Here is September’s installment of “Ask Shelby” from Chester County’s own Licensed Marriage and Family Therapist, Shelby Riley.
Suicide Prevention Month is September 10 – October 4 this year. The following is a special column to address the issue of suicidal thinking and what can be done to help.
This weekend, a primary care physician in the Chester County community wrote a post on Facebook about assessing for suicide that got 245 likes and over 60 comments. This topic obviously affects many of us, but it is one of the least talked about topics in families, friendships, and even in your doctor or therapist’s office.
A lot of people have suicidal thoughts, or thoughts of death, or passive desires to not be here anymore because being here feels so hard right now. Maybe being here feels so hard because of life circumstances like the death of a loved one, loss of a job or relationship, or failure at a life goal. Maybe it feels so hard because the person is suffering from debilitating anxiety, depression, or some other mental health issue.
Many people won’t share thoughts of suicide and death with their friends, family, or even their health care providers for fear they will be locked away in a psychiatric hospital, have their kids taken away, or for fear they will lose their job. It isn’t a crime, or even often a safety issue, to have suicidal or death related thoughts. But it is something to care about and explore with people.
The first step is to be comfortable hearing suicidal thoughts from your loved one. Don’t freak out, brush it off, or make a joke. Take a few moments to validate, explore, and lovingly, not dismissively, normalize these kinds of thoughts. Assure them that it’s okay to talk about these things. Letting people know they won’t be hospitalized (unless they want that) for having these thoughts and feelings will help. It’s important to know that health care providers only hospitalize someone if either they want that level of care (which sometimes they do, and it can be really helpful), or if they are an imminent threat to themselves or someone else. Having suicidal thoughts isn’t an imminent threat. Having a plan and stating you are prepared to carry out that plan today is an imminent threat. There is a big difference.
I think the thing that scares people the most is the fact that thoughts can turn into an imminent plan very quickly. Stay open and stay in communication. And have qualified professionals to refer your loved one to. You should be one part of a large and loving team who will support your loved one through the process of feeling more hopeful and healthier.
A qualified mental health professional can help assess the level of risk and the person’s needs. Lots of people have thoughts of suicide and death. It’s important to know if they are true desires because of intense pain, or if they are symptoms of depression or anxiety that need to be managed. If the suicidal thought is a true desire, my job is to help the person hold on to some hope for the future, learn to cope with the current pain and make life changes so that they are no longer in such intense pain. If the thoughts aren’t true desires, but are symptoms, I often help people see that they don’t have to believe the thought, they have to acknowledge it, take care of it, soothe it, and remind themselves of the truth: life with anxiety and depression is hard, but it’s worth it. There are many things a person can do to help decrease and eventually eliminate suicidal thoughts that are symptoms, including medication changes (suicidal thoughts are a common side effect of some medications), increasing meaningful and supportive social connections, improved self-care, etc.
People need to know that it is fairly common when dealing with depression and anxiety to have thoughts of death. They need to know you care about them, that they are not a burden, and that their existence is a gift to those around them. And they need to know they are not alone in the fight. I cannot tell you how many times I have looked at a client and said, “I love you. Your life matters to me. I know you can’t see your future right now, but I can, and it’s a beautiful thing. Hang in there–we’ll get through this together.”
If you, or someone you love, is struggling with thoughts of suicide and death, I encourage you to reach out for help. Build a strong team of doctors, therapists, faith leaders, friends and family to join together and help. No one should ever have to go through life (especially the rough parts) alone.
For more information on Suicide Prevention month, visit the ActiveMinds website.
Shelby Riley, LMFT is the owner of Shelby Riley, LMFT and Associates, LLC. She is currently the Past President of the Pennsylvania Association of Marriage and Family Therapy (PAMFT). Remember to check out Shelby’s website www.shelbyrileymft.com for useful information about therapy for individuals, couples, and families.