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The Awkward Question that can Save a Life



***Need help? Call the National Suicide Prevention Lifeline: Call 1-800-273-8255. Available 24 hours every day.***

Anthony Bourdain and Kate Spade's recent deaths triggered an effort to raise awareness about suicide, and I’d like to do my part.


What are the warning signs and risk factors of suicide? How do we prevent our loved ones from hurting themselves? Where do we find help?


On a daily basis, I ask my patients and clients a super awkward question: “Are you thinking about killing yourself?” It’s a very common thought in our society, and although it’s not the very first question I ask, I do ask eventually, unless there are immediate warning signs. It doesn’t seem to offend people too often, and I don’t care if it does. Look at it this way. It’s better to offend than to allow someone to die because I didn’t ask.


I get a “yes” to the awkward question almost every day. When you really talk to people, you’ll find that people will often acknowledge that they’ve had passive suicidal thoughts (“It would be OK if I didn’t wake up tomorrow”), and a few may have active suicidal thoughts (“I want to end my life now”). As a therapist, I have to be aware of the red flags that make one person more likely to commit suicides than others, and assess that risk.


Here’s what I look for:


· Family history of suicide

· Drug use

· Trauma/PTSD

· Chronic or severe health issues

· Diagnosed mental/emotional disorder

· Past attempts at suicide

· Plan for carrying out suicide

· Drug or alcohol use

· Body language

· Ability to make eye contact

· A “vibe” that this person is more of a risk


At this point, I may need to put some protective factors in place.


For non-immediate risk:


· Alert family support system

· Spiritual or religious grounding

· Reminders that children or others depend on them

· Employment assistance

· Community or social support

· Safety planning


For immediate risk:


· Hospitalization


Suicide is one of the most prevalent killers for teens. There are some risk factors that increase the chances, such as:


· Bullying/ Cyber-bullying

· Abuse

· Brain is still developing (every teen)

· Impulsivity

· Extreme “always/never” thinking


If a person is suicidal at one point in their life, it doesn’t mean that person will always be suicidal. It’s normal to question life and existence, purpose, and our place in this world once in a while.


Anthony Bourdain had a history of drug use, which is a risk factor. Still, people were stunned when someone so “successful” would choose to end his life. If a person is struggling with a major mental health disorder, any level of perceived success may not rule out a feeling of extreme emptiness. That’s part of many peoples’ struggle I see in therapy.


“I have everything I need, and everything I want, but I still feel empty inside.”


As a therapist, I have a legal and ethical obligation to protect people. It gets murky, because I have to take appropriate actions to make sure my client is safe. This might be sending someone to the E.R. or documenting a safety plan.


For those of you who are reading this, and suspect someone is at risk of suicide:


· Ask the awkward question!

· Be there for that person in a non-judgemental way. Put yourself in their shoes and praise them for being strong enough to open up about their emotional pain.

· Call for help. (Phone number at top of this article). You can also call 911 if someone is actively trying to hurt themselves.


It can be scary to have feelings of suicide and very difficult to reach out for help. I realize there is a stigma to mental health issues and seeking professional help. New research is showing that depression (an illness not a weakness) is a precursor to suicide. Depression has both mind and body origins.


If you are experiencing depression, please take care of your physical and mental health! See your mental and physical health providers, eat a nutritious diet, drink lots of clean water, get sunlight, move your body, and surround yourself with positive people.

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American Counseling Association Professional Member Matt Hollo
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