it is hard not to see the obvious pattern created by the number of people who come into the EDs and state to a staff member that they want to kill themselves.
Why do we all want to die?
Sure, the world has its ups and downs and stresses, but there seems to be so many people who are bent on their own demise that it is mind-boggling.
Allow me to posit some reasons for this disturbing trend:
We do not feel that we belong.
I heard that folks who are required to check the”other” box on standard forms do not feel special when doing so. They actually can be made to feel apart from, cast out, cut off from the mainstream, since they don’t fit a standard group. It is socially and emotionally ostracizing. It means that we do not belong. That hurts.
We do not feel loved.
I hear over and over from folks in the ED that they do not feel loved by their parents, their spouse, their children or anyone else. Once again, whether it is feeling like the “other” or not loved by anyone at all, it is a huge cause of self-loathing, isolation and hopelessness that will drive someone towards not wanting to exist at all.
Everything seems too hard these days. Nothing is guaranteed.
It used to be if you went to school, graduated, kept your nose clean and played by the rules, you would almost certainly succeed in life. You would be able to find a job, you would have a place to live, you might find love and even raise a family. Today, it seems that none of this is guaranteed and that for some it all seems just out of reach
We feel hopeless.
Hope keeps us getting up in the morning.
Hope keeps us going to school, working our way up the ladder, doing the jobs that no one else wants to do, taking on challenges that we are afraid of.
If we lose hope, we have lost our will to challenge ourselves. We have lost our dreams for the future.
We have lost our ability to see ourselves in the distance, happy and healthy and prosperous.
Financial problems and reversals can produce high levels of anxiety that seem insurmountable.
The same holds true for health problems and reversals.
Some patients are dealing with chronic mental or physical conditions that they are simply tired of. The ups and downs of bipolar disorder, the pain of congenital spinal malformations, the physical and emotional trauma of cancer and its treatment can all lead to feelings that it would just be better to end things on your own terms rather than wait for the diseases to take their course.
Perceived failures and disappointments (both disappointing yourself or others) often lead to the mistaken notion that if you kill yourself, the problem goes away for not just you but everyone involved with you. The thing that most of these folks have not thought about to any degree is the pure devastation that is left in the wake of suicide. The family members, spouses and friends who must live on after you are gone must ask all the hard questions, the what ifs the whys. The guilt and emotional suffering they feel is tremendous, and it never really, truly goes away.
I’ve thought about this a lot, measuring my suffering versus that of my loved ones if I were to leave this world. Relieving my own pain would only be shifting it to others, and that is not the “painless exit” I would want.
Fear and anxiety drive many suicide attempts. Odd, since most people think that only those who are severely depressed kill themselves. Anxiety, severe and unrelenting, actually leads more folks to actually complete an attempt than depression.
I totally agree. I’ve often been depressed since my hormones kicked in at puberty and I had to learn to cope with frequent spells of suicidal ideation. But when I developed anxiety at 40, it was unbearable.
Depression is a passive suffering that doesn’t require any action on my part, but anxiety is a constant desperate cry to “Do something!” to prevent some unknown disaster.
What is the common feeling that weaves its way through it all?
If you think that there is no way out, that there are no viable solutions left, that you have exhausted all reasonable possibilities for making your situation better, then that gun or bottle of pills or telephone pole look like rational and logical answers for your unanswerable questions.
You give up. You quit looking for answers. You feel lighter, happier, more confident because you have made that decision just to let it all go.
If there is no intervention, swift and appropriate, you will die.
Concomitant mental and physical illnesses can spell disaster. Those dealing with longstanding cardiac disease, severe diabetes, metastatic cancer, and other devastating illnesses may be overwhelmed with the emotional counterpart of the illness and if not noticed or addressed, it may steadily worsen and become malignant itself.
What to do if you find that you are one of those people who is thinking that death looks like your only option?
See a psychiatrist or other qualified mental health professional right away. If you are turned away when you call, call somewhere else. Don’t accept anything less than an option for immediate assessment. This is your life in the balance, and it is important.
Suicide kills over forty-four thousand people in the United States every year. For each completed suicide there are twenty-five attempts. On average, there are over one hundred twenty suicides per day in the U.S.
There are many reasons that many of us really want to die. The job for the rest of us is to convince those folks on the edge that there is help.
Link to death numbers from suicide vs overdose
There is treatment.
There is hope.
Author: Greg Smith is a psychiatrist who blogs at gregsmithmd.