We're a therapist and a HuffPost reporter here to talk about a really important and simple way to help with suicide prevention. Ask Us Anything

so often, when someone commits suicide, I hear others say it's "such a selfish act," as if they could understand every bit of trauma and depression they were carrying. How do you respond to people who react in this way? Especially if you're trying to change their mind.

the huffpo story truly destroyed me. so much respect to you both: for writing it, and for doing this critical work!

Dear Fat,

When someone says something like "such a selfish act" to me, it feels like someone has punched me in the stomach.

I might say, "You know what, when you say that it hurts. My understanding is that it is an act of extreme suffering and often people who die by suicide think that they are relieving a burden* on others."

Or, "People in the field of suicide vehemently disagree with that analysis. It puts the focus on the wrong thing. That person was suffering and, at that moment, could see no other way out. We need to put a focus on helping people find a way out when they feel that way."

* is not true (burden relief) because in fact it increases the risk of suicide for those left behind.

With care,

u/ursulawhiteside

Thank you for this. I have been dealing with depression/anxiety/other stuff for 10 years, lots of negatives with all that. It would be impossible (if i wanted to try) to explain to people that this stance is wrong without coming off as a 'boohoo, woe is me'. I've lived for 10 years with suicidal ideations and I've lost very close friends and family. Losing someone you love without a doubt causes more intense pain/suffering in the immediate future, but it just does not compare to having a mind that literally tells you to kill yourself every single day for years on end without no end in sight. Hearing people say that literally only detaches those who are struggling even more and can no doubt cause a lot more grief. We need more support for those in need, not 'how dare you even think about that, that would cause ME pain'.

​

Also, thank yall for all of the other hard work that you have put in. It really does mean a lot to know that other people are out there fighting for people like me when I'm still all too often struggling to even leave the house. <3

​

Yes Porcovich, So many of the things we hear about people who are suicidal are wrong (selfish, weak, manipulative, attention seeking, hopeless).

People (who aren't suicidal) carry those beliefs and pass them on. It's not their fault that they don't understand, but they can learn and change.

I see why you might want to detach, especially when you crave any real understanding or connection. I'm really glad you are still here. Right here and now, your post is important to me and others.

​

With care,

u/ursulawhiteside

Thank you, Ursula. I will be using these responses in the future.

GREAT! you made my day!
u/ursulawhiteside

Suicide is a big issue, but I'm always worried to discuss it as open discussion has been linked to increases in suicide (ex: 13 Reasons Why and some reports of increased teen suicide attempts). Is this relationship true? And if so, how can we address this very important topic without accidentally promoting suicide?

Hi Eastern,

​

You are right - such a confusing topic. You aren't the only one unsure of what to say. And people get really emotional about it because they are scared, and often rightly so. But often not.

The simple answer is that stories of hope have a positive impact. Stories that include detailed or sensationalized methods of how someone attempted, without hope, can be harmful.

​

But also, we also need to talk about it and know the statistics and the scope of the problem to get our country socially mobilized (even though they are *so* depressing!). Open discussion is necessary!

Rock forth!

u/UrsulaWhiteside

​

P.S. Also, you didn't ask, but FYI for other readers, asking someone about suicide will not put the idea in their mind.

This article seems to indicate that at least in the UK, the primary driver of young male suicide is the boys crisis in education.

​

https://www.independent.co.uk/news/uk/home-news/teenage-suicides-london-national-rate-higher-deprivation-young-people-figures-a8387501.html

​

Do you think that dealing with institutional disadvantage and discrimination against boys is a more productive approach to take compared to managing the fallout? Prevention V Cure. And if so, why is so little attention given to that approach?

I agree that prevention should start before people -- adults and kids -- are in crisis. Too often, the mental health system feels set up only for when you are in crisis. Schools can be refuges against poverty and hopelessness. At least in the U.S., many school districts are starting to take more pro-active approaches when it comes to mental health and at-risk teenagers. There are now DBT programs in some schools and suicide prevention campaigns. More attention should be paid to the school setting as place where kids can find help and support -- and not just from faculty, but from their peers. Faculty need to be trained to help kids who are struggling, to learn how to build trust and support for them. I wonder how many teachers and counselors know how to do this? -- J.C.

