Last summer, my brother-in-law killed himself. The suicide seemed to come out of the blue. Though we knew Chris was dealing with stress and unhappiness, he was talking about his troubles openly, without expressing any desire to hurt himself. He was also enjoying time with his family: He’d gone to an amusement park days beforehand. And he was making plans—he even kept a dentist appointment the morning of his attempt. “I know time will help me feel better about my situation,” he texted me, only hours before he killed himself.
Chris’s suicide gives no indication of having been premeditated. In the wake of his death, a horrible thought occurred to me: Was it possible he had taken this most permanent action—one that traumatized his family—on something like a whim, the way he bought a new truck one Sunday, or gambled big at the casino?
Or had we all missed something? I was frustrated by the fact that the research I did mostly turned up resources focused on looking for warning signs—such as withdrawing socially, talking about wanting to die, or giving away prized possessions—that, in Chris’s case, hadn’t appeared. Although we typically associate suicide with debilitating depression or excruciating illness, many people who attempt may not be diagnosed with illness or depression at all.
Here are ten things I’ve learned from my experience of a loss that we never saw coming:
Most people who attempt suicide do not pre-plan the attempt.
Contrary to depictions of suicide in which a person has decided that they do not want to live any longer and concoct an elaborate, premeditated plan for their own death, suicide is a often an in-the-moment decision, even though nearly all attempters have thought about suicide—even if only passingly—at some previous point. In a 2002 study from the journal Suicide and Life-Threatening Behavior in which survivors of attempts were interviewed, about 75 percent of the attempters report having thought about the choice for less than an hour before attempting, and of the 153 case subjects between the ages of 13 and 34 interviewed, one in four reported having deliberated for five minutes or less.
Therefore, suicide can be hard for loved ones to anticipate. If a person doesn’t know even minutes beforehand that they will attempt suicide, they are probably not going to be saying goodbye to loved ones, giving away possessions, or talking about their plans—because, as yet, they have no plans.
Despite the fact that these suicides can seem impulsive, they have not actually “come out of nowhere.”
Even with suicides that seem completely out of the blue, an attempt almost never represents the first time the person thought about killing themselves. “There is almost always a sense of hopelessness that has led to the person having considered suicide in the past,” says David Klonsky, a professor in the department of psychology at the University of British Columbia.
“There is a continuum in suicidal behaviors,” adds Cathy Barber, Director of the Means Matter organization at the Harvard TH Chan School of Public Health. “Some involves a lot of thought and planning and some does not.” So even if someone has seemed as if they were coping well with difficulty in recent days or weeks, in the bigger picture, they almost certainly had been struggling. In our case, we found out after his death that Chris had previously attempted suicide years earlier, before he met my sister, and was no stranger to feeling unable to cope.
Suicides that occur without advance planning are often triggered by a difficult life change.
Chris wrestled his whole life to take instability and loss in stride; he could be a jovial, calm guy until the shit hit the fan. We may associate suicide with long-standing, extreme melancholy, but attempts often occur when someone faces a destabilizing situation—a break-up, work crisis, or other personal loss or challenge—and doesn’t feel they can handle it.
Klonksy notes that it is human nature for our emotions to ebb and flow, and those who attempt suicide without more forethought are having a potentially lethal response to a temporary spike in despair. “People who attempt suicide are usually experiencing both a feeling that things will never get better, plus some type of increased agitation that makes that feeling seem urgent,” says Alex Millner, a postdoctoral fellow in psychology at Harvard working with the American Foundation for Suicide Prevention.
While there may not always be classic “warning signs,” there are assessable risk factors.
According to Barber, while feeling hopeless is probably the most common theme among suicide attempters, if someone is dependent on or abusing drugs or alcohol, dealing with depression or other mental illnesses, or acting impulsive and aggressive, these are factors that may indicate a chance of suicidal behavior. Other factors that can raise risks include a family history of suicide, and previous attempts.
Suicide attempted in a moment of crisis occurs when methods are available and accessible.
Klonsky and his colleague Alexis May developed what they call the “Three-Step Theory,” that posits that following previous thoughts of suicide and a spike in despair caused by some kind of crisis that brings those thoughts to the foreground, there also has to be the capability to act on those ideations. Which means a method needs to be handy, even convenient.
Studies have shown that if there is even a minor barrier to a suicide method (the poison tastes worse than expected, or it turns out the town installed a fence on that bridge), attempters may change their minds and never attempt again. “All our emotions, including the very difficult ones, can shift rapidly, and we are hard-wired to fear death and physical pain,” Klonsky notes. “So it’s often true that we give up on harming ourselves, even when we are feeling suicidal.”
This means that a key to suicide prevention is making some of the most common methods less available. In America, this means taking away guns, even if only temporarily.
Firearms are by far the most common method of suicide in the US: More attempters use a gun than all other methods combined. And these attempts are more likely to be fatal than any other method, too.
We live in a country where guns are quick and easy to get. So if someone you know has been feeling despondent and is also dealing with a crisis such as a break-up or job loss or feeling bullied, offer to babysit their guns until things stabilize, and store your own guns securely off-site until they do. This is especially important for gun-owning parents who have a child who is struggling. A NVISS (National Violent Injury Statistics System) study has shown that 82 percent of youths 17 and under who killed themselves with guns used a firearm belonging to a family member, often kept in unlocked storage or in an on-premise cabinet to which the child could gain access.
People grieving the sudden loss of a loved one may not want to be consoled the way we typically console someone impacted by tragic death.
Although people mean well, it doesn’t sit right when my sister is told that Chris is "free from pain" or "in a better place." She feels he could have moved through whatever he was feeling, which makes her feel betrayed. So while she certainly misses Chris sometimes, it can feel hurtful to her when someone says he’s somehow in a “better place” than with his own children. The Support After Suicide organization suggests that those of us sitting with the griever try to listen intently to what they actually feel, without judgement, rather than offering clichés or explanations.
One important way to prevent a suicide a loved one hasn’t yet planned is to seek help before things get too bad.
“There’s no magic risk detection tool that indicates a person is at imminent risk, unless the person says so,” Millner says. “But if someone expresses hopelessness, get them professional help, even if it’s hard to see the value at the time, or it feels like a hassle or waste of money. You don’t want to wait for a sign of imminent risk, because that ‘sign’ might be wrong, or never come.” Barber adds, “Don’t let it get to the point where a person is clearly suicidal, because in many cases, by the time you know that, it’s too late.”
Finally, we can all work to remember that our feelings—even our scariest, loneliest feelings—are temporary, and to help those we love remember this, too.
“Suicidal feelings may come on like a ton of bricks, and you may feel like it’s the only way out. Try to recognize that you have hit a horrible period, but that you can make it through alive,” Barber says. “It won’t stay this bad permanently, and the voice that’s telling you it will is wrong. We’re not meant to be miserable. There is almost always a solution out there, and if the ones you’ve tried haven’t worked, try others.
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