Suicide.. .. ..

Suicide: Acknowledging and Addressing the Issue

News hit that yet another beautiful soul has passed. We've crept to the number of over one hundred deaths in our community within the past year. The reality is disheartening and it hurts that we cannot bring those we lost back to life. We can, however,  listen to the echoes of those who are no longer with us to empower ourselves with knowledge and tools to help those suffering today.

According to the American Foundation for Suicide Prevention, suicide is the 10th leading cause of death in the US. Each year 44,193 Americans Die by suicide. These numbers apply to every community, ours included. Provided below is an outline to understanding your role in lowering the number of suicide in our immediate community.

One of the biggest roles in prevention is knowledge, knowledge, knowledge.

The same way we have our little boys strengthen their brains so that they'll be successful men, and girls are told to behave in just the right manner, balancing the finesse of being refined yet building their sharpness and wisdom, our children need education about mental health. 

What anxiety it.

What sadness feels like.

What depression is.

What is normal and what is ok.

Their feelings are ok.

We've come a far way in reducing the stigma of mental health, and I'd encourage continued education and awareness about mental health. Our children need to know they can speak up. If they can be heard that is a game changer. If you're a  mom, a dad, an uncle, a neighbor, a rebbe, a teacher, a community leader. Let your children (big or small) know that you are interested. Lean in if you sense sadness. Let them know they are normal. They are ok. There are resources. There are people whose job is to help them figure out the things that are too complicated to figure out alone.

Causes of suicide

According to the National Institute of Mental Health, there are various psychological, environmental and social factors. Based on their 2016 research, risk factors for suicide include depression and other mental disorders, and substance-abuse disorder. More than 90% of individuals who die from suicide have these factors. Frequently, the risk for suicide occurs in combination with external circumstances that seem to overwhelm the individual, leaving them unable to cope with current challenges due to predisposing vulnerabilities.

Here are some stressors that cause an increase in suicidal risks.

• Interpersonal losses
• Physical and/or sexual abuse
• Anxiety Disorder and/or Personality Disorders
• Remorse Rejection
• Relationship Breakup
• -Family Discord or Family Violence
• Life stage transition (Graduating High School, Seminary/Yeshiva/College, Quarter Life/MidLife Crisis, losing job, divorce)
• Latest research proves that the two strongest factors in suicide are isolation and feeling like a burden onto other; sensing that other people would be happier without them around.

Since depression is a biological illness ,when prevention does not suffice, as adults we need to notice warning signs.

Warning Signs:

1. Recent Loss: through death, divorce, separation, broken relationship, self-confidence, self-esteem, loss of interest in friends, hobbies or activities previously enjoyed.
2. Fear of losing control: harming self or others, may be acting erratically.
3. Talk About Dying: mentioning self harm, disappearing, jumping, dying or other self harm.
4. Change in Personality: withdrawn, anxious, irritable, indecisive, apathetic, sad.  
5. Change in Behavior: inability to concentrate at work, school or daily tasks.
6. Change in Sleep and/or Eating Patterns: insomnia, waking early or oversleeping, often with nightmares, reducing or significantly increasing food intake. 
7. Increased Isolation: change in social behavior, disconnecting from social network.
8. Low Self Esteem: feelings of shame, overwhelming guilt, self-hatred, worthlessness
9. No hope for future: feeling and believing that nothing will ever change or get better.
10. Access to means to go through with suicidal plan.

If you notice any of this, reach out. Call. Make some time. Take note and take an action that fits the situation. Call a parent, a friend, a mentor. Be the mentor or provide a number to a mental health professional or clinic.

Suicide hotline: 1800-273-8255

24 hour hotline: 212-673-3000

Intervention:

Here I'm going to let you know that people do get better.

Mental health issues and subsequent suicidal intention ARE treatable. With proper support and help and good intervention people do get better.

Here are some tips on how each person can intervene.

