Recent deaths call attention to suicide preventionDate: 7/19/2018 GREATER SPRINGFIELD – Suicide isn’t something people like to talk about. It’s only when celebrities like Kate Spade and Anthony Bourdain take their own lives that suicidal behavior comes to the forefront of public discussion.
But it’s a topic that bears examining for more than a couple of news cycles. Recent Center for Disease Control statistics show in 2016 America recorded an overall national suicide rate of 13 individuals per every 100,000 – the highest recorded since 1986 – with increases occuring in every age group.
Most troubling, according to the data reported by the National Center for Health Statistics, the biggest increase occurred among middle-aged men – 43 percent – and women – 63 percent.
Suicide is now listed as the 10th leading cause of death for all ages in the U. S.
According to Dr. Gaurav Chawla, MD CPE, chief medical officer, Providence Behavioral Health Hospital, these troubling statistics, coupled with the recent high-profile suicides, point to just how complex any discussion of suicide actually is. In his opinion, suicide is “a topic that needs to be studied from a public health perspective,” taking into account myriad factors from the effects of social media on people of all ages to the economic pressures generated by our 24/7 society to the pervasive devastation being wrought on families of all socio-economic backgrounds by the opioid crisis.
Sandwiched by stress
Chawla noted that from a generational standpoint, middle-age Americans have experienced an unprecedented level of stress in recent years, sandwiched between “having to care for our seniors as well as carrying on with employment responsibilities in addition to taking care of our children” – all while coping with one of the worst economic downturns in several decades.
“We all have different vulnerabilities, different skill sets on how to cope and have resilience within ourselves to deal with circumstances,” Chawla said. “Finances, interpersonal relationships get added to your genetic vulnerability [to mental health conditions such as depression or suicide].”
And Chawla said having a family history – or a genetic trait – does not mean, “You will go down the path” to develop a condition. “You can prevent these genes from expressing fully, or keep them to a minimum, by the right kind of interventions.”
Social media stigma
Chawla noted that the prevalence of social media is a double-edged sword, “you can’t do without it, but if you don’t watch what you are doing on it and with whom, it can really be detrimental.”
The biggest danger, he said, is that social media presents the user with “a curated version of your inner connectedness with everybody, it presets you with the false perception that you are interacting with everybody” on your friend list, while it in many cases isolates users from true interpersonal relationships that can lend emotional support in times of crisis.
Chawla said the effects of social media could be especially hard on young people, who have less life experience to help them put things in perspective.
“Figuring out who you are making friends with, how do you decide to share what you share, protecting your identity, protecting yourself from predatory connections online, things like that have to be facilitated by adults around a teen,” Chawla said. “It’s not an easy conversation, but one that need to be had with them.”
The opioid effect
Chawla said the impact of the opioid crisis on our society has only deepened the effects of generational, economic and social media stress by leaving families with holes in their personal support systems.
“When you have fewer adults that are available and present to teach children what are the healthy ways to cope with stress, give them life lessons, we are leaving these young folks to figure [these things] out on their own while they are experiencing unprecedented stresses,” he said.
Blunting the effects
Chawla said it’s important for families to be aware of their health history, especially when it comes to any unexplained deaths – potential suicides – in the past on either parent’s side.
“You would want to take this into account when you talk to your children [and] your brothers and sisters, because this would be an area where you can talk about coping skills, how to manage stresses, and how not to get down that dark hole of desperation and hopelessness. How to seek the real connections that exist in the word for you and how to create a sense of purpose [for your life],” Chawla said.
He said awareness of family history – or genetic predisposition – toward a mental health condition such as depression or suicidal tendencies can help families “be aware so [they] can detect things early on [and] seek help, or family members can reach out,” he said.
Chawla noted the stigma attached to suicide –and other mental health conditions – often still prevents people from talking about these issues.
“We need to elevate the conversation so we are not longer shaming people, forcing them into isolation when they are suffering,” he said.
Interventions to mitigate predispositions to mental health conditions such as depression and suicidal thoughts can range from medical therapy to more holistic approaches that look at diet, exercise and “supporting us through our daily lives,” Chawla said, with each individual and their medical team “picking a combination based on the information we fully understand” about the condition and the individual.
The unexpected attempts
Though we associate suicide with mental health conditions, Chawla said that isn’t always the case.
“I want to add that suicideality does not always, only, come from mental health conditions,” he pointed out. “A poor coping strategy, a personality of impulsiveness, viewing the world in extremes, [this] can get to a state of mind where [an individual] feels trapped and hopeless very quickly.
“This can be one example of the kind of a path that can take [someone] to that kind of [suicidal] thinking,” he added.
Other factors, such as substance abuse, or individuals who perceive themselves as trapped in a life that is hopeless where “nothing will improve” – combined with other internal risk factors that are not mental health conditions – can create a high risk of suicide.
“This is a cohort of suicide attempts, or completed suicides that are harder to predict because of how quickly a person descends into that state,” Chawla said.
Where to turn for help
Chawla stressed that an individual need not feel suicidal to reach out for help.
“[You] can call when you are not feeling right in your state of decisions,” he said.
In the greater Springfield area, the National Alliance on Mental Illness (NAMI) Massachusetts lists the Behavioral Health Network 24-hour hotline at 800-437-5922 as an emergency resource. Individuals can also call the statewide Emergency Services Program (ESP) toll free at 877-382-1609 and enter their zip code to get the toll free phone number for their local Emergency Services Provider.
Chawla said there are also several good resources for information online, including the American Foundation for Suicide Prevention, which under its support tab, offers help to individuals contemplating or who have attempted suicide, as well as family members concerned about them (afsp.org/find-support/), as well as the National Suicide Prevention Lifeline, online at suicidepreventionlifeline.org or toll-free at 1-800-273-8255.
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