September is Suicide Prevention Awareness Month, and World Suicide Prevention Day is September 10th. Suicide is a silent epidemic that is the 2nd leading cause of death in the US for people aged 10-34. 18.8% of high school students reported seriously considering suicide and 78% of all victims are male despite common stereotypes that more women die by suicide.
Despite how common suicide has become, it is still a highly stigmatized topic filled with myths that make it challenging to spot and support. The first step to reversing the stigma is to increase our own knowledge on the topic and normalize conversations about suicide.
What is the difference between suicidal ideation vs intent?
Passive ideation refers to someone wishing he/she were dead or could die, having fleeting thoughts or images, without concrete plans to carry it out. A teen may express suicidal threats like "I hate my life, I'm going to kill myself!!!" or "There's no meaning to life anymore, everything sucks!", but if asked further, does not have a plan of what to do about that thought.
Active intent is not only thinking about dying, but also researching and intentionally planning on how to commit suicide. This might include a time and place, a method and tools needed, giving away prized possessions, spending last moments with loved ones. Here's a severity rating scale published by the New York State Psychiatry Institute that measures the intensity of suicidal thought and intent.
What happens neurologically when someone decides to die by suicide?
Suicide is not a spontaneous decision with sudden onset. It is usually a culmination of stressors that lead someone to believe that suicide is the only way to escape the pain they feel inside. When someone decides to end their life, a concept called cognitive constriction occurs in the brain. “The actual physiological functioning of certain parts of the brain changes in this acute suicidal moment,” said Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention. She explains that there’s a narrowing of coping options that stem from changes in the brain’s ability to come up with three or four ideas to problem-solve, like it usually would, making it extremely difficult to access your other ways of thinking. This cognitive impairment acts like tunnel vision and keeps someone from seeing beyond their circumstances and therefore believe their pain will never end. Other neuroscience research points to a variety of abnormal brain activities and chemical imbalances that may make a person more susceptible to thoughts of suicide. So, ultimately, suicidal thoughts are not necessarily just thoughts that a person can "push out of their minds" as common myth would have it.
What are some warning signs to look out for?
Unfortunately, often times warning signs of depression or risk of suicide get written off as "typical teenage angst behavior" and parents may miss or dismiss these hidden calls for help. Some common behaviors that you should look out for include:
Lack of interest in activities that they used to enjoy
Loss of appetite or significant gain in appetite
Increased use of drugs and alcohol or other self destructive activities
Talking or writing about death or wanting to die
Making statements about feeling helpless, hopeless, or worthless
Sudden changes in behavior such as drop in grades or increased anger towards others
Withdrawal from friends and family
Saying goodbye to friends, family, or other loved ones
Saying ominous phrases such as "I won't be a problem for you much longer"
Giving away prized possessions
If you haven't noticed these exact behaviors but are still concerned about whether your teen is "just being a teen" or if their behavior is something you should worry about, check out our article about teen mental health red flags.
How do I respond to suicidal intent or ideation?
There is no easy way to bring suicide into conversation, but the severe consequences call for an urgent response and any form of prevention is crucial. If you're wondering about how to respond to comments of self-harm or suicidal threats, how to prevent this from happening to your child, what to do if you know someone else's teen is suicidal and what things you should avoid doing, please read on here.
If someone is in immediate danger, please do the following:
If you or someone you know is in an emergency, call 911 immediately.
If you are in crisis or are experiencing difficult or suicidal thoughts, call the National Suicide Hotline at 1-800-273 TALK (8255)
If you’re uncomfortable talking on the phone, you can also text NAMI to 741-741 to be connected to a free, trained crisis counselor on the Crisis Text Line.
Call the National Suicide Prevention Lifeline at 1-800-273-8255 and follow their guidance.
Ways to Support the Cause
Safe2Tell: Safe2Tell focuses on anonymous reporting if you've noticed a young person struggling and believe intervention is needed. The goal of Safe2Tell is to receive information about the person and get that information to a team at the local level who can help and intervene right away.
The Jason Foundation Parent Resource Program: If you prefer to watch a video, a nonprofit organization, The Jason Foundation, provides a youth suicide prevention seminar that goes through strategies of awareness and prevention, including an exercise called Project Hug to build better communication with your teen.
Stories of recovery and hope from suicide survivors: There is a way out of the darkness and listening to these brave suicide survivors share their stories of hope may encourage you to believe that this cause is worth fighting for.
American Foundation for Suicide Prevention: Out of the Darkness Community Walks: Another active way of supporting suicide prevention is to participate in one of the Out of the Darkness Community Walks happening all around the country. Check to see when it's happening in your town or city.
Suicide Prevention Month - Ideas for Action: Here are some ways you can act on suicide prevention this month, whether it's within your community, social media network or in your home.