Sunday, December 15, 2013

Survivors Speak Out on the Stigma of Suicide

Three very different individuals discuss their attempts, how their experiences forever altered their lives and what they are doing today to help others who may be thinking about committing suicide. 

Photograph courtesy of Cara Anna.

By: James Swift

Just months after accepting her dream job -- a position as a foreign correspondent for the Associated Press -- Cara Anna said she snapped.

“For me, who identifies my life with journalism, that was incredibly scary, because if I fail at this, I fail at everything,” she recalled. “I remember the stress very clearly.”

That stress ultimately resulted in Anna attempting to end her own life. “Why remind yourself everyday that you no longer have any potential and you can’t pretend that you do?” she said. “If I’m going to be a failure at everything, wouldn’t I just be better serving everyone if I just left?”

Cheryl Sharp describes an overwhelming loneliness that engulfed her youth -- a place where she did not feel as if she belonged, nor had any value. Between the ages of 13 and 18, she attempted suicide three times. Before she turned 24, she would attempt to end her own life on six more occasions.

She recalled one attempt in which she overdosed on her mother’s medication. Instead of being taken to an emergency room, Sharp said her father instead made her ingest hot salt water and walk around her neighborhood.

“Things did not get reported,” she said. “These were big family secrets.”

Throughout his life, Kevin Hines said he has struggled with mental illness. “It affected everything I did and didn’t do,” he said. “And it brought me to a point of such deep depression that I believed I was useless and I thought I was a burden to my family.”

In 2000, Hines said he made the single worst decision of his life. “Due to my brain disease of bipolar disorder,” he recalled, “I attempted to take my life by jumping off the Golden Gate Bridge.”

Various circumstances may have brought these three individuals to attempt suicide, but in the wake of their experiences, they have found a common calling. In different ways, they have all transformed their own attempts into a springboard to address suicide prevention -- and methods for combating the stigma associated with the oft-hushed issue.

Why Are We Keeping It So Quiet?

Anna’s first suicide attempt occurred when she was a senior in high school. While driving one evening, she intentionally veered off-road, striking a guard rail.

In hindsight, she recalled being stressed, but she didn’t consider that same duress to be overwhelming.

“It must’ve been at the time, but again, it seemed like such an impulsive decision that, really, it just didn’t feel like it made much of an impression on me,” she said.

She was soon dismissed from a hospital. Her mother, suspecting there was something more to the incident, asked Anna to speak to a therapist. She went to a few sessions, but said she was “scornful” of the experiences.

“I look back on it now, and it’s sort of strange,” Anna said. “It’s like, ‘Gosh, I tried to commit suicide.'”

In her thirties, Anna said she made a pair of much more serious attempts to take her own life. Following her last attempt, Anna sought online resources for suicide survivors. The lack of outlets for individuals to discuss suicide attempts in a supportive manner troubled her.

“There was no organization that addressed people who have been suicidal, aside from some very murky, sort of anonymous, sketchy forums,” she said. “This could happen to a lot of people, why are we keeping it so quiet?”

Anna then decided to create her own website, Talking About Suicide, to tell the stories of other survivors. Since then, she’s posted more than 50 interviews, with individuals from five different countries. The American Association of Suicidology noted her work, and asked her to design a similar site for their organization, Attempt Survivors, earlier this year.

“I am heartened and relieved to find more and more people continue to write to me,” she said. “They say they are surprised that there are no resources out there and they're happy to come across this one, and they want to do their part to sort of help break down whatever taboos there definitely continue to be.”

Many times, Anna said suicide attempts are situational incidents. Self-doubt, stress and a lack of support, she said, can all be major risk factors. With their easily shaken senses of self, Anna said that young people may be especially vulnerable; taboos surrounding suicide, she added, may also prevent individuals at-risk from discussing their thoughts with others.

“You just can’t lean over to your friends at the next table usually and be like ‘I feel really crappy, I’m kind of thinking of killing myself,’” she said.

A potential deterrent to suicide, Anna said, may rest in the hands of those that have survived previous attempts themselves “There needs to be a lot more of real people, who have had the experience, to be identified with, and can show a certain confidence,” she said, “that people can sort of be reassured by.”

She also cites another reason why some suicidal individuals may refrain from telling others about their thoughts. “It certainly would help if there were fewer punitive measures involved,” she said. “The fear of being locked up, the fear of having police come and knock at your door is another factor in keeping quiet.”

You Can’t See Anything But the Despair

The therapy she underwent from the ages of 18 to 24, Sharp said, wasn’t very fruitful.

“When I finally did the kind of help I needed, they just weren’t looking at ‘well, here’s someone who’s suicidal,’ they were looking at what happened to bring this young person, who has gifts and talents and potential, to a place where they no longer value their own life,” she said.

She credits a “strengths-based” treatment approach to helping her “think through” her suicidal thoughts. Today, she is the senior advisor for trauma-informed services at the National Council for Behavioral Health.