In your opinion

Is working with teen suicide and Adult different?

Do you approach Teen suicide and Adult Suicide differently ?

And can you elaborate alittle

(I work with young adults\ teens with bahaviour issues)

​

Hi Tag,

​

To add to what Jason said:

When suicidal thoughts start as a teen or child the likelihood of longer term impact is great. Brains need validation, and especially teens. We struggle as adults because they are not yet adults, but also preparing for adulthood,

Many times teens concerns and feelings have been ignored or invalidated. I think we need to treat them as if there experience is completely real, even if we think it is over dramatic, or they are just looking at things wrong.

To do this, I focus on the emotion, instead of "You are right, your dad is an a**hole," I say "I can see how painful that is. It is tearing you apart and you don't know how to move forward. I'm going to try to help."

​

u/ursulawhiteside

Could it be that teens lack a sense of proportion> Every small issue is magnified into something huge like a beakup between boy friend and Girl friend or a fail grade on a school exam ect.

Hi Tag,

Well, the first time you go through anything (in my case a Reddit AMA) it is overwhelming and big (and flustering). I think that's how we need to think about it: it makes total sense that they are feeling this way. It is part of growth and probably in some ways, a very good sign.

Best,

u/ursulawhiteside

The biggest difference between teens and adults is that there just aren't a lot of resources for suicidal teens. Too often teens have ended up hospitalized or placed in even more restrictive environments such as residential treatment centers before they can get adequate care. Even in places like Palo Alto, there just aren't a lot of resources for teenagers. And RTCs can be traumatic experiences -- especially ones that are more punitive (i.e. use restraints, isolation rooms). Treatments like DBT and CAMS have shown real promise in not just helping adults but teens as well. The problem is gaining access to these therapies and having understanding parents who will also be engaged in care. One thing I've learned from talking to parents is that the teenagers need to have a real say in their care. -- J.C.

Just want to add that the Trevor Project is a good resource for LGBTQ youth: https://www.thetrevorproject.org/#sm.00001cycp1ysbzeq7zi3v17tb1hq1

How can someone who struggles with depression but feels like professional help won’t benefit them cope with depression/suicidal thoughts? I have tried crisis hotlines and counseling but at best I feel I gained nothing I couldn’t rationalize myself, and at worst, I feel it was pointless. There are times I came away feeling worse. Reworded: are there ways for suicidal people to take care of their own mental health if professional intervention isn’t an option?

Hi Shark,

Absolutely, sometimes people do get better without seeking professional help.

Some people learn things like DBT skills on their own: radical acceptance, mindfulness of current emotion, Ice-water, paced breathing, and opposite action are some of my favorites. Also, sometimes hearing stories of how other people got through things (see livethroughthis.org) can be helpful. Sometimes it helps to think of suicidal thoughts as an old lover... People also read stories of people who survived intense suffering and came through transformed (see Victor Frankl, Man's Search for Meaning).

But, of course I'm a therapist and so I'm going to say it can be a lot easier (with the right therapist) to move forward. See also ButterKnifeScar's post below for ideas. But, don't let yourself believe it is impossible to find the right kind of professional help. It certainly is way harder than it should be (lack of resources, access, etc).

​

Also, there's the crisis text line (741741, text "matters"). If you don't get someone who is helpful on your first call or text, try back and ask to talk to someone else. Tell 'em Dr. Ursula Whiteside told you to.

My heart to you,

u/ursulawhiteside

[deleted]

Hi Def,

Therapists help people make friends and and improve relationships with loved ones (if that's what the person wants). That's a huge part of therapy.

Crisis lines help people get through crises while they are trying to build a life worth living. Can't improve your life if you are dead.

u/ursulawhiteside

[deleted]

No, not clubs.Therapists can help you be better at making the right friends - building depth and substance with people. We can all be better communicators - better at being warm and welcoming, not pushing others away while balancing self-respect and self-care and our own emotions. These are things to be learned and therapists can help. Relationships take skills - super skills. I'm always working to improve mine. God knows I could improve.

u/ursulawhiteside

Hi, I’m sorry if this is not the moment or place to share this.

