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Stronger Than the Storm

In July of 2012, my family and I received news of the unthinkable. My parents sat my

two younger siblings and I down in the living room to tell us that our dearest Uncle Johnny had

taken his life, due to his hidden struggle with depression. This heartbreaking announcement was

immediately met with an outpouring of emotions: sadness, devastation, anger, disbelief.

My Uncle Johnny was always the most joyful person, radiating happiness through his

infectious smile, his heartfelt conversations, and his overwhelming passion and gratitude for

family, friends, and even the random strangers he had made connections with. Johnny was

adored by all for his soft-hearted, friendly, goofy, courageous, goal-oriented, and generous

character. He was truly the patriarch of our large family, and the person that everyone relied on

for advice and support. He also made my siblings and I a high priority: by calling to check in on

us daily, by regularly visiting and taking us on outings, and by treating us with the patience and

compassion he knew we deserved. My Uncle and I were especially close, as he was my biggest

role model, my best friend, and, frankly, the person that I aspired to be when I grew up. Because

it seemed like he had everything to live for, his death was so difficult for me to understand.

Why did my Uncle Johnny have to die by suicide? Were there any words I could have

said that would have inspired him to ask for help? Would just one more visit with him have made

him want to fight harder for his life? Why did I not sense his suffering earlier? What would our

relationship be like now, and would he be proud of the young woman I have become? Although

it has been eight years since his passing, my questions continue to be left painfully unanswered.

Unfortunately, in the progressive society that we live in, mental health is still considered

taboo. Because it is not discussed enough, people are often forced to feel alone in their mental

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struggles, and all too many lives are harmed, risked, and taken. The harrowing stigma that is

associated with suicide and mental health conditions needs to be eliminated, so that the lives of

loved ones can be saved. My Uncle Johnny’s tragic death, the grief that has coincided with his

loss, and my feelings of obligation to spread awareness about mental health and suicide have led

to my questions: ​What are the symptoms of suicidal behavior, and how can we recognize these

symptoms, and use this knowledge to prevent people from committing suicide?

Suicide, the act of deliberately killing oneself, is a significant public health concern and a

major cause of death worldwide. According to the World Health Organization, approximately

800,000 people die by suicide annually, which is about one death per every forty seconds.

Additionally, the American Foundation for Suicide Prevention states that suicide is the tenth

leading cause of death among Americans of all ages, making the age-adjusted national suicide

rate 14.2 per 100,000 individuals in 2018. With these staggering statistics rising each year,

displaying the loss of so many innocent and deserving lives, it is clear that people are not

receiving the proper mental health support. Social, educational, and health-related progress must

be made to advance the global suicide prevention effort, to help people find and see the worth in

their lives, and to ease the pain of mental suffering.

While it can be complicated, suicide is very preventable. In ​Why Suicide?: Questions &

Answers About Suicide, Suicide Prevention, and Coping with the Suicide of Someone You Know​,

journalist Eric Marcus outlines the steps that must be taken to prevent suicide. According to his

research, prevention begins with the identification of risk factors and warning signs. Once any of

these signs are recognized in an individual, proper treatment methods must be found and

provided to them. With the correct treatment, individuals are able to recover and find a new

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sense of hope for themselves. However, Marcus makes sure to point out that these simple steps

may be hindered for reasons such as difficulties identifying those at risk, failure or refusal of

treatment, and faults relating to the affordability and accessibility of the healthcare system.

Suicide is a growing concern, therefore awareness about the many symptoms, risk

factors, and causes of suicidal behavior is extremely important, as it may help save lives. In an

interview with Scott Chavez, the Director of Outreach and Training at the Contra Costa Crisis

Center, he identifys some of the common risk factors of suicide as: “mental illness, hopelessness,

impulsive or aggressive tendencies, history of trauma or abuse, alcohol or other substance abuse,

previous suicide attempt, family history of suicide, job or financial loss, relational or social loss,

easy access to lethal means, lack of social support or sense of isolation, and nonsuicidal self

injury.” He also adds that there are some lesser known symptoms of suicide, which include, but

are not limited to, positive mood changes, giving away prized possessions, and withdrawel from

acitivities. Chavez went on to clarify that the presence of any of these risk factors does not

always mean that someone is suicidal, instead they can serve as a basis for better recognizing

warning signs or asking directly about thoughts of suicide.

The United States’ Centers for Disease Control and Prevention recognizes many of the

same suicide risk factors that Scott Chavez explained. However, the CDC also notes other

high-risk circumstances to include family history of child maltreatment, history of mental

disorders (particularly clinical depression, alcoholism, bipolar disorder, anxiety, and

schizophrenia), feeling like a burden to others, chronic pain, loss, impulsive or aggressive

tendencies, local epidemics of suicide, and inability to access health treatment. The CDC

continues on to highlight that “unwillingness to seek help because of the stigma attached to

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mental health and substance abuse disorders or to suicidal thoughts” vastly increases the prospect

of suicide. When people feel that they cannot reach out to ask or receive mental help, they are

left alone to deal with their mental battles, often convincing themselves there is no reason to live.

