Suicide Prevention: How To Recognize, Stop, And Prevent

December 28, 2015

Boston Evening Therapy Content

Depression, Suicide

Awareness of Warning Signs and Action Needed to Address Rise in Suicide, Especially among Middle-Aged White Men

Suicide is a major public health concern. It’s become more obvious in recent years that America’s major issue in suicide is among middle-aged white men.

That’s what is clear to Alan Holmlund, director of the suicide prevention program at the Massachusetts Department of Public Health. “That’s where the increase in suicides is here in Massachusetts. It’s also where the increase is nationally,” said Holmlund in an interview on suicide prevention that’s part of a year-long WBUR series called “Suicide: A Crisis in the Shadows.”

Not Asking For Help

“We don’t understand why that’s happening,” said Holmlund. He speculates that it “…seems to be partly the economy and primarily men not asking for help.”

Men often don’t seek help until it’s too late because “…they are traditionally discouraged from expressing emotions,” said Lata McGinn, director of the Cognitive Behavior Therapy Training Program for Anxiety and Depressive Disorders at Yeshiva University in New York.

Another reason suicide rates are higher for men is that they often choose more lethal methods when they decide to end their lives, said McGinn in an article on depression and suicide among older white men in the Huffington Post in 2014.

White Men's Privilege Limit Their Experience of Having to Cope

Looking more deeply into our culture that may put middle-aged and older white men more at-risk of suicide, McGinn suggests that white men often hold positions of highest privilege in society, so they “…tend to have less experience facing negative or stigmatizing experiences.” Groups such as women and minorities may have spent a lifetime learning to cope with difficult experiences.

“The effect of falling from power as they age, retire or develop medical conditions, combined with the lack of necessary tools to cope with negative experiences, may pose a greater challenge for white men as a result,” said McGinn.

Too Proud to Ask For Help

One possible instance of the burden of debt and the transition into retirement is the suicide of 52-year-old Ted Washburn of Waltham, Mass., who starved himself to death in three days. Washburn had mental health issues and an earlier suicide attempt when he was 21, but as the decades went by he was seeing his doctor, taking medication and maintaining his outgoing “life of the party” personality. So his adult children were shocked by their father’s suicide.

After their father’s death, son T.J. Washburn and daughter Valerie Alfeo learned their dad had financial problems. He had tens of thousands of dollars in credit card debt and only a little saved for retirement.

A successful accountant, T.J. Washburn said in an interview with WBUR he thought his father was too proud to ask for help.

Festering Mental Health Issues Exacerbated by Financial Burdens

“If that mental illness is there from 21 years old, and then you just add on kind of financial issues, it could definitely be the tipping point,” said T.J. Washburn.

Money and relationship problems are leading stressors that contribute to suicidal thinking, according to mental health professionals. Those stressors can become overwhelming at pivotal points in life, such as approaching retirement age.

The Relationship Between the Recession and Suicide Rates

The suicide rate among middle-aged Americans has been increasing for about 15 years, most notably since the economic downturn of 2008, and recent research has pointed to a link, according to the WBUR series. Middle-aged men now have the highest suicide rate of any group.

T.J. Washburn and Valerie Alfeo urge anyone with a depressed and potentially suicidal loved one to ask deeper questions than they did with their father.

“I guess part of my not wanting to talk about it was not wanting to kind of get pushed away and be somebody that was causing stress in his life, or kind of adding on to the feelings that he was going through,” said Washburn.

“If you know someone that’s struggling, but they can make you think that everything is OK, you need to get involved,” said Alfeo. “I think you need to ask to go to the counseling sessions, you need to make it that it’s not because you don’t trust them. It’s that you want to be a part of it.”

How to Recognize Warning Signs of Suicide and What to Do

Education: Learning about the signs of suicide and how to talk about it with those at-risk can help. Know that suicide is preventable. Mental health experts say there are warning signs, even when those at-risk may seem like they’re OK.

Risk is greater if a behavior is new or has increased and if it seems related to a painful event, loss or change.

These signs that may mean someone is at-risk for suicide are provided by SAVE, or Suicide Awareness Voices of Education.

Talking about wanting to die or to kill oneself.
Looking for a way to kill oneself, such as searching online or buying a gun.
Talking about feeling hopeless or having no reason to live.
Talking about feeling trapped or in unbearable pain.
Talking about being a burden to others.
Increasing the use of alcohol or drugs.
Acting anxious or agitated or behaving recklessly.
Sleeping too little or too much.
Withdrawn or feeling isolated.
Showing rage or talking about seeking revenge.
Displaying extreme mood swings.

Additional Warning Signs of Suicide

Preoccupation with death.
Suddenly happier or calmer, could mean they have a plan.
Loss of interest in things one cares about.
Visiting or calling people to say goodbye.
Making arrangements or setting one's affairs in order.
Giving things away, such as prized possessions.

Talk with someone who says they are thinking about suicide: Mental health experts and those who have attempted suicide, or have family members who have, say it’s important to ask people how they are feeling, and to find out if they are thinking about ending their life. While some people may fear it gives the at-risk person the idea of suicide, mental health professionals say bringing it out in the open can help prevent suicide.

If someone tells you they are thinking about suicide, trying to talk them out of it is not the best way to help. According to the American Foundation for Suicide Prevention, it’s best not to say things like, “You have so much to live for,” or “Think about how this will hurt your family.”

Show compassions and concern. Say things like, “It must be really awful for you to be feeling that way.” Encourage them to share their feelings and really listen. Let them know that sometimes people feel there is no answer, but treatment can help them feel better. Offer to help them find support.

Ask if they have a suicide plan. If they do, don’t leave them alone and take away firearms, drugs or objects they might use to hurt themselves.

A suicidal person urgently needs to see a doctor or mental health professional. Take them to a hospital emergency room or mental health facility, if necessary. If it seems urgent and you need assistance for your friend or loved one, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.

Cognitive behavior therapy and/or medication: Working with a trained professional in cognitive behavior therapy, often along with anti-depressant medication, can help change catastrophic thinking and lead to steady improvement. This can help people who feel overwhelmed or hopeless and think suicide may be a relief from the suffering. A feeling of hope can decrease the risk of suicide.

Apps: The instant availability of apps for those considering suicide can avert a tragedy. Some of the apps being used include:

Optimism: Can increase a person’s awareness and understanding of things that affect their own mental health and “triggers” to be aware of, and offers the ability to create a wellness plan.

MY3: Defines a network of supporters. Used as part of a plan to stay safe by reaching out to others if someone is having thoughts of suicide. The three may be a therapist, a family member or a neighbor down the street.