My dad killed himself last year. My brother (39M) and I (29F) knew he was really sad, and had tried to convince him to get therapy or any kind of medical help. He was in an emotionally abusive marriage and had been withstanding some 15 years of emotional manipulation and abuse, but would not leave his wife under any circumstances. They lived in a small town in another country, away from friends or family.

My question is: what else could my brother and I have done? Besides talking to him. I can’t help but feeling guilty about his death. It kills me to admit that at one point my dad was so negative that we just said “ok it’s his responsibility to be where he is and who he is with, he’s an adult and we should not take responsibility for this”. Should we have taken that responsibility? Should we have physically dragged him back to his hometown and away from his wife? I’m always questioning if our dad’s suicide was fueled by our faulty support.

Thanks for your time.

Hi Break,

What a huge loss. I'm so sorry. I think it is especially hard to know what to do when men are going through hell. Well, in general it is hard to know what to do. We aren't set up as a society to know how to be most helpful to people. We need to be taught these skills in kindergarten.

But people who have been there have provided some insight. And you were probably doing the very things they've suggested: be present, don't panic, provide some hope, don't reject me.

I'm definitely not going to say you did the wrong thing, or that there was a right answer. We can never know and that's one of the most painful things (could I have prevented it).

What we are finding is that when healthcare clinics (using zero suicide approaches) are better trained people who are struggling with suicidal thoughts have better experiences and are less likely to die by suicide.

I wish this wouldn't have happened. I'm sending you love.

u/ursulawhiteside

I wanted to just add there wasn't anything you could have done. It sounds like you did so many of the right things -- being there for your father, listening to him, staying in his life despite the geographic distance.

Unfortunately, the majority of those who need help do not seek it. Federal data in the U.S. shows that more than 50 percent don't find or seek help in the mental health system. The question that we all face is how do bring help to those who won't seek it. -- J.C.

(Sorry if this was addressed in the linked artice, I tried to skim it so hopefully it wasn't.)

What do you think about the policies of suicide hotlines and mental health professionals involving actions taken against a suicidal person's will that can cause more harm than inaction? What I mean specifically is that I've heard of police calls which put the person at risk. (due to their status as POC, or as mentally ill, such as schizophrenics who are often harmed due to a police officer not understanding or being trained properly) also suicide hotlines that either contact the police or force hospital stays for suicidal people, giving them the extra burden of medical bills or of putting their jobs at stake.

As someone who's been in therapy for years, thank you very much for what you do.

Hi Suave,

Man, what a difficult question...

More and more officers are being trained in Crisis Intervention Training (CIT), and there are things called Mobile Crisis Units (that come with or instead of officers and have mental health staff). Both of these involve training the rescue staff to how to be helpful in an emotional crisis. There's a national movement, but there is along ways to go - especially in some areas.

​

Crisis lines, generally, really don't want to call the cops. Usually they will only do it if the person is saying they are going to kill themself, aren't willing to hold off on doing so for the next 24 hours, and have access to a gun or their preferred method of suicide. So, avoid saying those things if you don't want to cops to come.

Lot's of therapists still don't know what to do (they didn't get training) and sometimes overact when they get scared (just like the rest of us). Therapists need to know how to communicate with the 911 and police - to explain the situation and to provide suggestions for how to interact effectively with the person (and always ask for CIT or mobile crisis unit). But boy, that should be an absolute last resort in my opinion.

​

Honestly, I wish we trained our patients about what to do if the cops ever show up. How to manage that situation. What to say in order to not get shot. How to reduce the fear on on both sides. Sad, but that might be the most effective route.

The more connected we can help people get to their community, the less there will be intervention by police/fire. Jerome Motto said something like, "I'm not my brother's keeper, but I am my brother's brother." What if we were to watch out for the guy with schizophrenia across the street? And to be the person they could call if in crisis, or that the therapist could call.