Parents-if your child is struggling:

1.  Listen to your child.
2. Affirm and support their need for help. Be genuine in your care for them and what is going on. Don’t be afraid to say “I don’t know”. You will be figuring this out together.
3. Get your own treatment. The stronger you get, the better you model health and mental resilience. You will get tips in better navigating the unique challenge you are faced, as it's tough to witness and experience a child going through so much turmoil.
4. Family therapy.  All family members are affected by changes and they all deserve a space to talk so they don't keep their experience inside.
5. Be cognizant not to blame the child. They are doing their best.

If your partner is struggling:

1. Get your own treatment. Reach out for support. Individual therapy as well as support groups. Hear from others how they've gotten through this. Get educated about the process to feel empowered and equipped. As well, support goes a long way when the road feels scary and unknown.
2. Support your partner. Strong relationships are a strong motivator for change (it is important to note that each case is different and if your partner is unable/unwilling to get better that isn’t on you.)
3. Know what is in your control and what is not. Your partner will make choices and you do too. Know your limits so your preserve your energies for what is necessary. Check out Alanon groups for support nycalanon.org.

Friends:

1.  Be as supportive to friends as possible. You mean a lot to them!
2. Encourage honesty - allow them to feel safe enough sharing what is going on inside especially when there's chaos at their family  and no space to share.
3. Encourage reaching out for help to their mentor/therapist/psychiatrist/safe adult.
4. If your friend mentions suicide plan even as a joke, call the therapist or psychiatrists or a local hotline. Some clients share friends' numbers with their therapists as part of their safety plan support network. Some clients have given friends permission to leave voicemail on psychiatrists' or therapists' voicemail voicing concerns that are life threatening so action can be taken. If this is the case, call when you sense you need to .

If your parent is struggling

1. Acknowledge how scary it is to see "adults" struggle.
2. It's NOT your fault. Even if you've required a lot of attention, there are many factors at play; psychological, biological, neurological and your behaviors are not .
3. Get your own treatment on learning how to build your own life within this chaos.

If you're the one suffering:

1. Know there is good help out there.  You may have tried reaching out or you may even have been to treatment but it wasn't the right fit. There are so many different kind of therapists and options, it's worth your while to invest time to find the right fit for you.
2. Your path is the toughest. It's the hardest to be the one stuck in an inner storm that won't quiet down. You deserve so much credit for pushing through even just one more day.
3. Life doesn't need to feel this hard, forever. You may not be ok today, but someday you will be. That's how it works. You spiral for a while (or what feels like forever) and as you get the right help and support life begins settling down, one tiny moment at a time. It takes time, absolutely, and it gets a bit better.
4. Reach out. Look around for people who feel approachable. Identify who you can invite as supports for you.
5. The Twelve Step Mantra is "One Step at A Time." Literally, take one step at a time. There is much wisdom to those words.

There is no easy "cure" to "fix" an individual struggling with mental illness.

Utilizing interventions including individual therapy, family therapy, and attending group therapies provide newfound skills, offer new ways of coping and provide the support and space for healing to take place.

RESEARCH PROVES THAT GOOD INTERVENTIONS DECREASE ISOLATION, INCREASE MOTIVATION FOR CHANGE AND PROVIDE HOPE.  

There are plenty of resources available, here are some recommendations of reputable treatment centers.

Inpatient Programs:

Silver Hill: silverhillhospital.org 866-542-4455

Four Winds: fourwindshospital.com 1800-888-5448

The Meadows: themeadows.com 866-330-1524

Timberline Knolls : timberlineknolls.com (Women's residential program)

McLean Hospital: mcleanhospital.org

Sierra Tucson: sierratucson.com 877-616-9802

Outpatient Referral Sources:

Relief Referral Agency: Reliefhelp.org 718-431-9501

Ohel Community Clinic: Ohelfamily.org

Jewish Board Mental Health Services: JewishBoard.org

Psychology Today: psychologytoday.com

Alanon Groups for Family Members nycalanon.org

EACH PERSON CAN MAKE A DIFFERENCE IN CHANGING SOCIETY.

Let's make it our duty to get educated and know of resources available.

The next blog, Treatment Interventions, will explore the available therapeutic modalities in detail.