by Peggy Sweeney
Suicide is a serious topic that we rarely discuss. Yet, each year thousands of adults and children either attempt or complete suicide to resolve problems or put an end to emotional pain. As a result of their deaths, surviving family members and friends not only grieve but must cope with feelings of guilt and anger as well.
According to the American Association of Suicidolgy, statistics show that in 2014 approximately 42,773 people completed suicide [a minimal rate increase was seen from 2013 to 2014, continuing the recent rate increases after long-term trends of decline]. Suicide was the tenth leading cause of adult deaths in the United States; homicide ranked seventeenth. Specifically, more Americans kill themselves than are killed by others. 3.4 male deaths by suicide for each female death by suicide. An alarmingly high rate of suicide deaths was seen in young adults age 15-24 (second leading cause of death for this age group). Approximately 1,069,325 suicide attempts are made annually.
Survivors “know someone who died by suicide” and Suicide Loss Survivors are “those bereaved of suicide”. Research-based estimate suggests that for each death by suicide 147 people are exposed (6.3 million annually), and among those, 18 experience a major life disruption (1Cerel, 2015).
I have classified the survivors of suicide into three categories. First, people who have seriously contemplated suicide, but have not followed through with their plan. Second, adults and children “rescued” before death following an attempted suicide. Finally, family members and friends surviving the death of someone loved who completed suicide. For each group, their experiences are unique, yet with similar needs.
If truth were known, I believe most people have thought about “ending it all” at one time or another. Difficult problems, with no apparent solutions, appear easier to solve if life was over. However, after a few hours or days, they are able to resolve these problems and reinvest in life and living once again. Their thoughts of suicide dissipate and life returns to normal. It has been my experience that one specific issue does not trigger genuine thoughts of suicide, but rather a culmination of traumatic events. Left unresolved, without the benefit of help, many people become overwhelmed by these events. All too often, suicide is the answer. Their thoughts of suicide become more focused, seemingly a ready answer for ending the deep emotional pain that has been their constant companion. However, during or shortly after his or her attempt at suicide, someone calls for help. The attempted suicide is reversed. Rescuers have given them a chance to rebuild their lives.
To help you understand the severity of emotional trauma, I would like to paint a mental picture of what I have labeled the well of depression. It is a very deep, dark place. Cold and lonely. Similar to an old, abandoned well. The walls of this well are slimy and moss-covered. It smells rancid and the floor is broken and crumbled; you are not able to maintain a stable footing. As you look up from the depths of the well, you can only see a faint glimmer of light. No matter how hard you try, you cannot pull yourself up and out. Your silent screams for help appear to fall on deaf ears. Your once secure and normal life has suddenly plummeted into the depths of despair. You feel as though you have lost control of everything. You doubt your self-worth. Everything appears hopeless.
During my brief sojourn into this well of depression, I saw no ready answers for the problems I was facing. Many people would probably view my struggles as minor dilemmas, simple and easy to solve. Yet, as the days and weeks elapsed, I sank deeper and deeper into depression. I could not think. I could not rationalize the apparently easy solutions to my problems. I felt no one cared about me and I questioned my self-worth and the value of my existence. My thoughts of death had a calming effect. I cared very much for my family, yet their love could not dispel the need I had to end the pain. I needed help! I needed choices for survival. I needed someone to care enough to help me choose life, not death.
When someone is in a severe depression, they often disguise their true feelings. They may appear normal, their usual selves. Some of their behaviors may be somewhat out of character, but nothing so unusual that we would question them. They may have financial problems, have recently finalized a divorce, or are coping with other family or job-related issues. The list is endless. Children may reach their decision to end their life as the result of physical or emotional abuse, ridicule or shunning by peers, feelings of abandonment by a parent through divorce or death, or an overwhelming sense of failure.Slowly over time, however, we may begin to notice a deviation in their personality. A once happy and outgoing adult or child is now withdrawn and apparently troubled.
Professions, such as firefighting, EMS, public safety, emergency dispatching, and corrections, contribute many other elements of stress and trauma that greatly exaggerate depression. These men and women are placed in life-threatening situations and witness human injury and death daily. They may have become injured or disabled as the result of their hazardous job and believe that they are no longer of value to their department or have a purpose in life. They may be struggling with the seemingly senseless death of someone from their department. However, their co-workers appear to be adjusting to these same situations with no apparent trouble. No one talks about the incident or the feelings they have inside. He or she assumes that everyone else is coping with the stress; hence, something must be wrong with them. Rather than asking for help (they may be perceived as weak), they will turn these feelings and thoughts inward. As each new incident or struggle occurs, they slip deeper and deeper into depression. It is no wonder then that these professions have the highest suicide rates in North America.
Human beings have certain basic needs, such as food and water, for survival. It is also very important for our survival to feel needed and appreciated, loved and cared about. When our perceptions of life and living become skewed and there is no one to help us cope with depression, we fall deeper and deeper into the “well.” It is during this difficult time that many people will resort to the use of mind-altering drugs and/or alcohol (or other potentially addicting solutions such as chronic gambling or compulsive spending) as a means of coping with their emotional problems. These temporary remedies merely assist in numbing the pain they are feeling, but do nothing to resolve the reasons for the deep-seated problem of depression.