There are also specific populations that face a higher suicide risk, some being men,

Caucasians, middle-aged adults, and individuals in the LGBTQ+ community. According to

statistics published by the National Alliance on Mental Illness in 2018, males are three times

more likely to commit suicide than females. NAMI clarified that although females are more

likely to attempt suicide, women seek mental health treatment in times of need more often than

men. The age-adjusted national suicide rate for Caucasians is 16.84%, which is significantly

higher than those of other ethnicities, and the suicide rate is highest among individuals between

the ages of fifty-two and fifty-nine (21.56 per 100,000 individuals). The American Foundation

for Suicide Prevention also states that youth who identify as lesbian, gay, or bisexual are four

times more likely to attempt suicide than heterosexual youth, and people who identify as

transgender are twelve times more likely to attempt suicide than those in the general population.

Because of the extensive opinions and judgment about sexuality and gender identity in our

society, a large group of people are subject to unstable mental states.

Suicide can also be evaluated from biological and neuroscientific perspectives. The Brain

and Behavior Research Foundation, an American nonprofit dedicated to mental health research,

studies the relationship between suicidal behavior and the human brain. Medical researchers

associated with the Foundation found a link between low levels of the neurotransmitter seratonin

and suicide. They also found that abnormalities in certain parts of the brain, such as the

orbitofrontal cortex and the anterior cingulate cortex, are widely connected to suicidal thoughts

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and behavior. These scientific breakthroughs have contributed to the idea that people who are

biologically predisposed to handle stress poorly are at a much greater risk for suicide. The BBRF

also stated that genetic factors influence suicide risk by as high as fifty percent. With greater

knowledge of these symptoms, risk factors, and biological causes, people with mental health

struggles can be better looked out for, mental health treatment methods can be improved, and

more deaths by suicide can be prevented.

Approaching someone who is considering suicide may be very difficult, however, using

knowledge about the warning signs and risk factors of suicide to take these actions is always the

best choice. To provide aid to someone who is in an unstable mental situation, the Mayo Clinic

recommends that one be direct about asking questions relating to mental health, feelings, and

suicidal thoughts. Examples of such questions or conversation starters include: how are you

coping with what’s currently going on in your life, are you thinking about suicide and dying, and

have you thought about how or when you would take your life? These questions are often

beneficial in reducing the risk of suicide because they let individuals know they are not alone,

that they have someone to talk to, and that they are in the presence of someone who cares.

In addition, the Mayo Clinic writes that people should consider and follow up about all

warning signs, always taking the possible signs of suicidal behavior seriously. Reaching out to

follow up with someone who is having thoughts of suicide, whether it be in person or via the

phone, is key because it lets them know that they have someone supporting them and looking

after their wellbeing. Scott Chavez from the Contra Costa Crisis Center stresses a similar idea,

when he talks about the importance of active listening and empathy when conversing or checking

in with someone who is in a suicidal position. He defines these two critical principles as “simply

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listening to what’s going on in the life of the other person and understanding what they’re going

through, even if you don’t agree with it… even if you don’t think they’re looking at the world

correctly.” Practicing this active listening and empathy encourages people to stay involved and

authentically guide someone through their troubles. The Suicide Awareness Voices of Education

group also recomends that people avoid minimizing a suicidal individual’s problems and provide

a comfortable spirit, all the while never keep someone’s suicide plans a secret.

Keeping an at-risk individual safe should always be the main priority, so it can be

extremely helpful to seek outside help and resources from people who have more knowledge

about and experience with mental health and suicide. Immediate assistance can be provided over

the phone through local and national suicide hotlines, as well as in person at emergency rooms,

crisis centers, and support groups. These phone centers and meeting places are equipped with

trained professionals, who know how to best approach mental health related situations and

circumstances. Scott Chavez states that resources such as these can impart answers to questions,

provide therapy and counseling, give references, coach people through difficult thoughts and

situations, and even let loved ones know how to be helpful. He also says that hotlines and crisis

centers do not always provide advice to individuals, and instead they provide active listening and

a sense of calm, and are dedicated to the safety of the people involved.

There are a wide variety of biological and psychological treatment options that are

available and given to individuals who are contemplating suicide. According to the American

Foundation for Suicide Prevention, mental disorders that put people at risk for suicide can be

treated with psychotherapy and antidepressent or antianxiety medications. Other options that the

AFSP has listed to be beneficial are electroconvulsive therapy and alcohol and drug

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rehabilitative treatment. While these treatments are not a cure, they do lower the risk for suicide

significantly. People with suicidal thoughts must be made aware of these treatments, so that they

can have better opportunities to cope and survive, given their uncomfortable conditions.