​

I don't know.

u/ursulawhiteside

If you Google 911 and suicide, you get a lot of stories about families calling the police when a loved one is suicidal. The results can often be tragic. Police are just not trained for this unless they've been trained on the Memphis or CIT model. Or, as Ursula suggests, the police bring along a mobile crisis unit. Our country relies too heavily on police to intervene on problems they are ill equipped to handle. They see someone in crisis and they draw their guns. It's horrifying. I've written many stories on people who are in crisis that have ended up killed by the police. Here is one: https://www.washingtoncitypaper.com/news/article/13036582/david-kerstetter-was-killed-by-dc-police-in-his-own

​

This is where safety planning comes in. I know of one source who has written a card that she can hand to the police if she's ever pulled over and freaking out. It explains who she is and why she is feeling anxious about the police. If used properly safety planning can be a great way for those at risk to avoid getting to the point of a crisis. Here is some more info on safety planning: https://www.sprc.org/resources-programs/safety-planning-guide-quick-guide-clinicians

-- J.C.

Everyone is different, but in your opinion, what are the biggest signs of suicide and the most reliable ways to prevent it?

Brittersbear -Thanks for asking.

There are few things we know for sure prevent suicide:
-putting time and space between someone and their preferred method of suicide
-sending non-demanding caring contacts (see Jason Cherkis article)
-organizing care better in health systems (an approach called Zero Suicide)**see also ZeroSuicide.org

The signs questions is much harder. There are so many things that go along with suicide, but none of them are great predictors. So, just because you pull away from others, or lose your job, go through a divorce, or think about suicide - doesn't mean that you are at great risk for suicide. Almost 10 million American's seriously consider suicide in a given year. Less that one-half of one percent actually do kill themself in a year. But that doesn't mean suicidal thoughts aren't serious.

u/ursulawhiteside

The signs can be so difficult to see. But in the last few years researchers have started to develop algorithms that better predict who might be at risk. There's still work to be done. But the algorithms are interesting in that they use dozens of factors to identify those who might need help. Another thing that we've learned is that those engaged in therapies like DBT or CBT or CAMS can lower their suicidality and overcome it. -- J.C.

In my opinion, helping others is a great way to build our own resilience and broaden our perspectives. It trains us to see things in a glass half full manner in more fundamental ways, it helps us acknowledge our own fears and insecurities, it helps us think outside the box, etc. What are some things you're learned from helping others?

Hi 8Step -

Man, you are all over this. I'm going to say "What u/8steplisten said!"

And:
-It allows me to throw myself into something greater than myself (and out of my own brain)
-To do well, it forces mindfulness of the current moment
-I find connection (in a meaningful way) when being with someone. They aren't in hell alone
-I'm doing it for "selfish"* reasons, I can't handle my emotions when other people are suffering and sometimes I'll do almost anything to manage those emotions - helping others is a way to manage those emotions.

*and I'm okay with that

u/ursulawhiteside

[deleted]

Hi FR,

Medication can be a life-saver for some. And also for others it doesn't help, or takes many trials before they find something helpful

For myself, I do find it helpful but there have been times when it actually made things worse.

​

What is important is finding a provider who is willing to work with you to find the right thing. Tracking mood and symptoms is important to know if it works and to share with your provider.

It definitely tends to go better if people feel like it is a decision they made on their own.

Hope that helps,

u/ursulawhiteside

​

I just read the article, and it resonated deeply with me. Is there any place or way I can read Motto's 'Bingo' letter in its entirety?

​

Thanks and keep up the great work.

I believe the Bingo letter might be in the archives of UC San Francisco at this point. I was able to see it and copy it before his archives were transferred to the university. -- J.C.

Do you believe suicide is hereditary? Or have any insight on why it might happen in families making it look like hereditary?

Hi Kick,

​

We all have genetics that make us more vulnerable to things, like cancer or heart disease, right? And some conditions, such as bipolar disorder and schizophrenia are indeed associated with greater risk of suicide. However, few people with these conditions will go on to kill themselves. Usually it is a combination of genetic vulnerability and really tragic and difficult things happening. But, there is not "suicide is my fate" kind of person.

The short answerWhen someone in our family or that we care about (even celebrities) kill themselves, our brains sometimes think that this makes it okay, or that it is a solution. We learn by what we see.

BUT more importantly What I know about interviewing people who have nearly died by suicide is that people often think differently when they are very suicidal than when they are not. And this period of intense suicidality usually lasts less than 24-48 hours. People do things that they would *NEVER* otherwise do, but they can't go back and change it. I suspect people like Anthony Bourdain and Kate Spade didn't necessarily wake up that day planning to kill themselves. And they might not do it over if they had survived. I could be wrong.

