Dangerous Thoughts & Lethal Action: The Relationship Between Depression & Suicide
How many times have you heard on the news that yet another one of your favorite actors or musicians has died from suicide? You might think to yourself that they had it all - the fame, the success, the good life. However, when we dig deeper into their stories, we learn that beneath the shiny facade they were struggling with troubling emotional challenges - often in the form of depression. It’s easy to feel helpless, wondering what could have been done to prevent this terrible tragedy.
The fact is, it isn’t just celebrities who share this experience. More often, this is the story of someone you know personally, or it might even be you.
This topic can be heavy to read about and to talk about, but healing only happens when we bring something from the shadows into the light. This article is intended to bring compassionate awareness to the topic of suicide and men, especially as it relates to depression. Whether you are personally struggling with suicidal thoughts, have attempted suicide in the past or are a witness to someone else’s struggle, I want to tell you that you are not alone and there are many valuable resources available to help you.
How are depression and suicide connected?
To be clear, depression is not a precursor to suicide. It’s quite possible to have depression and not have suicidal thoughts. However, the rate is very high for those who attempt or complete suicide to have also depression. It is thought that the severity of the depression can increase the likelihood of suicide. General depression, known as dysthymia, does not commonly lead to suicide. Gone untreated, regular depression can compound over time, leading to more severe depression.
Know that while suicidal thoughts or actions are not necessarily uncommon, they are not part of the normal stress response. They are signs of extreme distress and should be addressed immediately.
The Myth of the Chemical Imbalance
A pop culture construct that is scientifically invalid is the idea that depression occurs because of ‘a chemical imbalance in the brain’. The idea that low serotonin levels in the brain are a direct explanation for depression oversimplifies the issue.
As serotonin supports the brain in learning and remembering, lower levels of serotonin are thought to cause shorter attention spans and lower memory capacity. New studies suggest this could influence the thought process of someone struggling with depression, as they are likely to have repetitive thoughts and have difficulty shifting from negative thoughts to positive ones.
Suicide and Depression - The differences between men and women.
While men die by suicide 3-4 times more often than women, women attempt suicide more frequently. Women tend to attempt suicide by overdosing on pills, but men typically use firearms or hanging - which leaves less potential for recovery.
Regardless of gender, depression is one of the leading factors linked with suicide. Women, however, are more likely to seek help for their depression, while men suffer in silence and go untreated.
Perhaps the widest gap between men and women occurs when it comes to looking at those who have a lifetime history of depression, in which case 7 percent of men will die by suicide, in comparison to 1 percent of women.
What are the Risk Factors?
As a therapist who works with guys that experience suicide ideation, the assessment of risk factors is part of an individual’s treatment. A risk factor is a characteristic, variable, or hazard that, if present for a given individual, makes it more likely that this individual, will develop a disorder.
Remember those suicidal thoughts and behaviors can occur at any age or in any gender or ethnicity and there are multiple possible causes.
The main risk factors for suicide are:
Depression, other mental disorders, or substance use disorder
Chronic pain
A history of suicide attempts
Family history of a mental disorder or substance use
Family history of suicide
Exposure to family violence, including physical or sexual abuse
Presence of guns or other firearms in the home
Having recently been released from prison or jail
Exposure, either directly or indirectly, to others' suicidal behavior, such as that of family members, peers, or celebrities
Most people who have risk factors will not attempt suicide, and it is difficult to tell who will act on suicidal thoughts. Although risk factors for suicide are important to keep in mind, someone who is showing warning signs of suicide may be at higher risk for danger and need immediate attention.
Stressful life events (such as the loss of a loved one, legal troubles, or financial difficulties) and interpersonal stressors (such as shame, harassment, bullying, discrimination, or relationship troubles) may contribute to suicide risk, especially when they occur along with suicide risk factors.
What are the warning signs for suicide?
