Suicide: the legacy for those left behind

The topic of suicide is incredibly sensitive, and distressing to discuss, but it’s only by breaking the stigma that we can bring the subject into the light, and ensure those in need get help as soon as possible

Suicide isn’t an easy topic to talk about, but many of us have been impacted by losing a loved one or friend, or know someone who has. That’s why it’s so important that we talk about it together. Here’s what I have learned though my work as a psychotherapist, clinical supervisor, critical incident debriefer, and survivor of multiple deaths by suicide in my family, and of my beloved best friend. Please take care of yourself as you read this, as you may get triggered.

Suicide isn’t a new idea; the intentional ending of one’s own life has been practised throughout human history. It is a deeply evocative and provocative subject, and one unique to humans, so it’s not surprising that researchers clearly want to know the why, in order to answer questions about human cognition, and to understand free will and choice. Those left behind, also wondering why, want to make some sense of their bewilderment and devastation.

The World Health Organisation estimates that there are more than 700,000 completed suicides each year around the world. In the UK, the Office for National Statistics reported a total of 5,224 deaths by suicide in England and Wales in 2020 (75.1% males). For every completed suicide, many more are attempted, and this is the single most important risk factor in future attempts.

Suicide is often the end point of a journey; an accumulation of experiences, related thoughts and feelings that result in a fatal choice. Ultimately, the fact is, each individual is precious and unique, with their own experience of the world and, try as we might, we may never pin-point why they took that path, even if we had the capacity to retrace every moment of their lives.

I want to offer some definitions of suicide so that we can have a framework to use.

Suicidal ideation is generally defined as thoughts about engaging in suicidal behaviour – wanting to cause intentional, intended, and fatal self-harm. Feelings vary from mild to severe (mild thoughts that come and go and which are very common, to severe, i.e. having a clear plan). This can change from one extreme to the other within hours, or between one day and the next.

Para suicide refers to engaging in highly risky and dangerous behaviours with absolute disregard for one’s own safety, or that of others. Examples include dangerous driving at excessive speeds, excessive drinking, drug overdoses, and picking fights despite the dangers involved.

Suicide is the deliberate intent of employing one or more means to end one’s own life. Individuals with a history of previous failed attempts have been shown to have a significantly higher likelihood to end their lives through suicide.

Impulsive suicide is often driven by extreme feelings in relation to major adverse events, such as a sudden (unexpected or traumatic) death of a loved one, loss of a relationship, home, status, or job. In some cases, this can be an act of absolute rage associated with wielding power, control, and to manipulate someone’s behaviour. For example, ‘If you leave me, I will kill myself.’

Non-impulsive suicides refer to those that have been meticulously planned by individuals, whose aim is to end their lives, who have no regrets about dying,and absolutely intend to kill themselves regardless of any intervention offered.

Everyone has, or will experience mental health issues in the course of their lives; we are living in a world that has changed drastically in the last few years, forcing us to adapt faster than at any point in human history. Deteriorating mental health is linked to an increased risk of suicide. When we are happy and thriving, we do not have any intention to harm ourselves – why would we? However, something may happen that affects this.

Another risk factor focuses on children and young people with parents who abuse drugs and/or alcohol. This is further exacerbated if the person is bullied, abused or victimised at school, and feels they have no source of support.

The risk of suicide is further amplified in young people identifying as part of the LGBTQ+ community who may be victimised or rejected by their family and friends.

This spiral of chronic sadness, lasting for more than a month, can get very distressing and cause feelings of helplessness and hopelessness at not being able to have control over, or see a way out of the situation.

So what can you do to help yourselves, and when should you seek professional help?

1. Speak with your GP or call Samaritans’ 24/7 helpline on 116 123 immediately upon realising something is wrong, especially if you find yourself experiencing dark or unwanted thoughts.

2. Identify and list what is going on for you, if something is off, or you are withdrawing from work, family, or friends.

3. Consider: how is this different to your normal? Try to write out what you would expect in a normal day for you.

4. Think about what has happened in your life to make you feel this way. This could be a recent experience, or something from the past triggered by something else at home, work, socially, or in the media.

5. What support have you got around you, and how easily can you access it? For example family, friends, your GP, therapy, or a spiritual community that you trust to support you?

With these steps in mind, it’s crucial to set the record straight on some myths and misconceptions which might prevent someone from reaching out:

“Seeking help is weak.”

No, seeking help is a very powerful thing to do to take control of the situation.

“I may be struggling emotionally, but I am doing something about it.”

It’s vital to not downplay the situation or try to handle it on your own. There is support out there.

“I don’t want to burden anyone.”

If your friend was struggling, what would you want them to do? Talk to you, let you help them, or find someone who can? So, let them be there for you, too.

“I’m so useless, I can’t even cope with this!”

Not being able to cope with something doesn’t make us useless. It makes us human, and at the last count, there were nearly 8 billion of us muddling our way through life, together.

We all have limits, and sometimes we have to cope with so many things that it feels as if it is too much to bear.

But know that sharing how you’re feeling or that you’re struggling is not a burden to loved ones – losing you would be far more distressing. I know how shattered my heart feels. The pain doesn’t go away. So, please, when you need it, let the help in.

Support lines

• Call Samaritans on 116 123 or email them on jo@samaritans.org
• The Campaign Against Living Miserably (CALM) is a line for men, and is open from 5pm–midnight: 0800 58 58 58
• Papyrus supports young people under 35 years old. Call them on 0800 068 41 41
• Shout offers a crisis text line. Text ‘SHOUT’ to 85258

If you are struggling and would like to talk to a counsellor, connect with a professional using the search box below, or visit Counselling Directory.