Many individuals who think about suicide feel hopeless and powerless, she said. “That kind of thinking is what sets the stage for a person to really start thinking about [suicide,]” Sharp continued. “When you’re in that place…you can’t see anything but the despair.”

A Wellness Recovery Action Plan (WRAP), she said, would have made a tremendous difference in her youth. Viewing suicide as a process with ample intervention opportunities, she encourages treatments that allow individuals to identify triggers and determine what they may be able to do to intercede on their own behalf. “I wanted someone else to stop the pain,” Sharp said. “What I realized is that I could actually stop the pain, that there were things I could do, that include reaching out to someone else.”

While adequate access to effective treatments are pivotal suicide prevention tools, Sharp believes there’s much more than can be done to prevent others from attempting to end their own lives.

“There’s so much more than just putting somebody in a hospital,” she said. “How do you help somebody create the social supports and the social networks that they need?”

Primary care visitations, she said, could also be an intervention point. “There should be behavioral health questions asked,” Sharp said. “They’re finally starting to ask questions about trauma and the impact of trauma in a person’s life…but primary care has been the slowest to adopt.”

Sharp believes that there is less stigma regarding suicide today than when she was younger, but the "blaming and shaming" associated with suicide attempts still keeps many from discussing the topic.

Reflecting on her youth, she wished she knew then that life was worth living, and that whatever ongoing difficulties present in her life weren’t destined to be perpetual struggles.

“If a person feels trapped in the way they're thinking and feeling, there are keys to unlock the door, there are ways to move beyond where a person is right now,” she said. “That’s what drives me, because I do know there’s another side.”

Always in Recovery

As a motivational speaker, Hines has traveled the world, speaking to military personnel, psychiatric nurses, high schoolers and college students about suicide prevention and what he calls “the art of living mentally well.” His book, “Cracked Not Broken: Surviving and Thriving After A Suicide Attempt,” was released earlier this year.

“My symptoms occur everyday,” Hines said. “I just am able to cope with them better now, because I’ve learned the tools.”

After his leap from the Golden Gate Bridge, Hines said he has been placed in psychiatric wards on several different occasions. He said he still faces the same mental illness struggles that drove him to attempt to end his own life almost 15 years ago.

“Today, I still have all of the symptoms that I used to have, from paranoia, to depression to hallucinations,“ he said. “What I have to do is learn to cope with that.”

Hines said he is “always in recovery,” no different than someone who may be recovering from alcohol or drug misuse. Talking to his doctors and therapist is helpful, but he said being open with his friends and family and talking about his thoughts and feelings is also extremely beneficial.

“The misconception out there in the world is that you take your meds, and you’ll be all better,” he said. “You have to fight very hard, you have to work very hard…if you accept the illness and accept the treatment, you can live a good life.”

Individuals with mental illnesses, he said, are often discriminated against, describing the stigma mental health treatment seekers face as “epic.” Those in the field of suicide prevention are among those, he said, that are leading a charge to change how the general public perceives individuals with psychiatric conditions.

“I hate using the word stigma over and over, because people don’t really get the picture,” Hines said. “We are in a time where the mental health movement is pertinent…it is the civil rights movement of our time.”

What Doesn’t Help, and What Does

Sharp said that many factors could lead to individuals hearing “the voice of despair” which may lead to suicide ideation. One such example she notes is divorce; drastic life changes, especially at vulnerable times in one’s life, may goad some individuals into suicidal behavior, she warns.

“When somebody says they feel hopeless, that’s the step right before a person really starts thinking [about suicide,]” she said. “We need to be able to do something before things are that bad.”

Telling a potentially suicidal individual that he or she has “so much to live for” may be counterproductive, Sharp said. “That automatically implies the person’s not grateful,” she said, “or there’s even more wrong with the person because they can’t see what they have to live for.”

Dismissing suicide attempts as nothing more than “cries for help” could result in dire consequences, Anna said. She recalled reading tweets about recent suicide victims, whom were described by others as heroes and angels. Conversely, she cites other messages regarding individuals who survived suicide attempts, whom were called “losers who are just looking for attention.”

“I just think it’s amazing that suicidal thinking, which can be so fatal, which can affect so many millions of us, can be dismissed as something like, ‘whatever, they just want attention,’” she said. “My goodness, what does that sound like to some people but a challenge?”

Both Anna and Hines advise those who suspect their friends and family members of thinking about suicide to ask questions. “If you’re concerned, just ask it,” Anna said. “Because it can be so hard for the person, who feels so bad, to say anything.”

Hines said individuals should ask if their friend or loved ones are thinking about suicide and whether or not they have a specific plan to end their own lives.

“The common denominator in suicidal thought [is] they want to end the emotional and physical pain,” he said. “So if you reach down into their minds, and share with them that you care, that you empathize and that you understand what they’re thinking…they’re more likely to tell you the truth."

"And if they aren’t thinking it," Hines concluded, "that talking about it doesn’t put the thought on their minds.”

Uncommon Journalism, 2013.

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