It is imperative that all of us become more sensitive to the needs of family members and friends. We must show more compassion, caring, and love. We must not judge people, but rather provide support and offer positive suggestions to help them cope with their problems. If they had a physical illness—cancer or diabetes—we would not turn away from them. We should respond to mental and emotional illness no differently. Do not be afraid to discuss suicide with them. If they admit to serious thoughts of suicide, or worse yet, a definite plan of ending their life, this is a red flag warning. Please get them immediate help! Do not shrug it off as a passing remark, but a cry for help. We must lead them from the depths of despair into the light of a new day. Everyone who has struggled with depression, has contemplated suicide, or worse yet, has attempted suicide deserves a second chance at life! We can be their lifelines.
When someone we love dies, it is always difficult for his or her family and friends to journey through grief. The trauma of a death by suicide compounds the emotional devastation. These survivors must not only cope with grief, but with the stigma that surrounds a suicide death. This stigma began many centuries ago when the Catholic Church took a strong stand on the issue of suicide, labeling it a mortal sin—an unforgivable sin. The Church believed that only God had the right to take a life; therefore, the act of suicide went against the laws of God. Other churches agreed with this opinion and banned family members of suicide victims from participating in church functions. They were abandoned and shunned by the people of the community. They were outcasts. Their church, and the people whom they needed the most at this devastating time in their life, turned their backs on them.
Our perceptions of suicide, fortunately, have changed somewhat over the years, but many people still consider suicide a weakness. They condemn the victim for their actions and ignore the needs of the surviving family and friends. My opinion is that God is a loving and forgiving God. He views our life based on a multitude of deeds (good and bad) and does not determine our punishment based on one single action alone. The family and friends, the survivors, need our love and support, not our condemnation.
Guilt and Anger: Two of the most difficult issues in coping with the grief of suicide are guilt and anger. Survivors constantly question why the person chose to take their own life. Was there something they themselves did that prompted this decision? Why didn’t they realize what was happening before it happened? Why didn’t the deceased person ask for help? The lives of the survivors become fragmented as they search for answers that never come. Even if the deceased left a suicide note, they still cannot understand what was so wrong in this person’s life that they chose suicide. It is an endless game of questions with no answers.
Survivors must realize that there may never be a definitive answer. They must relinquish this quest and focus on healing their broken heart. Most suicides, in my opinion, happen due to an accumulation of events, rather than one particular incident. Please bear in mind that your loved one did not commit suicide because of anything you did or did not do; said or did not say. They were in a place of very deep emotional pain and wanted to end that pain. In order to end that pain, they had to take their own life. They did not do it to hurt you; they did it to end the pain.
Life is like a puzzle, intricate, with many pieces. Each piece of the puzzle must be fashioned in a certain way to be joined to other pieces to make a complete picture. This puzzle takes a lifetime to finish. Every day, another piece of the puzzle is shaped and designed to blend with the others. When someone we love dies, it is as if our puzzle is tossed in the air, the pieces scattered. As we begin to rebuild our puzzle (our life), we realize a vital piece is missing. An empty spot in the border of the puzzle will always remind us of the person who has died. We become frustrated and may lose interest in completing this puzzle. All of the pieces are not there. It seems as though our puzzle, our life, will reflect someone who is not complete. You are so wrong! Grief and the healing process provide the opportunity to redesign this puzzle. You must learn to fashion and blend other pieces to accommodate the missing puzzle piece. You must direct your focus on life, your family, and on living in spite of your loss. You must learn to love and laugh and remember the happy times once again. You have a choice and your choice should be life and loving.
The reason I feel so strongly about suicide education and prevention is due, in part, to the fact that I am a survivor of suicide. I was once in that well of depression. I had given up on life. I had my plan to end my life in place in my mind. I know the depths of the emotional pain of depression and the physical toll that depression can have on a person’s body. I will always be indebted to my friend, Gretchen, who reached out her hand to me and would not let go until I was strong enough to walk alone into the light of a new day.
I will never allow myself to go back to that deep, dark well, but the memory of that pain enables me to help others. Those of us who are stronger must always be willing to help other people who struggle with emotional pain. We must lend them our strength and be their ray of hope.
There have been many articles written recently concerning the health of emergency response professionals and the staggering number of suicides. In addition to the prescribed physical exams and daily exercise, I strongly believe that departments and administrators must realize the importance of programs that focus on healing grief and depression. Some departments have implemented such programs, but far too many departments have not. It is a known fact that continuous stress and traumatic events influence a person’s susceptibility to heart attacks, strokes, and other medical problems. If programs designed to help resolve grief and stress, suicide prevention and intervention are not implemented we will continue to see emergency response and public safety professionals dying as the result of physical illness, suicide, or substance abuse. It is time to stop ignoring these problems—they will not go away.
1Cerel, J. (2015, April 18). We are all connected in suicidology: The continuum of “survivorship.” Plenary presentation at the 48th annual conference of the American Association of Suicidology, Atlanta GA. [data from Cerel, Brown, Maple, Bush, van de Venne, Moore, & Flaherty, in progress; personal communication 20 Dec 2015]
About the Author: Peggy Sweeney has been an advocate for the mental and emotional wellness of first responders for over twenty years. Peggy is a mortician, bereavement educator, former member of the Comfort (TX) Volunteer Fire Department and a former EMT-B. She was honored with the 2014 Firefighter of the Year award from her department. You may contact Peggy through her email firstname.lastname@example.org