​

On Fire Steps

What we all need to know is what to do if an overwhelming urge to kill yourself does arise (not just suicidal thoughts - many many people have those). Here's some tips that I've Put Together to manage that urge. If we all knew these in advance, it could make a difference. To help ourselves or someone we care about.

​

Much love,

u/ursulawhiteside

How often you face the people who just manipulate with suicide to get attention, but dont going to do it in the real? Unfortunaly I had a friend who did that. In the beggining i was trying to help, but it didnt stop and I break a friendship. PS. Friend is alive and fine now

Hi Travolta,

I'm glad you asked. I'm been working with suicidal patients since 2000, and this narrative (they are faking it) just doesn't pan out and it can be incredibly harmful. What may seem obviously intentional and conscious to us, is often not at all the experience of the suicidal person.

*I've seen how devastating this assumption can be on someone and how much it gets in the way of recovery.\*

The term "manipulative" often comes up, or "cry for help." I find that people who are struggling with suicidal thoughts are bad manipulators, and people who aren't suicidal are good manipulators. I mean that in the sense that suicidal people are often really struggling to get their needs met. While many of the rest of us are walking through our days and weeks getting our needs met (we are good manipulators of our environment).

That all being said, sometimes people don't know how to communicate their pain or get what they need without going to suicide and saying they are going to kill themself. This is often because their pain has not been acknowledged unless they were basically screaming. What I would do in this situation is to send that person caring messages (see Jason's article) on a regular basis, not just when they were suicidal. I'm not saying you should do this with your old friend or that you should tolerate someone being abusive.

I would encourage a friend going through something like you describe to get to therapy, especially DBT, (you can learn a bit about DBT skills here). Offer to help them find a therapist and take them to their first and second appointment.

Great question!u/ursulawhiteside

Thank you for answer!Probably I already adviced and gave contacts of good doctor and help center. But he dont want to solve his problems with proffesionals unfortunaly

It is really hard to know how to help people sometimes. Thank you for trying. With care, -uw

The last time HuffPo was on Reddit it was because of a story about how they don’t pay their writers and instead promise “exposure”.

Did either of you receive monetary compensation for your hard work?

I didn't write anything (or get paid). Jason wrote the article for Huffington Post, he gets a salary.-uw

I think you are referring to our old blog system. We no longer use such a system (thank God). I've been at HuffPost since 2011 and have always been on salary. -- J.C.

​

I really appreciate this conversation. Thank you. I blog about adoption, and am an adoptive parent. An AAP study has shown adoptees are 4 times more likely to attempt suicide than non-adoptees. How can we in the adoption community, often fighting the traditional adoption narrative that adoption is win-win and without trauma, best help adoptees?

Hi MMC,
Boy, if you could teach parents and kids basic things about the function of emotions (communicate to self and others, motivate behavior), and reinforcement and validation principles - that would be huge.
Check out DBT in Schools for ideas. Also, Don't Shoot the Dog for reinforcement principles.

u/ursulawhiteside

​

As someone who is on and off again on medicine & therapy and dealing with depression for a few years, my view has kinda changed over the past year. Last summer a friend of mine committed suicide and I did not feel sad over it. Is it normal to turn completely numb over it, even so considering it myself by not seeing a bad side to it anymore?

Hi Real,

There are all sorts of emotional reactions to trauma and loss - none of them wrong, including numbness.

My advice is to not take your numbness as a sign of anything - especially that it is okay to die. People can not be afraid to die and still live productive and meaningful lives.

I'm glad you are talking about how you are feeling. I hope that you are talking to others about this.

u/ursulawhiteside

Someone chronically ill, very limited physical ability, strength and endurance so more or less housebound and refused therapy - How can they cope better when this has been and is their life permanently?

Hi Deadly,

Being limited, especially when it is in more than one way, can contribute to hopelessness. Hopelessness, in addition to the physical limitations, is an additional weight to bear. It's certainly overwhelming.

One thing that has worked for me when I've been immobilized (with anxiety or sadness) and that I've been helpful is to reach out to someone at the beginning of the day with a text: "hey, just thinking of you. hope your day is good." Then I let go of whether I get a response or not. I find that consistently making contact in a positive like way, without asking for anything, improves my mood. This is also in-line with Jason Cherkis' article.

