5 Surprising Truths About Suicidal Thinking

I served in the Army as a psychiatric nurse for three years. Three long, tragedy-filled years. By the end of it, I had become an expert in military suicide.

No one sits in her high school counselor’s office and cheerfully says, “When I grow up, I want to become an expert in military suicide!” That distinction is something you fall face-first into out of necessity, not by happy choice.

When I joined in 2004, military suicide was not yet hitting the front page of the NY Times nor was it a regular point of discussion on CNN or NPR. But over the next several years, it became a central theme in public discourse.

With suicidal thinking, the truth is a truism to the point of being cliche: early intervention saves lives.

It is equally obvious that intervening early ain’t so easy. We learned this excruciating truth hundreds of times over in the Army.

For starters, a lot of folks who are reaching a breaking point don’t let on how desperate their situation has become.

Even if some of their pain leaks out into plain view, their families and friends rarely understand what they’re seeing; only a very trained eye usually grasps how perilous the situation is. Only in tragic hindsight, do the pieces begin to fit together.

But occasionally, the opportunity does present itself–a chance to bring their friend or loved one back to safety arises. And yet, as often as not, the chance slips away. Why?

Well, frankly, people are worried they’re going to say the “wrong thing” and somehow make things worse. Or they’re fearful they might open Pandora’s box and see a depth of pain that might overwhelm them.

So they shy away from asking the hard questions.

Unfortunately, when someone is rapidly coming to the conclusion that they cannot stand the pain one more minute, there’s just no time to be precious or cowardly. We have to ask, “Have you been thinking about suicide?” and then have the courage to stay with them every, single second until they are getting professional care.

Perhaps knowing the following surprising truths about suicide and suicidal thinking will help you to take that courageous step, should you ever have to.

1.  It often comes from a place of profound love and selflessness.  You read that right.  Far from the typical accusation that suicide is the height of selfishness, it is often the person’s (admittedly incorrect) belief that their family, friends, or the world at large would be better off without them.  If they think they are a burden to someone or if they see themselves as the source of others’ suffering and humiliation (if they’ve conducted themselves in a way they believe is degrading or socially unacceptable, for instance), the research shows that people consider suicide as a way of saving their families from further pain.  I saw this a lot in the military.

2.  Families never, ever get over a suicide.   They are burdened with guilt.  They spend years, decades, wondering why, wondering what they should have done different, berating themselves for not seeing the signs sooner.  Incredibly, people who are suicidal often think their families will hardly notice they’re gone. By teaching this to those who suffer from depression, a tragedy might be averted.

3. It is not “anger turned inward.”   When I went through nursing school, we were taught that depression was anger turned inward.  That was the only explanation we were given. The antidote then was to get these depressed people to get in touch with their anger and express it.  That was back in the day when psychiatry ludicrously had people with depression pounding pillows and screaming epithets, thinking it would somehow get all this emotion out of their systems and put the ship right again.  What a crock of nonsense.  Research has subsequently shown that a) depression is an illness and not some subverted form of anger, and b) that expressing anger outwardly gets people more jacked up, not less.

4.  Suicidal thinking is distorted thinking. It is a symptom of the disorder itself.  When we are in the throes of a bad depressive episode, one of the things that the brain does is look for ways of easing the pain. And on paper, suicide can look like a “solution” to the pain.  The problem is that the brain is both the thinker and the organ that is disordered.  So thinking when in a depressed episode cannot be trusted all the time–it misfires and starts to think things that are absolutely not true.  Once again, if we can educate people about this, it’s an opportunity to keep them from making a choice that is permanent for a problem that is temporary.

5.  Suicidal thinking is often an attempt to cope, to open a pressure-valve a little–a self-protective response to unbearable pain.  Some people use suicidal thinking as a way of saying to themselves, “I don’t have to endure this pain forever.  There’s always suicide.”  It doesn’t mean the person has a plan and has started rehearsing it.  It just means they are desperately searching for ways to soothe themselves during the worst moments.  Now, that’s not to say it’s OK, no big deal.  It absolutely IS a big deal.  It is a HUGE deal.  And something that needs to be talked about at length.  Just keep in mind, the real problem here is the unbearable emotional or psychological pain the person is in–the suicidal thinking is just their way of coping.

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