Hope, resilience, and recovery — though the words that make up the theme of 2020's Suicide Prevention Week are potent enough to themselves briefly invoke comforting feelings, there's no denying that this year has, for many people, been sorely lacking those things.
Just in recent years, as awareness of mental health and mental health struggles has grown and having open discussions has become less taboo, the World Health Organization recognized social disconnection as a global public health threat. The United States' Health Resources & Services Administration declared a "loneliness epidemic" and acknowledged that social isolation can have as negative an impact on someone's health as smoking 15 cigarettes a day.
Then along came 2020, with a pandemic of a whole different kind, turning our worlds upside down — and placing many people, both those who previously struggled with depression and other mental health conditions and those who were perfectly content before, in great literal and emotional isolation.
How does the COVID-19 pandemic increase the risk of suicide? Who is most vulnerable?
Suicide doesn't usually have just one cause. Rather, the intersection of layers upon layers of different factors converge to create a situation in which someone doesn't see any other way out. Yes, mental health conditions contribute to a person's risk of taking their own life — besides depression, other known suicide risk factors include bipolar disorder, anxiety disorders, addiction, post-traumatic stress disorder, and schizophrenia. Other source of great stress, like chronic pain, unemployment, (domestic) violence, divorce, increase the risk, too.
COVID-19 has, for many, exacerbated stresses they already lived with before, and added new ones — to the point that several scientific papers investigating how the pandemic may lead to increased suicide rates have already been published. One paper, noting that loneliness and social isolation already posed a great risk of suicide before, warned that the pandemic has only magnified this. During a time when health systems are stretched to the limit, it is important to take proactive steps to save people's lives by recognizing the risk.
One study published in The Lancet titled Suicide risk and prevention during the COVID-19 pandemic created a comprehensive overview of ways in which the pandemic may place people at risk of taking their own life, as well as suggestions as to how our institutions can help mitigate them:
- Financial stress resulting from reduced income or job loss, which needs government-instituted safety nets as a response.
- Domestic violence victims have fewer means of escape than before the pandemic. They require support and need ways to safely leave.
- Alcohol and other substance abuse rates have risen during the pandemic, including as people seek to self-medicate stress and mental disorders due to COVID-related care shortages. Addiction care is just as important now, and perhaps even more so.
- Social isolation and loneliness, in some cases when people need support most because they are grieving the loss of a loved one, increase the risk of suicide. Communities can help by offering (online, or otherwise pandemic-safe) support, especially to people who live alone. Mental health support services need to be increased so those who are struggling have access to care.
- People living with mental disorders and those who are currently experiencing suicidal crises need active and very accessible help. New ways to deliver this help need to be established.
How can you recognize the warning signs of suicide in someone else, and what should you do?
You don't need to be a mental health professional to be able to help a loved one, or even someone you barely know. The warning signs that someone is feeling suicidal and is at risk of taking their life include talking about wanting to end it all, or planning to, but they can also be more subtle. Someone who talks about being in emotional pain, feeling hopeless or down, or not having a reason to live anymore, may be at risk, too.
People who are contemplating suicide may put their affairs in order, and sometimes give away their most valued things. They may have changed sleep patterns, sleeping more than usual or not sleeping much. They may be drinking a lot. Someone in crisis may withdraw from everyone in their lives, or on the other hand get in touch to say good bye.
Someone who is at risk of suicide may seem overtly depressed, anxious, or withdrawn. They could also, however, be aggressive, or even seem to be feeling better and more optimistic as they are overcome by a sense of resolution now that they have made the decision to commit suicide.
If you are worried that someone you know may be considering suicide:
- The National Institutes of Health recommend asking the person if they are contemplating suicide, adding that research shows that this question does not further increase their risk. You may also ask if they have a concrete plan.
- Keep the person safe(r) by trying to remove their access to means of suicide.
- Listen to the person. Really listen. Don't just try to talk them out of suicide, but listen to their feelings, concerns, plans, and thoughts. There is some evidence that the act of listening and connecting with the person, at the point they're at, can in fact reduce their risk of suicide.
- Put the person in touch with resources that might save their life. This can include anyone from a trusted spiritual teacher to their family doctor, but the National Suicide Prevention Lifeline (1-800-273-TALK (8255)) and the Crisis Text Line (741741) are also very much there to help.
- Follow up. Seriously. Keep talking to the person, to whom knowing you care may make all the difference. Research suggests that staying connected with someone after they have had an acute suicidal crisis can reduce their risk of going through with suicide.
What should you do if you are thinking about suicide?
If you are in crisis right now, you are living with unbearable pain and you see no other way out. You may think that things will never get better, feel that nobody cares, and that there is no reason to keep going. Reach out to anyone who can help, and do not spend more time alone with those feelings. The National Suicide Prevention Lifeline (1-800-273-TALK (8255)) and the Crisis Text Line (741741) are open every hour of every day, and so is the Veterans Crisis Line (800-273-8255 — press 1). They are free of charge, confidential, and the best places to turn if you need help immediately. If you need to, you can also absolutely go to the ER and say that you are suicidal.
You are not alone, and those who have been where you are know that it can get better, even if you don't feel it right now. Hope, resilience, and recovery are possible. Don't give up. You matter, and today's reality does not have to be tomorrow's.
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