I know that's a tiny thing, but it is just one idea.

Sending you much care,

u/ursulawhiteside

I know of people struggling that found useful therapy via telemedicine. Therapy via Skype or text message could maybe helpful. -- J.C.

Pineapple on pizza, yes or no?

I'm gonna say no on the pineapple. -- J.C.

Hopefully you don't make mistakes this big very often...

Pineapple and black olives, x2

u/ursulawhiteside

JC appears to be a sane person

That is definitely a given!
u/ursulawhiteside

Every time i read a huff post article I feel like killing my self, can you help?

Stop reading Huff Post articles. - uw

The Simple Way to Help with Suicide Prevention

The simple way to prevent suicide is to tell people you care about them via brief messages
-you are see them even when you aren't physically together
-you think of them and they matter
-you are express no negativity towards them

Do this using what are called caring message or caring contacts:
defined as non-demanding non-judgmental expressions of care and support (usually through letters or text message)

Examples
"I was thinking of that time you squirted milk out your nose. I love you."
"I miss your face. I'm always happy to see you."
"Here's a photo of us I found on my phone. We crack me up."
"Hey bud. That Oakland game on Saturday was wild."

Not Example
"Are you okay? I'm worried about you."
"Are you taking your meds? You know you should be"
"If you don't turn things around, I'm not going to be able to help you."
[This is not to say that you shouldn't ever express concern. But these do not qualify as a "caring contacts" ( research studies and shown to prevent suicide)]

In Sum
People going through hell are often not their best selves. We push people away, and at a time when we need people the most. Think of your friend that has dropped off the radar, is no longer posting or responding on social media, that is acting rude or is hard to be around. That doesn't mean they are going to kill themselves of course. But it does mean there is an opportunity for a tiny bit of magic.

u/ursulawhiteside

"Over the last two decades, suicide has slowly and then very suddenly announced itself as a full-blown national emergency...According to the most recent figures from the Centers for Disease Control and Prevention, there are now more than twice as many suicides in the U.S. (45,000) as homicides;"

​

Maybe I'm looking at the wrong sources, but it seems like the suicide rate in the US...

​

https://en.wikipedia.org/wiki/Suicide_in_the_United_States#/media/File:Suicide-deaths-per-100000-trend.jpg

​

...is basically flat since the 1960s, and the homicide rate...

​

https://deathpenaltyinfo.org/images/murderrate-2016.png

​

...has dropped to roughly half of what it was in the 1980s. Are those charts incorrect or is there some way we should interpret them as signs of a national emergency?

Hi Axnu,

Here's the latest per the Center for Disease Control:

2017 rate of suicide was 47,000 - up 33% in less than 20 years.

Yet, research and treatment funding lags behind other top killers.

u/ursulawhiteside

How does a person know if they need to seek help? You mentioned in a comment that suicidal thoughts aren’t uncommon but a smaller number of people commit suicide - how does someone know if their thoughts are becoming something more than relatively normal?

Hi Hockey,

Thank you for your question.

Here's when help need is critical: If you have started planning or preparing for suicide in any specific way (not just passing thoughts or "what ifs"). If you have set a date. It is really critical to find someone you trust to talk to about this. That could be a therapist or other healthcare provider - or someone else while you are trying to get connected to care. Hold of making any decisions while you are having these thoughts and the feelings that go along with them.

If you are *just* having passing suicidal thoughts \* There is something really important your brain is trying to tell you. It is trying to find a way out of a situation that seems unsolvable or unbearable. Think of it as a warning sign - RED - BLINKING - "I need to change something." You could start by sleeping at least 6 hours a night (pref 8, a cold shower can help if you can't sleep), eating regularly. Talking with someone you can trust can also start to create immediate relief. Those are some first steps.

Recurring suicidal thoughts are always important to pay attention to. I don't want to imply otherwise. I hesitate to use the word normal (like you did and even though they are relatively common) because it makes it seem like it isn't a big deal. It (your brain) is signaling something really important.

