Suicide

How serious are thoughts of suicide?

Suicide is a tragic and potentially preventable problem. Suicide deaths out­ number homicide deaths by almost five to three, and there are many more attempted suicides that don’t result in death. The majority of suicide attempts are expressions of extreme distress and not just harmless bids for attention.

Is it normal to feel depressed during recovery?

It’s normal to feel a great sense of loss during recovery. Your addiction may have caused the loss of friends, family, or other important relationships. Some people even lose contact with their children during their active addiction. It’s normal to mourn these losses now that you’re in recovery.

But if you feel consistently unhappy, unusually sad, or depressed for more than two weeks, you might be clinically depressed, which could threaten your life and your recovery. If you suspect that you are clinically depressed, consult your physician or a mental health counselor for an evaluation. Depression is a very treatable illness with proper medical attention.

Personal Recovery Story

“I’m a proud single mother of two great kids. I’ve been working a solid recovery program for more than five years. Staying clean and sober has allowed me to turn my life around. During the last few years I’ve gone to meetings regularly and helped others succeed in their ongoing recovery. But about a year ago I started feeling unhappy and withdrawn from others. I wouldn’t say I was depressed; that would just seem like an excuse. I just knew that I was being very irritable with my family and friends. Over the next few months I began to feel more sadness. I even started to feel that no matter how hard I worked the program, recovery wasn’t working. I started feeling that if I can’t stay sober, I didn’t want to go on living.
“After seeing a therapist recommended by a recovering friend, I identified that I was really coming into a period of personal growth in my life. It was hard. I was facing new truths, making hard decisions, and accepting the responsibility that I could change my life and my family’s life for the better. I put my trust in my Higher Power to help me work the Steps. I relied on the support of my sober friends, my sponsor and my recovery support group. It wasn’t easy, but I eventually made it through that period of sadness. It made it easier to know that if things got really bad, there are doctors and mental health professionals I could call for help.”

—Diane, in recovery for five years.

Thinking about suicide is scary, but it doesn’t mean you’re crazy, hopeless, ungrateful, or worthless. It might mean that you are entering a period of per­sonal growth in your life. You may have come to a crossroads where you have the opportunity to face new truths, make new decisions, and change your life for the better. However, if suicidal thoughts continue to occur, they become more persistent, or you begin to make plans for a suicide, take these signs seriously and get help immediately. Make an appointment to see your physician or mental health counselor, or call 911 for help if you are in immediate danger.

The most important thing to do when you’re in a crisis is to talk with some­ one. If you feel sad, unhappy, or depressed, don’t isolate. Instead seek out re­ sources such as your family, sponsor, sober friends, or self­help meetings. Talking with others who have gone through similar experiences will help.

You may be working a great recovery program, but if you have clinical depression (consistent depressive symptoms that last for two weeks or longer), it won’t go away just because you work the Twelve Steps harder, read more meditations, or attend more meetings. In addition to working your recovery, get professional help to recover from depression.

If you feel that you are depressed, get help; make an appointment to see a phy­ sician or mental health counselor. These professionals will talk with you about your specific circumstances and help you create a recovery plan. Depression is an illness that is treatable. There is no reason to suffer. In fact, ignoring depression could seriously threaten your recovery and your life.

Remember Step One, admitting that you are powerless over the disease of addiction, applies to depression as well. No amount of willpower—simply deciding not to feel depressed—will make clinical depression go away. Your brain chemistry may be as powerless against clinical depression as it is against addiction. Diminished levels of the brain chemical serotonin have been found in patients with depression, impulsive disorders, a history of suicide attempts, and also in postmortem brains of suicide victims. The bottom line is that if you have clinical depression, you need to get help. This is not a time for isolation, secrecy, or shame. Just as you learned in Step Two, you need the help of others; you don’t have all the answers.

If you or anyone you know is thinking about committing suicide, seek immediate attention, preferably from a mental health professional or a physician. Anyone who talks about suicide should be taken seriously.

For immediate help, call the Suicide Awareness Voices of Education (SAVE) hotline at 800-273-TALK.

Recovery Action Steps

1. Make a list of people you can talk to if you feel suicidal. Add those contacts (names and phone numbers) to your list of recovery resources, which should include your sponsor, your recovery coach, and supportive family members. Don’t forget to include the Suicide Awareness Voices of Education hotline, 800-273-TALK. Keep this contact list in your wallet in case you need to talk with someone immediately.
2. List any thoughts, feelings, or behaviors you experience that could lead you to feel suicidal. Discuss those thoughts with your sponsor or mental health counselor.

Is there a link between alcohol and other drug use and suicide?

The link between alcohol and other drug use to suicide and suicidal thoughts is strong. A research study found that 37 percent of eighth grade girls who drank heavily reported attempting suicide, compared with only 11 percent who did not drink.

Alcohol or chemical use can lead to depression, hopelessness, mood swings, and feelings of shame and guilt, which can result in suicidal thoughts. If you are thinking about suicide, alcohol or other drug use could give you a false sense of courage that might lead to a suicide attempt. Using substances will impair your good judgment and could leave you vulnerable to suicidal thoughts that you might never have if you were sober.

Is there a link between co-occurring mental health disorders and suicide?

