Jensen Suicide Prevention Peer Protocol

YOU DON’T HAVE TO BE DEPRESSED TO BE SUICIDAL

More and more forensic research is being done in the name of suicide prevention and I am absolutely nonplussed at the conclusions that are reached by talking to the suicide victim’s PCP, their family, friends and by researching whatever writings or videos the suicidal victim left.

First off, individuals in relationship to the person who died by suicide have a distinct and obvious reason for not delving into the situation. It has been found that many coroners are asked by family members to obscure the reason for death or just list it as accidental if no absolute evidence to the contrary is presented.

Some person told me years ago that depression was caused by being suicidal. I shook my head and laughed, treating the comment with scornful condescension. How could you be suicidal before you became depressed? Specializing in treating suicidality for decades as a licensed mental health therapist and a certified chemical dependency counselor, I now know that comment was closer to correct than I ever suspected. I have been doing research involving those who are suicidal and who have recounted the circumstances around their numerous suicidal attempts. From that direct data I formulated the “psychobiology of suicide”.

I discovered that the majority of my suicidal patients did not qualify for a DSM diagnosis. When I delved into the naissance of their suicidality, I discovered something else extremely significant – they all could identify a period in their childhood when they felt helpless to change their situation or to improve an untenable problematic atmosphere. At this point the child began thinking about “not being here” in order to cope with the untenable situation. Thinking about “not being here” brings on a rush of “well-being” and somehow they know they have hit on the answer – the one thing that makes everything bearable. It is this thought pattern of “not being here” that makes the situation liveable. That is about all a child can do. The brain will always look for ways to relieve pain, whether the pain is emotional or physical.

No one knows about that except the enlightened suicidal person. Certainly no onlooker would ever pick up on it. No way. Most people think that suicide starts in adolescence or adulthood because that is when others find out about attempts. There are usually an average of six attempts for every suicide. So you think you are hearing about the one time. But guess what?!  It has happened many, many times before that. I assure you. I must have tried at least that many times before I ever even told anyone I was suicidal. But when I think about it I used a lot of metaphors for suicide before I actually used that exact term. I noticed that was true for most of my patients also. I’d use the words, “not long for this world, leaving this place for good, buying the farm”. Now that I think of it there were quite a few and said in a flippant, kind of haggard way, no one would really stop and think I might mean just that.

When a kid decides that not being here is the only answer to overwhelming problems, he or she is reinforced by the endorphins that accompany finding an answer that works – if only temporarily. Still over time that relief is sufficient only if the thought generating it is sufficient to resolve the level of problems presented. Sooner or later just thinking is not good enough and planning must take over. That’s when the pain and agony really begins. The emotional toll that takes on one’s mind is unbelievable. The constant onslaught of emotional pain results in thoughts of suicide to relieve it. That’s why I believe the person who told me that suicide causes depression was right. Suicidal thought can cause depression, not the other way around.

And as far as discoveries concerning any aspect of suicide, the investigators are asking the wrong people. It still amazes me that anyone who reports suicidal thoughts is dismissed from most studies on suicide or most any study really. That leaves only second hand information about the experience of suicidality and that information is often based on biased and stigmatized report. To understand suicidal thought investigators need to ask the right questions but they also must ask the right people. There needs to be more listening to those of us who have been suicidal and note taken on the methods we have employed successfully to deal with it.