Warning signs that someone may be at immediate risk for attempting suicide include:
Talking about wanting to die or wanting to kill themselves
Talking about feeling empty or hopeless or having no reason to live
Talking about feeling trapped or feeling that there are no solutions
Feeling unbearable emotional or physical pain
Talking about being a burden to others
Withdrawing from family and friends
Giving away important possessions
Saying goodbye to friends and family
Putting affairs in order, such as making a will
Taking great risks that could lead to death, such as driving extremely fast
Talking or thinking about death often
Other serious warning signs that someone may be at risk for attempting suicide include:
Displaying extreme mood swings, suddenly changing from very sad to very calm or happy.
Making a plan or looking for ways to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun
Talking about feeling great guilt or shame
Using alcohol or drugs more often
Acting anxious or agitated
Changing eating or sleeping habits
Showing rage or talking about seeking revenge
If these warning signs apply to you or someone you know, get help as soon as possible, particularly if the behavior is new or has increased recently.
How to Correctly Refer to Suicide
Language matters when discussing issues of suicide; language reflects our attitudes and influences our attitudes and the attitudes of others.
Unfortunately, suicide is still a highly stigmatized experience. Amongst people who have lost a significant other due to suicide, stigma has been associated with increased social withdrawal and reduced psychological and somatic functioning.
People bereaved by suicide have highlighted that the word “commit” is most commonly used in conjunction with a criminal act, (such as committing murder, committing arson), resulting in a negative or immoral connotation when used with the word suicide.
Take care when talking about suicide - many of the terms we use to describe suicide carry harmful connotations which contribute to the shame and silence surrounding suicide.
By reframing the way we talk, we encourage guys to maintain support and combat the stigma that far too often prevents men from reaching out.
Avoid using terms such as “committing suicide,” “successful suicide,” or “failed suicide” when referring to suicide and suicide attempts, as these terms often carry negative meanings. Similarly, "successful suicide" or "unsuccessful attempt" are considered poor choices because they connote an achievement or something positive even though they result in tragic outcomes.
The correct terminology is:
Correct Term Incorrect Term
Died of suicide Committed suicide
Suicide death Successful attempt
Suicide attempt Unsuccessful attempt
Reference the behavior.. Manipulative, cry for help, suicidal gesture
Working with.. Dealing with suicidal crisis
Positive Action When Experiencing Suicide Ideation.
No matter how low you might feel in the moment, you are never a lost cause. With the assistance of psychotherapy, medications or other treatments (or a combination of these), it is completely possible to treat depression.
If you’re having suicidal thoughts, it doesn’t mean you are crazy or that something is wrong with you. It just means you are experiencing painful emotions that are too difficult to deal with on your own.
The pain can feel so real and so acute that you believe there is no way to escape it. But the more support you have, the faster you will be able to shift toward more positive feelings that also shift your perspective. While you can’t control the bad things that happen to you in your life, you can also trust that it is equally possible to be surprised by positive things that emerge, just when you least expect them.
The most important thing to remember is that suicide is final. There’s no bouncing back so the best thing you can do, even if you don’t believe it will help, is to take action steps that lead you away from the edge.
Follow these positive actions if you are feeling suicidal or are experiencing suicidal thoughts.
1 - Delay Action & Step Back from Your Thoughts
A lot of good can happen when you allow some time to pass between a feeling and a reaction. When you are having suicidal thoughts, remember there is a difference between thinking about something and actually doing it. Promise yourself you will not act harmfully toward yourself for a set period of time (say, a week) and then find a positive way to distract yourself from your suicidal thoughts like going for a walk or calling a friend. Creating distance between your thoughts and actions gives you time for your emotions to lift and to see things from a new perspective.
2 - Avoid Drugs and Alcohol
Drowning your sorrows may seem like the perfect way to numb out, but avoid using nonprescription drugs and alcohol if you are experiencing suicidal thoughts.
3 - Make your Environment Safe
To eliminate the possibility of doing something impulsive to harm yourself, it’s best to remove all potential hazards from your environment, such as weapons, pills or sharp objects.
4 – Seek Connection with Others.
Call a friend, a family member or the crisis hotline. Isolation can increase the intensity of your suicidal thoughts. Talking about your feelings and thoughts with someone else can help to reduce the intensity of your feelings and will make you feel less alone in your pain. Sharing how you feel can be a release for you and also enrolls someone else in helping you, should you need it.