Suicidal behavior is often connected with substance use disorders and a co­ occurring mental disorder, such as depression. Research has shown that more than 90 percent of people who kill themselves have depression or another diagnosable mental or substance use disorder, often in combination with other mental disorders.

If you have a coexisting mental health condition such as bipolar disorder, depression, or even stress, you are at a higher risk of suicide, especially if you return to any level of use.

What are the other suicide risk factors?

Besides substance use disorders and mental illness, other risk factors include previous suicide attempts, a family history of suicide, exposure to suicidal be­ havior in others, access to lethal methods such as guns or poisons, incarceration, and physical or sexual abuse or another stressful life event or loss.

Adverse life events in combination with other risk factors such as depression may lead to suicide. But suicide and suicidal behavior are not normal responses to stress. Many people have one or more risk factors and are not suicidal. Attempts at suicide can occur in clusters, sometimes following the suicide of a friend or a celebrity that received widespread media coverage.

Is age a suicide factor?

Older adults

Older adults are disproportionately more likely to die from suicide, because many of these older adults suffer from a depressive illness. Depression is not a normal part of aging. In contrast to the normal emotional experiences of sadness, grief, loss, or passing mood states, symptoms of depression tend to be persistent and to interfere significantly with a person’s ability to function. If you are an older adult who is experiencing these symptoms, seek help. Make an appointment to see your physician or mental health counselor, or call 911 for help if you are in immediate danger.

Children, teens, and young adults

In the year 2000, suicide was the third leading cause of death among children ages ten to fourteen, and in adolescents fifteen to twenty­four years old, follow­ ing unintentional injuries and homicide. These are shocking statistics, but most youth who commit suicide suffer from a mental or substance use disorder or both. It is important to look for signs of substance use or depression and get professional help for your child if he or she needs it.

Watch for These “Suicide Signals” in children and Teens

Your children may be at risk if they

• complain of being a bad person or feeling “rotten inside”
• give verbal hints, such as “I won’t be a problem for you much longer,” “Nothing matters,” “It’s no use,” and “I won’t see you again”
• put their affairs in order; for example, they give away favorite toys, clean their room, or throw away important belongings
• become suddenly cheerful after a period of depression
• show signs of psychosis (hallucinations or bizarre thoughts)
• show little interest in the future
• act in rash, hostile ways, often expressing rage

What are the signs and symptoms of suicide?

• talking about feeling suicidal or wanting to die
• feeling hopeless, that nothing will ever change or get better
• feeling helpless, that nothing one does makes any difference
• feeling like a burden to family and friends
• putting affairs in order (for example, organizing finances or giving away possessions to prepare for one’s death)
• writing a suicide note
• putting oneself in harm’s way, or in situations where there is a danger of being killed

What should you do if someone tells you that he or she is thinking about suicide?

If someone tells you he or she is thinking about suicide, you should take this person seriously, listen without judgment, and help him or her get to a mental health professional or physician for evaluation and treatment. Don’t ever try to minimize or trivialize a suicidal person’s problems or try to shame the individual into changing his or her mind. Your opinion of a person’s situation is irrelevant. Trying to convince someone that the situation is not that bad, or that he or she has everything in the world to live for, will only increase feelings of guilt and shame. Instead, use this time to reassure him or her that help is available, depression is very treatable, and suicidal feelings are temporary. People con­sider suicide when they are hopeless and unable to see alternative solutions to problems.

If someone is in imminent danger of harming himself or herself, do not leave the person alone. When a family member may be at risk for suicide, make sure that firearms or other lethal means of committing suicide are removed from the home. You may need to take emergency steps to get help, such as calling 911. Make sure you follow through and that the person finds a doctor or mental health professional. Don’t assume that your persistence is intrusive. You may feel that you are interfering or being too pushy, but it’s worth it if it results in a life saved.

Web Resources

There are many resources out there. The websites for the following organizations were chosen for their usefulness and user friendliness.

National Institute of Mental Health (NIMH): NIMH is a U.S. government organization, an agency of the Department of Health and Human Services, dedicated to research and education in the field of mental health. Its website is a great resource of information for specific mental health disorders, eating disorders and suicide prevention.

American Foundation for Suicide Prevention (AFSP): AFSP is a national not­-for­-profit organization exclusively dedicated to funding research, developing prevention initiatives, and offering educational programs and conferences for survivors, mental health professionals, physicians, and the public. This organization’s website offers research on prevention and resources for survivors.

Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA is part of the U.S. Department of Health and Human Services. Its mis­sion is to reduce the impact of substance abuse and mental illness on America’s communities. Its website offers information and resources about preventing and treating addiction and mental illness as well as suicide prevention.

American Association of Suicidology (AAS): The goal of AAS is to understand and prevent suicide. Founded in 1968, AAS promotes research, public awareness programs, public education, and training for professionals and volunteers. AAS serves as a national clearinghouse for information on suicide.

Suicide Awareness Voices of Education (SAVE): SAVE’s mission is to prevent suicide through public awareness and education, eliminate stigma, and serve as a resource to those touched by suicide. The SAVE site includes tips on prevention, coping with loss, news and events, statistics, and a suicide hotline: 800­273­TALK.