Thanks so much for your question,

u/ursulawhiteside

​

P.S. Also, most people will have a thought like "what If I jumped off that bridge?" or "what would happen if I walked into traffic" or "I wish I didn't have to wake up." at least once in their life. Be curious when you have those thoughts. Sometimes it is totally random, sometimes not.

​

This is just my take from reading the research that is out there and talking to therapists and friends. I think people might need to talk to someone (a therapist, a counselor, a friend) if the thoughts become persistent or a coping mechanism. Like after a bad day of work, you start thinking about suicide. Or if thoughts of self-harm become regular, almost daily thoughts. Talking to someone could help get your brain rewired so that the first thought after a bad day isn't a suicidal one, but say, maybe a thought about going for a hike, or calling a friend. -- J.C.

Why do people only talk about depression in the context of suicide? Its debilitating to the bearer even if they stay alive.

Hi Pope,I'd find some people you can talk to about depression. If the ones around you don't think it is important, find new people. Check out the depression bipolar support alliance for groups in your area (and awesome resource, check out Greg Simon on Ask The Doc (their own AMA), search for facebook groups, there are people everywhere.

It is debilitating. I'm glad you are still here.With care,

u/ursulawhiteside

For Ursula: Do you have any coping strategies/things you remind yourself so you aren’t taking on too much responsibility for your client’s’ actions?

That may not be phrased correctly, but my sister is a trauma-certified social worker and she is dealing with such heavy situations all day long, made heavier by the fact that she obviously can’t discuss the details with the people who care about her.

Like you, she also checks in with her clients throughout the week and has said she feels like she is never off the clock/feels extremely guilty if she is not able to respond to a client’s text or call immediately. What would be helpful for her/How can I support her?

Hi T,

"For Ursula: Do you have any coping strategies/things you remind yourself so you aren’t taking on too much responsibility for your client’s’ actions?"

You know, this is a HUGE problem. In a treatment a called DBT, therapists have a team of therapists called the consultation team that they meet with weekly to discuss what they are going through with the patients. It is called "therapy for the therapists". I've found that incredibly helpful when I've been a part of it.

We need legislation to demand that healthcare insurance providers cover this work, because currently we don't have funding to support it.

​

Thanks for your question,

u/ursulawhiteside

​

Should suicide always be something we try to prevent? Is suicide always bad?

For your first question:
Absolutely we should be working to prevent it. Just like deaths from other health-related conditions. If we treat it differently we are doing so out of lack of education and stigma.

For your second question:
It's a choice that can't be unmade. There are always options until you make the option that eliminates options. See KidPix666's post above.

u/ursulawhiteside

​

I constantly grapple with just how narcissistic our nation seems to be. Is it just my brain that’s causing me to be miserable or do you think there’s some merit there. If it is just my brain failing to see hope in our nation do you have any advice on how to train my oftentimes pessimistic mindset into a more hopeful one?

Hi MrNice,

You know, for many of us, when we see ourselves as a nation getting in our own way (Understatement!) - it creates sadness and sometimes hopelessness. I don't think you are alone in that.

Sometimes I think the most radical thing you can do is to maintain hope. Like it is your job. Like you are searching for all the little bits of light and then shining your light on them so that others might also see them. Right?

I think someone really wise once said, "nothing is the end of the world until the end of the world."

Radically hopeful here,

u/ursulawhiteside

I think people find hope in their own communities, on their own block. It doesn't take much for me -- a kind word from a coffee shop owner, a neighbor's wave, an afternoon at a record store or book store. Politicians let us down. People sometimes don't. -- J.C.

Jason, do you think the division of the media into the two political parties contributes to more suicides than we had in the past? Why doesn't the media just focus on facts and not sensationalize their stories?

Not sure how to answer this question. I do think the news these days can be depressing. But not all media focuses on sensationalism and cheap clicks. Local and regional papers remain a vital resource. I think of the great work from the Charleston Gazette-Mail on the opioid epidemic in West Virginia or magazines like Mother Jones and their fantastic coverage of the private prison industry. Beyond politics in Washington, there are reporters and newspapers and magazines covering real issues in deeper ways than the usual clickbait. One of the things that I think prevents suicide is when people are seen and heard and remembered. Newspapers can do a great job telling the stories of people outside those sensational headlines. --J.C.