5- Hold Hope
With the right support, many men who experience depression and suicidal thoughts are able to regain their sense of purpose and joy and go on to live a good and meaningful life. Your current thoughts do not have to define your future.
6 - Reach Out for Professional Support
As long as you are alive, it’s never too late to ask for help. Many men feel ashamed about their depression and especially about having suicidal thoughts. It makes them feel weak or embarrassed to feel so helpless. But seeking professional help - whether it’s a psychotherapist, a spiritual/religious leader, a physician or someone on the other end of a crisis helpline - is paramount to getting better.
By talking with a professional about your feelings and accepting advice from a trained individual who understands what you are going through, you’ll gain valuable insights and learn techniques that can help you move away from your suicidal thoughts.
7 – Post Suicidal Thoughts
Even when you’re feeling better, if you have been in such a dark emotional place that you have contemplated suicide, you need to seek help. Your best shot for staying in a positive and healthy headspace is to work on the underlying issues that had you considering suicide.
Concerned about the wellbeing of a friend or family member? Follow these steps.
1 - Ask: “Are you thinking about killing yourself?” It’s not an easy question, but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts.
2 – Keep Them Safe: Reducing a suicidal person’s access to highly lethal items or places is an important part of suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or disabling the lethal means can make a difference.
3 - Be There for Them: Listen carefully and learn what the individual is thinking and feeling. Research suggests acknowledging and talking about suicide may reduce rather than increase suicidal thoughts.
4 – Help Them Connect: Save the National Suicide Prevention Lifeline’s (1-800-273-TALK (8255)) and the Crisis Text Line’s number (741741) in your phone, so it’s there when you need it. You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional.
5 – Stay Connected: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person.
It’s time to open up the conversation and remove the stigma surrounding both suicide and depression. No one should ever suffer alone or lose hope when there are so many incredible resources available.
If you are struggling with depression and have also had thoughts of suicide, remember, your thoughts and feelings are impermanent. Even when you are feeling your lowest or like you can’t take it anymore, hold on to the hope that things will get better. Take action to surround yourself with loving people and professional support and trust that you will recover and heal from this traumatic experience.
As always, if you or a guy you know could use professional support with a mental health issue, I hope you’ll reach out and schedule a free 20-minute phone consultation.
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Cheers
Simon G. Niblock, MA, LMFT, is a licensed psychotherapist, specializing in men’s mental health and wellness. He provides tailored psychotherapy services and online programs for men and is the author of the Anxiety Workbook for Men, Evidence-based Exercises to Manage Anxiety, Depression, and Worry.
Important Notice: The content in this article is for informational purposes only. It does not replace direct professional mental health, medical treatment, or professional care in any way. Seek the support of a physician or other qualified healthcare provider to diagnose and treat any mental health concern directly. Contact 911 or your local emergency services number if you are experiencing a mental health emergency.
References
Padmanathan, P., Biddle, L., Hall, K., Scowcroft, E., Nielsen, E., & Knipe, D. (2019). Language use and suicide: An online cross-sectional survey. PloS one, 14(6), doi.org/10.1371/journal.pone.0217473
Jaffe, J., Robinson, L., & Segal, J. (2020). Are You Feeling Suicidal? Accessed:
www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm
Institute of Medicine (US) Committee on Prevention of Mental Disorders; Mrazek PJ, Haggerty RJ, editors. Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. Washington (DC): National Academies Press (US); 1994. 6, Risk and Protective Factors for the Onset of Mental Disorders. Available from: https://www.ncbi.nlm.nih.gov/books/NBK236306/
HHS.Gov. (2014). Does depression really increase the risk of suicide? Accessed: https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-depression-increase-risk-of-suicide/index.html
Jacobson, R. (2014). Robin Williams: Depression Alone Rarely Causes Suicide. Scientific America. Accessed: https://www.scientificamerican.com/article/robin-williams-depression-alone-rarely-causes-suicide/
