumatic experience)
Encourage your loved one to get help: Help locate a mental health professional, call for an appointment together, or go to the appointment with the loved one
Be assertive: Those who contemplate suicide may not be in a place where they will follow up on your suggestions. So, it’s OK to be proactive to make sure your loved one follows up on plans or mental health appointments
Remove any lethal or potential means of suicide: Take away pills, guns, knives, or any other tools the person can use to end their life
Stay in touch: Continue to support, keep in contact, and reinforce communication with your loved one
Be empathetic: Keeping an open mind and non-judgmental attitude will help your loved one feel safe to talk about delicate or private issues
Ayana Jordan, MD, PhD
Ayana Jordan, MD, Ph.D was born and raised in Pittsburgh, Pennsylvania. In 2003, Dr. Jordan began an MD, Ph.D program at Albert Einstein College of Medicine of Yeshiva University in New York City. She completed a general adult psychiatric residency at Yale University in 2015, where she served as Program-Wide Chief. Currently, Dr. Jordan is completing her training as a Yale Addiction Psychiatry Fellow, with a particular interest in using her research background to address clinical questions in the Black community. She is committed to increasing access to addiction services within minority communities, both nationally and abroad. Dr. Jordan has done research in Sierra Leone, West Africa examining the link between, mental illness, substance use and stigma, and has served as an expert witness discussing the current mental health system in Sierra Leone.

7 COMMENTS

  1. What do you do if your depression has gone on for over 35 years and you’re manic (I think shrinks call it; no offense). You have no health insurance. Your family avoids you like the plague after you reached out. You try. You lost 30 pounds and had a resting heart rate of about 63 until you got a hernia 8-10 months ago. Then you gain 20+ of the weight back. Kicked yourself and cried when you weighed yourself the other day and forced yourself to start exercising again (mostly because it’s the only way to burn off the anxiety–not for vanity–and you dimly realize the anxiety’s killing you faster). You’re drinking every day except for the last two because you were too tired from exercising again. But you’re drinking right now and that’s the only way you would ever write this to a bunch of strangers. You’re destroying the life of the only person trying to help you. You are wary of and distrust everyone. You avoid social interactions like the plague. This distrust affects your ability to get and hold a job. You talk to yourself, A LOT. You yell at the TV because, F&*k me!, there’s a possibility a douchenozzle like Trump could be elected and your only hope for progressive salvation was destroyed by Hillary Clinton and her neo-liberal minions, and you, in no way, see the point of living in a world like this… Sorry, I’m ranting now.

    So what do you do when you have no health coverage and you, unfortunately, live in a buttscew Southern state? And every day you wake up you’re looking for a reason to go on? I’ve been in limbo for 15 years and the only reason I haven’t made the final cut is because I don’t want to hurt her more than I already have by having her come home to the body. Or maybe I just don’t have the balls to do it (hernia not measured).

    P.S. Don’t worry. I don’t want to hurt anyone else (because that’s the first thing medical professionals ask you after you divulge). I’m not a psychopath. I just do not see the point. Of anything.

    E-mail is fake. I’m not trolling. Just curious if there is a solution. I’ll check back if any of this goes through.

  2. From working with many clients going through suicidal ideation, i know that telling them “life is great” and “so many people love you.” is not the antidote. Asking a person to tell you about their pain will touch the place where they are devoid of feelings. Listening and using key phrases is the way. At that stage where they’re at it takes too much energy to think of all the good things that may be out there. They need to talk about their pain and know that someone will listen, not judge, not give advice but convey understanding.

  3. Yes D., it’s true many people do care. I usually check the news and read comments on issues and here I am commenting which I have never done but today I do for you. Life is a great thing and it would be a disaster without you. Give your self the chance to live a happy and health life. Take care and hope you stay forever.

  4. You have no idea. Telling someone to “get help” just reconfirms that everyone thinks they’re nuts and can’t be bothered with them.

    I have no idea how many messages I’ve sent to my parents in the past 24 hours telling them I can’t be bothered anymore, that I have nothing to live for, asking why don’t they even care about me…. They can’t even be bothered to pick up the phone.

    On the other hand my boyfriend is worried sick about me. He’s six hours away though and has no way of getting to me, I can’t help thinking there’s really no point anyway as I fully intend to be gone tonight anyway.

    But at least he has the right idea. Ringing me and telling me he loves me and don’t give up and he wants to grow old together – hearing this stuff gives me a LOT more reason to live than my parents silence.

    I don’t know what I’m going to do. If I’ll still be here tomorrow or not. But if I am I can pretty much guarantee it’ll be because my boyfriend cared; it’ll be nothing to do with family who simply tell me to get professional help but don’t want to bother themselves with tears or emotions.

    And counselling is a waste of time. Who wants to talk to someone who wouldn’t give a shit if they weren’t getting paid?

    • D. I hope this is not ‘too late’, and that you are still around to read this.

      20 years ago, I too was in a similar frame of mind to yours! Though I hadn’t talked to anyone about my thoughts, as I didn’t want to be stopped from my chosen course of action; I was out of work, our house had been sold with no profit or debt, and my wife had left me.

      These are supposed to be the 3 anchoring bricks, keeping the human psyche grounded. In addition, based on Dr. Jordan’s 9 point scale, I ticked 4! I took an o’dose of 100 tablets washed down with cider and tears. I ended up in hospital and was told that the tablets I had taken (a common strong pain killer!) would not kill me!

      I can remember my response as if it were yesterday. “It’s something else I’ve failed at!” I was hospitalized in the local Psyc. Hospital, I felt the resident Psychiatrist totally useless (sorry Dr. Jordan) when after 5 days he eventually saw me and told me “You are depressed”. But the psychologists, psyc. nurses, and fellow patients were brilliant help.

      I was discharged after 7 weeks, but had daily out patient therapy consisting 1-2-1 counseling, occupational therapy (I took pottery and woodwork), and group therapy sessions – one of which was survivors of sexual abuse, another (anger management) I didn’t understand at all. I’d never hit anyone nor threatened or even shouted at anyone other than close family. It was only 6 or 7 weeks into a 10 week session that I, at last, had a ‘lightbulb moment’ and realized depression is in part due to unexpressed anger being internalized.

      A lot of people put a lot of working hours into getting me better and I’m including myself in that – it was very hard work turning up each day to involve myself in those sessions.

      BUT IT WAS WORTH IT! I was rehoused in our local social housing scheme, I retrained and got paid work within the adult education field teaching IT (previously was a car salesman); remarried and retired. I’m now 70, and life is worth living.

      Those counselors you disparage have the same bills and costs everyone else has, BUT THEY DO CARE, as did the nurses who gave me my meds and ensured I bathed and fed myself. Would you begrudge THEM the fact they were paid? I’m sure not.

      If your parents didn’t care, they would not tell you to get help. They probably just don’t know how to respond to a sickness they don’t understand!

      D what I would say is PLEASE DO NOT GIVE UP, accept all the help that is offered, give the counselors AND medication from your doctor a chance. It may well be 6-8 weeks before you start o feel a change, but you will gradually start to feel that perhaps the deep hole you feel you are in, perhaps does have a rim after all, and that you CAN see sky above it. It may be cloudy sky but it is sky not bleak blackness.

      Wishing you a safe journey back,
      Hugs and Love, Henry.

    • D, this is the author Dr. Jordan. I would encourage you to seek help. You are worth it and people do care about you! Mental illness has a way of making it seem like your life doesnt matter anymore and that’s not true. Please call the suicide hotline immediately: 1-800-273-TALK. Someone can get you connected to care as soon as possible

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