Understanding More About Suicide

The walk that I am doing this June is called the Out of the Darkness Overnight walk. It will begin with an opening ceremony around dusk and then the walkers walk a route of 16-18 miles through the darkness (I'm sure the route will be lit in some way for visibility) and into the dawn. Since this is a walk that is to raise funds for suicide prevention, I think the idea of walking overnight is a brilliant one.

Out of the darkness.

That is so very much what it feels like when you get to the other side of a suicidal episode and you find a little bit of something to hold onto again. What most people don't know about suicide is that when a person is actively suicidal, the window of time when they are feeling that way is relatively narrow. If they can find the help they need to get through that narrow window, the chances for their survival are much greater. They are able to come out of the darkness and hold onto the light for another day.

There are, in my experience, two different kinds of suicidal thinking. My very patient therapist, Pendragon, and I have discussed this on quite a few occasions. Part of the reason for our frequent discussions of this is because we've needed to develop some kind of language about it where I can express what I'm feeling and also because I have been somewhere on the spectrum of suicidal thinking more often than I'd like to admit. The reason I refer to it as a spectrum is that even within these two major categories, there are a range of emotional states that a person may be feeling. The two kinds of suicidal thinking are passive and active.

Passive suicidal thinking

Many people know that if someone says they're thinking of killing themselves that it's a bad thing, but few people know how to recognize and assess just how serious the situation is. The biggest reason I bring this up is because understanding the seriousness of the situation is key to knowing the best approach when you are faced with it. Before I begin to explain though, please know that ANY time a person says something that makes you believe they may be in danger of hurting themselves, it's a good time to stay with them, ask them questions (and don't beat around the bush -- be direct!), and LISTEN to what they have to say. Many people who feel suicidal feel as though no one cares or that they can't be helped or that their situation is truly hopeless. When you sit with them and listen to whatever they have on their minds, you show that you care and you help them by allowing them an outlet to vent, and you have the opportunity to help them find hope again. Part of listening is trying to understand just how serious they are about wanting to attempt suicide. If you can ascertain whether they are having more passive thoughts or if the thoughts are more active, you will know better how to help.

Some passive suicidal thoughts may include things like:

• "I'd rather be dead."
• "I could kill myself." 
• "I wish I were dead."
• "They would be better off without me around."

There may be other things that fall into this passive category, but those are just a few that have crossed my mind in that state. Another thing about passive suicidal thinking is that it doesn't normally involve creating a plan or securing the means necessary to go through with that plan. It is in that way that it is passive. The thoughts may be there, but it is more a state of feeling despair and the beginnings of serious contemplation of suicide. The thoughts that one has in this state of mind may also be very fleeting and easy to talk yourself out of without any help, but that's not a guarantee either.

Passive suicidal thinking can go on for days, weeks, or months without it becoming anything more serious. This isn't to say that passive suicidal thinking is a totally benign thing. It isn't at all. It can, if left unchecked, turn to active suicidal thinking and that can be deadly. I know this from experience. In the spring of 2013, I had been feeling very depressed for two or three months already and it wasn't showing any signs of lifting. At that point, I began to passively contemplate suicide. In the last couple of weeks of June, my passive contemplation turned active and on June 28th of that year, I came within a hairsbreadth of attempting suicide.

Active suicidal thinking

If passive suicidal thoughts are the more benign ones, then active ones are generally more malignant. They involve such thoughts as:

• "I want to die."
• "It hurts too much to go on."
• "This will never get any better." 
• "No one will miss me."
• "It would be so easy to....<insert method here>"
• "There's no other way to end this pain."
• "I am going to kill myself." 

These kinds of active suicidal thoughts lead to more concrete action. Often the person who is actively suicidal may be thinking about a plan or have one worked out totally. If they need something to accomplish this plan, they may be working out how to get it or may already have it.

Remember the narrow window of time I spoke about earlier? That's when it comes into play. Most people are only actively suicidal with a plan and a firm intention of carrying it out for a short period of time. The longest period of time I think I ever felt what I would consider actively suicidal and firmly intent on acting on that was about a day and a half. Most of my battles with active suicidal thinking have been between 8-12 hours at the longest and some even fewer. That's what I mean by it being a narrow window of time. Active suicidal thoughts can be fleeting (those are usually accompanied by a sudden intense urge to hurt yourself), but those are kind of rare. Most of the times that I have been actively suicidal, the thoughts persisted something fierce and sort of enveloped me in a kind of mental fog that just wouldn't lift without help. People who are actively suicidal may not reach out for help but may show other signs like becoming withdrawn or isolating themselves, giving away prized possessions, calling or visiting people they love to say goodbye, etc. This link from the American Foundation for Suicide Prevention gives a more exhaustive list of warning signs to look for if you think someone you know may be contemplating suicide.

The reason I wanted to post this is because I believe education and awareness are both critical to reducing the stigma surrounding suicide and understanding how to prevent it. Part of helping someone who is struggling with this is realizing that they are struggling and knowing what to do to help them through it. Here are a few simple strategies that just might save a life:

• Ask questions over the course of a conversation with the other person - "Are you thinking of hurting yourself?" "What do you think is making you feel this way?" "Do you have a plan?" "Do you have pills/weapons?" 
• Listen. I cannot stress enough how important it is to listen. Let the person talk as much as they need and be an active listener. Don't judge them or chastise them or offer advice or bombard them with reasons they have for living -- just LISTEN. 
• When there is a natural lull and it seems a natural place to say it, let the person know that you are sorry they are feeling so badly and you care/love them. Let them know that you are there for them and you want to and are willing to help. 
• Stay with the person until they are no longer feeling suicidal or -- in the case of more severe cases -- until emergency help arrives. 
• Encourage the person to seek help and offer to help them find it. This may mean an appointment with a competent therapist, a psychiatrist to help with medication, calling a crisis line (in the US: 1-800-273-8255), or in an emergency situation, a trip to a local emergency room. Note: A trip to the ER should be a last resort kind of thing. I have my own biases against this having been to an ER once when I was suicidal, but those aside, I have talked to many people who have had very negative experiences with going to an ER that were anything but helpful. 
• PRAY. I know not everyone believes in God, but I highly encourage you to pray. Pray when you begin talking, pray while you are listening, pray as you stay with the person, pray when you are trying to help the person get help. If you believe in guardian angels, ask your angel (and the other person's angel too) to pray and to help in any way they can! I can personally attest to angelic intervention. That almost-attempt I had in June of 2013 would have been a definite attempt without my guardian angel and, I am convinced, my best friend Sif's angel too. St. Dymphna is the patroness of mental illness and mental health workers and she is a powerful intercessor in these situations as well if you are so inclined to ask for the intercession of a saint. 

I hope this helps you better understand both the mind of a suicidal person and how to help them. Please comment below if you have questions or thoughts on this subject. As the 1980s PSA said, "the more you know...."