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September is National Suicide Awareness Month. In a recent conversation, an acquaintance questioned the need for all of these “awareness months.” Why a specific month for checking on your buddy? Why not all the time? Absolutely correct, of course, but having a specific time period that brings it into the national consciousness is one that invites conversation. The only other times, in my observation, that people generally talk about the subject is when there is a high-profile death. In order to facilitate that conversation, here are some thoughts on the subject.
First, let me say to begin with, I don’t want you to die. Seriously. Not in an accident, not in some freak occurrence, and certainly not by your own hand. As a veteran, as a fellow human being, I wish for you to have a long life with a passing by natural causes. However, suicidal ideation is common…and dangerous
Suicidal ideation happens. More people than you might think have thought of taking their own lives within the past year. This takes on many different forms, but simply the thought of taking our own lives is dangerous. It’s a signal, a symptom of a more serious underlying condition. It doesn’t mean you’re crazy, it doesn’t mean you’re broken, and it certainly doesn’t mean that there’s no hope. It simply means that there are challenges going on that need to be attended to. Here are a couple of considerations when it comes to suicide.
Suicide is Complicated
It’s a very complicated issue. What may cause suicide in one person is not what would cause suicide in another. When we say we want to “solve the suicide problem,” one of the problems is that it there is not simply a one size fits all. No one solution will work with everyone, because not everyone’s reason is the same. One person’s suicidal ideation may manifest itself due to emotional dysregualtion. Another person’s may be driven by pain. Terminal illness. Emotional/psychological pain (guilt, shame, depression, anxiety). Consider Arial Castro, the Ohio man who held women hostage for decades, and killed himself in prison. Some would say poetic justice, right? Good riddance? Or Albert Wong, the veteran who took three hostages at The Pathway Home in March of 2018. He killed the three hostages before turning his weapon on himself, but that tragic story was as much about his desire to kill himself as it is about the three doctors he took with him.
Suicide Happens on a Continuum
In a recent conversation with Stacey Freedenthal, a recognized expert in the field of suicide, we discussed the concept of a spectrum or continuum of suicide. Emerging in the early 1970s, the concept of suicidality happening on a continuum is a widely accepted model used to explain the process that most people experience. Many people think suicide is either an on-or-off proposition. Either “I’m suicidal or I’m not”. It’s not that black and white, but instead happens on a continuum or in stages. On one end of the spectrum, you have no thoughts of suicide. Completely not suicidal. A little farther along, you start to have vague, non-specific thoughts. “Maybe it would be better if I wasn’t here” or “man, this day really sucked, I could really check out” or “they’d be better off without me.” Beyond that, you have the specific thoughts of taking your own life. Saying things like, “I want to shoot myself.” You don’t actually go through with it, or take the thought farther than that, but the thought of taking your own life is fully formed in your consciousness.
Beyond the specific thoughts, you have contemplation of how you will do it. Thinking of the method, when, where, and how. Once the plan is contemplated, the next step is preparing for the plan, then putting the plan in action, then the attempt, then death by suicide.
Here is the continuum outlined:
- No danger of suicide
- Vague thoughts
- Specific thoughts
- Contemplating a plan
- Preparing the plan
- Putting the plan in action
- Follow through with the plan
- Death.
The problem here is that intervention can occur at any point all the way up until 8…it is literally not too late until it is too late.
Suicide is Highly Individualized
The other insidious part about the continuum is that not everyone moves through the continuum at the same pace. One person might flash through all of theses stages in the space of an hour, or even ten minutes…others will take years of moving along the spectrum before actually progressing to take their own life. And there can be all the signs in the world, or no signs at all.
I don’t want that to happen…not to you, not to me, not to anyone. Reaching out for help, talking to a mental health professional, even getting on medication, if necessary, will keep this from happening. Maybe medication is necessary…for now. It doesn’t mean being on anti-depressants forever. You can talk to your medication provider and come up with a plan of how to take medication for about eighteen months. Over that time, put skills into place while your brain chemistry is being regulated and responding back to a set non-depressed level.
As I always say, awareness is key. To become aware of how much at risk you actually are, check out this site: https://www.vetselfcheck.org. It has an anonymous self-assessment quiz that will kind of show the level of risk that you’re under. Maybe it might give some insight into where you are at, or were at.
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