Joel L. Smith, M.Ed, FISP Program Director
Death by suicide carries tremendous personal, family, community and cultural cost. In 2017, it was the 10th leading cause of death in the US when 47,173 Americans died by suicide and there were an estimated 1.4 million suicide attempts in 2015. Suicide and self-injury cost the US $69 billion. The age-adjusted suicide rate in 2017 was 14.0 per 100,000 individuals. [https://www.nimh.nih.gov/health/statistics/suicide.shtml]
Why do people choose to end their life? There is no single answer to this question. There are many factors, such as traumatic and difficult life events, that can contribute to suicide risk. However, an estimated 90% [www. suicidefindinghope.com/content/mental_illness_statistics] of people who take their own lives have a mental health condition, such as a depressive disorder, bipolar disorder, anxiety disorder, or substance use disorder. Individuals with depressive disorders are especially at risk for suicide, but this risk is not overwhelming. Most people living with a depressive disorder or other mental illnesses can receive help through awareness, education, and treatment. The most common source of suicide risk is when a mental health condition is mistreated or left untreated.
Major depression is one of the most common mental illnesses, affecting more than 16 million American adults each year [https://www.healthline.com/health/depression/facts-statistics-infographic]. Depression causes people to lose pleasure from daily life, can complicate other medical conditions, and can be serious enough to lead to suicide. Depression can occur to anyone, at any age, and to people of any race or ethnic group. Depression is never a “normal” part of life, no matter what your age, gender or health situation.
While most individuals with depression have a full remission of the disorder with effective treatment, only about a third of those suffering from severe depression seek adequate treatment. Too many people resist treatment because they believe depression isn’t serious, that they can treat it themselves or that it is a personal weakness rather than a serious medical illness. The wonderful news is that these illnesses are treatable. Unfortunately, so many people suffering from depressions disorder either do not seek help or do not stay the course. Why? Because, as a culture, we stigmatize the individual’s effort to achieve mental wellness. We expect people to ‘tough it out’, to try harder. The fact is that mental illness is the result of chemical changes in the brain, often initiated by ongoing stress and trauma. These chemical changes alter behavior and thought processes, and often lead the individual down a dark pathway to overwhelming feelings of helplessness and hopelessness… feelings that pain will never go away…that there is no value to their life…that there is no light at the end of the tunnel. It seems that the only way out…the only way to end the pain…is to die.
Our children live with our stress and the additional stress that school performance and peer pressure place on them. As adults, there are signs we can and should be aware of:
1 Behavior changes, taking unnecessary risks, acting out… just not being themselves
2 Changes in eating habits; noticeable weight gain or loss
3 Changes in sleep habits; too much or too little, tired all the time
4 Trouble concentrating or being indecisive consistently
5 Withdrawal from family, friends or social interaction
6 Unexplained fatigue or apathy
7 Inability to experience joy; unexplained crying
8 Loss of interest in work, school, hobbies
9 Loss of interest in personal appearance; loss of sexual drive
10 Giving away prized possessions
11 Talking about or a preoccupation with death and morbidity
12 Previous or continuing mental illness; previous suicide attempts
13 Experience with a recent or unexplained loss
14 Increase in risk taking behavior; increase in the use of alcohol and/or substances
15 Failure to address illness or health needs; failure to take medications according to prescription
16 Manic behavior, inflated or deflated self-esteem, euphoria
17 Extreme and / or persistent anxiety, agitation or anger
18 Feelings of helplessness, hopelessness, desperation, guilt or worthlessness
19 Saying goodbye to family or friends
20 Planning death by suicide or acquiring the means to do so [weapon, pills, etc.]
It’s important to be aware of changes over time. Most often, these signs are there for us to see…. if we are vigilant. If you feel that there is an immediate or imminent threat of action….do not delay. Call 2-1-1-!
It’s important that we understand this and create supports for people who are struggling, before the struggle becomes too much. We need to respect the struggle. We respect people who are dealing with cancer. We respect people who are dealing with heart disease. We do not say “so and so committed cancer”. We do not say “so and so committed heart disease”. Yet we say, “so and so committed suicide”. This dishonors the disease they are suffering from and the struggle to treat the illness. When people die by suicide, it is because the depth of the illness drove them to seek relief from the pain. As a culture, we need to understand that mental illness is an illness; caused by chemical changes in the brain. We need to understand, and honor the fact, that the process of seeking mental wellness is the same as any treatment response to an illness.
Joel Smith is the Programs Director for The Florida Initiative for Suicide Prevention (FISP). It provides:  Services to Survivors: by supporting survivor groups addressing the grief that family members and loved ones’ must traverse to recover their life equilibrium. This takes time as each person experiences grief – and recovery – along their own path.  Seminars, trainings,
participation in a wide variety of community events; FISP is an acknowledged community leader in addressing; death by suicide, mental illness, and survivor supports and  HOPE Sunshine
Clubs, which provide positive social and emotional learning environments, in our schools, addressing: mental health, bullying, suicide prevention, social and the “SUN” problem solving program as well as fun and engaging activities. The clubs are designed to: promote community leadership, develop empathy, self-worth, feelings of belonging and good citizenship skills.