I have been seeing more social media posts and questions regarding the suicides of Kate Spade and Anthony Bourdain than ever on the subject of suicide, and it stirs up a lot of deep emotional stuff for me. Most of what I read is well-intentioned and perfectly valid but still, possess an ignorant and even harmful bias and privilege that I cannot ignore. As much as I loathe listicles, I am posting a few points to consider about mental illness, addiction and suicide (ok, really a long list), from someone (me) with lived experience with mental illness, suicide attempts, recovery, and family with addiction and mental illness:

1. Mental illness and addiction are not a choice or a moral failure. They are the result of a combination of biological and social origin and usually triggered by trauma or other environmental and social factors.

2. Most people who suffer from mental illness and addiction were not taught healthy coping skills  which are normally taught to us by our parents, our schools, and our peers.  Many have experienced childhood trauma before any healthy coping skills they may have been taught had time to sink in.  The symptoms of mental illness and addiction are the coping skills that developed from this trauma. This is how mental illness and addiction are socially created and perpetuated. We need to look at ourselves and how we are perpetuating the problem and trying to solve the problem as a society instead of demonizing the individual. 

3. Many people who attempt suicide have reached out for help, and have been in therapy or recovery. Sometimes therapy dredges things up that were buried so deep that working through those issues is too painful to face;  no layperson has the training to work through those kinds of issues and professionals are limited by insurance regulations, heavy caseloads, and an inability to provide an emotionally safe and secure long-term environment in which a person can work through these things. For many people, such services are not available because of funding for services, lack of insurance, overcrowding of available services, trainees staffing said services, and the stigma of obtaining such services.  Many times friends and family don’t understand the cries for help, or do not have the skills to help.  Sometimes family is the cause of the trauma and is the least likely to be helpful.

4. If you really want to help someone in crisis, ask them what they need and listen to them (within ethical reason). Don’t tell them what is best for them. If they don’t know what is best for them, and you don’t have the training to deal with a crisis situation, actively help them find resources, and keep your ears open to listen to and acknowledge their pain without judgment. This is the most compassionate thing you can do for someone who is suffering.  A suicidal person usually just wants the pain to end.  Do not argue with them or tell them they are wrong or minimize their experience.  Focus on resources, letting the person know what they mean to you, their hopes and goals and dreams, letting them know they are not alone, and acknowledging their pain.  

5. If a person reaches out on social media and says they are struggling… acknowledge their cry for help. Even if they have cried for help 100+ times, they need to know who they can count on for support. Within healthy boundaries, you can let them know what you can and cannot do for them, then follow through to the extent that is safe and healthy for you. Don’t assume that a person is being manipulative or needy because they are in pain. Don’t tell them that their feelings are wrong. Just acknowledge their pain and what it is that you can or cannot do for them.  Be careful about circulating their cries for help or posting public notices… reach out to the people closest to the individual privately first, whenever possible.  Often there is a deep sense of shame and embarrassment after a suicide attempt, and well-intentioned social media posts or text-blasts can have the opposite effect and make the person feel that they cannot trust those who do care.  

6. Telling someone to reach out for help is a form of victim-blaming. Yes, we need to let people know what resources are available, but we also need to learn to be more compassionate toward and aware of the people whom we profess to care about.  Sometimes depression and anxiety make it so difficult to do simple daily tasks, and reaching out and being more vulnerable feels antithetical to the pain they are experiencing.   Sometimes depression and anxiety present in other ways such as constant happiness, being overly helpful to others, or excessive creativity or productivity.   When this is the case, do not demonize people for not being honest about their pain.  This may guarantee that they will no longer trust you.

7. It’s ok to be angry or confused by the death of someone who has committed suicide or had an accidental overdose. Anger and confusion are part of the grieving process. However, it is NEVER ok to tell a person who is suicidal that suicide is a selfish act. They are already feeling that they are the worst person in the world. Introducing ideas that make them feel worse about themselves is selfish on your part because you are thinking about yourself as the survivor of the act, making you a victim of another person’s suffering.  Compassion requires that we step outside of our own pain to acknowledge the pain of another.

8. If you haven’t experienced true long-term depression, addiction, anxiety, trauma, or complicated grief, don’t compare your experience to that of someone who has struggled with these. Acknowledge what you can’t understand and don’t project your experience of therapeutic activities (religion/prayer, medication, yoga, meditation, support groups, positive thinking, diet as medicine, etc) as the one and only answer to their problems. All of these are healthy parts of a whole person and of productive recovery, but none alone can cure mental illness or addiction. Recovery is a difficult life-long process, that sometimes ends with the person deciding that they have suffered enough in this life. It is ok to grieve a completed suicide, but remember that it is always better to support a person while they are still alive in being the best version of themselves they can be than to blame them for choosing to end their pain. Recovery is also highly individual… don’t tell a person that what they are doing is wrong just because it didn’t work for you.

9. While we’re on the subject of positive thinking, manifestation, and other spiritual ideas… a person who is in so much pain that they want to end their life is not able to process such advanced ideas. While these ideas are valid throughout all faiths, they have only been fully realized by the masters; and the master knows that a person must start where they are, that mastery is nothing more than the continual failure and re-commitment to a practice, and that a person cannot fast-forward from crisis to enlightenment. If you are telling a person that their emotional state is a result of not doing a particular practice correctly, you are participating in victim-blaming (and deep denial of your own spiritual and/or emotional state) and guilty of spiritual and emotional bypass.

10. If the person is not a middle-class heterosexual white person, do not call the police for a safety check.  Police welfare checks for BIPOC, Queer, and poor people often end in violence, arrest and sometimes death at the hands of police.  This is a result of systemic racism.  Engage with the person yourself and try to get them to a mental health professional, crisis stabilization unit, or an emergency room.  Ask for permission to bring in people they trust to work with you.  If you take them to the emergency room, stay with them until they are sent home, transferred to a higher level of care, or stabilized.  ER nurses are not very kind to suicidal people.

11.  Don’t reach out and tell a person you support them if you aren’t going to back it up with action.  We live in a society that reacts to trauma, but doesn’t prioritize the resources and time it takes to truly make human connections.  Most suicidal people and addicts suffer from a lack of connection in life.  

12. Don’t only focus on celebrities… 22 veterans and 141 civilians committed suicide per day in 2016 in the US.

11. Support social services, mental health, and addiction services, and vote for people who will fund these programs.

12. Practice some compassion in your everyday speech. Words like crazy, insane, borderline, and psycho are hurtful to people suffering from mental illness. These words are part of what perpetuates the negative self-images held by that person.

** P.S. This is by no means a thoroughly inclusive or wholly correct list… just pieces of one person’s lived experience and education.

Resources for Queer and BIPOC folx:  

Trans LifeLine:  877-565-8860  translifeline.org

The Trevor Project (LGBTQ+ Youth Crisis Resource): 1-866-488-7386  thetrevorproject.org

Black Lives Matter Resources by and for BIPOC: https://www.talkspace.com/blog/black-lives-matter-resources-people-of-color/

National Alliance on Mental Illness: nami.org