I loved your article... I found the prevention methods to be so simple, yet completely revolutionary. My question stems from personal experience. My father took his own life in 2016, and I have gotten to a better place with his loss, but for quite some time I didn't know how to deal with the loss. What is your most important recommendation for survivor's of suicide loss? I've read a lot the questioning never goes away, and that is something that you just have to deal with... Is there a good way to help find resolution within oneself?

Hi Literally,

Loss survivor groups can be very powerful. Here's one resource; https://suicidepreventionlifeline.org/help-yourself/loss-survivors/

​

People say that they never recover. But they do become transformed through the experience. My dear friend Julie Richards who lost her mom is now leading research in the field of suicide. Not that you need to do something like that.

Best wishes,

u/ursulawhiteside

Very sorry for your loss. I think a lot of people have found solace in group therapy for loss survivors. You can find a list of resources here: https://afsp.org/find-support/ive-lost-someone/ There might be a group for loss survivors in your community. -- J.C.

Can you please give a TLDR for the "form letter"? The article you link to is very long and I simply don't have time to read it.

Hi Wrapped,

What it comes down to is that a researcher, Jerome Motto, did some research that found a way to prevent suicide.

We actually only know a few things that prevent suicide - and the larger suicide prevention community didn't pick up on his findings.

This story was an example of how caring messages (the approach Motto found), was applied with suicidal people.

u/ursulawhiteside

Here is a link to a brief overview of Motto's study: https://www.ncbi.nlm.nih.gov/pubmed/11376235

--J.C.

And here's a link to a short documentary on Motto's study that just came out -- https://www.retroreport.org/video/suicide-veterans-and-how-a-simple-idea-tried-to-combat-a-crisis/

I'm an individual who believes that suicide can be right solution for some people. It's assumed in a therapist's role that suicide must be prevented. But do you believe at some point, suicide is the healthy choice?

Hi Kid,

[Separating suicide from assisted suicide here (I'm assuming we aren't taking about death with dignity)]

I think it makes sense that people what to leave when they are in unbearable pain. But our brains sometimes get stuck on one solution (suicide in this case) and we can't see any other options. I always say, "Never kill yourself when you are suicidal" because often you are in an altered state of functioning when suicidal. Not the right time to make such an important decision.

Experiencing depression, Bipolar, schizophrenia, and substance use disorders are really awful. But by themselves, they are not terminal (read: it is *never* hopeless). I've met people who suffered with depression and suicidal thoughts for 30 years, who finally find the right combination of treatment and therapy and now have a life they enjoy and find worth living. I can't promise that for anyone, but I also will never let go you either

Short answer to your question: It is not okay to say suicide is the right choice.\*

*mostly because it is wrong, but also because that idea, when supported by others, is incredibly damaging to people suffering.
Thanks for your question, u/ursulawhiteside

Since asking for help is really important for suicidal people, but they may not be in a good place of mind to differentiate the good from the bad ones, what are the signs that this therapist "work" for you?

Hi Butter,

Finding the right therapist is an art and a science (or something - it is often just HARD).

Some tips:
1. Listen to your gut. If you feel misunderstood, unheard, etc. tell them. How they respond will help you determine if they are a good match.

1. If you have the resources, do interviews. You can Google to find interview questions for therapists.

2. Tell them what has worked and hasn't in the past for you for therapy or treatment. Ask them their thoughts on that.

3. IMHO the best therapists are a mix of listening, really hearing and allowing you to be seen and cared for AND helping support your growth and changing and helping hold you to it.

4. If you feel motivated and inspired, that's a good sign. But it may not happen if you are really depressed.

Hope this helps,

u/ursulawhiteside

People who haven't received any mental health or sickle prevention training can sometimes say the wrong things. How can raise awareness and skills on a large scale?

Hi Again, :)

Good question. We want to know the same thing. Jason's article is one way of doing that. Large scale media efforts, like the USAToday articles yesterday, can make a huge difference.

u/ursulawhiteside

The vast majority of our modern suicide prevention efforts have been spearheaded by people who are not therapists but work as volunteers on suicide prevention hotlines. In the early days of the first hotline, many of the call takers were mothers. The point is -- it doesn't take much training to make a big difference. All you need is a willingness to listen deeply and without judgment. -- J.C.