In order to reduce suicide rates in the near future, the appropriate preventative actions

must be implimented within society as a whole. Currently, stigmas unfavorably shape the way

that many people perceive individuals who deal with crippling mental health conditions. These

stigmas surrounding mental illness and suicide are negatively impactful and dehibilitating to

those who are struggling. As stated by the Mayo Clinic, some harmful effects of these stigmas

include self-doubt, lack of understanding from loved ones, bullying, harassment and violence,

reluctance to seek help or treatment, difficulties finding insurance companies that will cover

treatment, and less opportunities. Putting mentally struggling individuals in this position is

incredibly dangerous, as they are not being set up for successful and healthy lifestyles. These

stigmas must be eliminated, so that people with mental instability can be treated with the

acceptance, compassion, and respect that they deserve.

Moreover, actions must also be taken at the public, political, and community levels to

further push forward the suicide prevention effort. The article “Can We Really Prevent Suicide”

in the United States National Library of Medicine says that policies directed at means restriction

and public awareness campaigns should be enacted, in order to create comprehensive mental

health treatment plans and methods. Additionally, the article states that because managing

suicide risk is very complicated, media coverage needs to be more responsible when reporting on

the matter, being careful to not glorify or sensationalize suicidal acts. Another way that the

suicide prevention effort can be advanced in communities is to make mental health screenings

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more easily accessible. If these policies are accomplished within society, more people with

mental health issues will be able to receive help and live in comfort.

Lastly, there are many ways that groups or individuals can get involved with the suicide

prevention cause. The National Alliance on Mental Illness suggests that people volunteer with

mental health organizations, like National Alliance on Mental Illness, Mental Health America,

the Anxiety and Depression Association of America, and the Trevor Project, and at local crisis

centers or suicide hotline phone centers. People can also make a difference by taking a

stigma-free pledge, participating in Out of the Darkness walks to honor those who have died by

suicide, donating money to suicide reach or mental health organizations, providing prevention

trainings, or bringing suicide prevention discussions to schools. Still, the simplest ways to play a

role in the suicide prevention community is to be a positive support system to others, to show

willingness to talk and listen, and to continue to be accepting of all people.

All in all, knowledge about the symptoms of suicidal behavior can be used to help people

who are struggling with their mental health. By recognizing symptoms, such as mental illness,

hopelessness, impulsive tendencies, or previous suicide attempt, people can better help suicidal

individuals recover and find the hope and reasons to live. To help someone who is in a suicidal

position, people should remain present by asking questions, checking in regularly, and seeking

treatment. There are many resources and mental health professionals that are always available to

provide guidance and support in times of need. Society must also make changes by enacting new

policies, eliminating stigmas, and encouraging people to become active with the suicide

prevention cause. Suicide can be prevented now and in the future, but only once the proper

education is provided and the necessary personal and societal changes are made.

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Works Cited

Chavez, Scott. Personal Interview. 4 March 2020.

“Depression.” ​NAMI,​ NAMI, 2020,

www.nami.org/learn-more/mental-health-conditions/depression.

“How to Help Someone Who Is Having Thoughts of Suicide.” ​Suicide Awareness Voices of

Education​, SAVE, 2020, save.org/find-help/im-concerned-about-someone-else/.

Mann, J. John. “Reliably Predicting Who Is at Risk of Suicide.” ​Brain & Behavior Research

Foundation,​ Brain & Behavior Research Foundation, 5 Feb. 2018,

www.bbrfoundation.org/content/reliably-predicting-who-risk-suicide.

Marcus, Eric. ​Why Suicide?: Questions and Answers About Suicide, Suicide Prevention, and

Coping with the Suicide of Someone You Know​. HarperOne, 2010.

“Questions and Answers on Suicide.” ​World Health Organization,​ World Health Organization,

28 Aug. 2017, www.who.int/features/qa/24/en/.

Schwartz-Lifshitz, Maya, et al. “Can We Really Prevent Suicide?” ​Current Psychiatry Reports,​

U.S. National Library of Medicine, Dec. 2012,

www.ncbi.nlm.nih.gov/pmc/articles/PMC3492539/.

“Suicide and Suicidal Thoughts.” ​Mayo Clinic,​ Mayo Foundation for Medical Education and

Research, 18 Oct. 2018,

www.mayoclinic.org/diseases-conditions/suicide/symptoms-causes/syc-20378048.

“Suicide Risk and Protective Factors.” ​Centers for Disease Control and Prevention​, Centers for

Disease Control and Prevention, 3 Sept. 2019,

www.cdc.gov/violenceprevention/suicide/riskprotectivefactors.html.

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“Suicide Statistics.” ​American Foundation for Suicide Prevention,​ American Foundation for

Suicide Prevention, 16 Apr. 2019, afsp.org/about-suicide/suicide-statistics/.

NOTE: Only completed 1 interview. My second interviewee still hasn’t gotten

back to me, as she is a DVC professor.

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