Something to talk about

“Hopelessness and complacency are my biggest enemies.”–Inga Muscio

Like so many others this week, we have been shocked and saddened by the death of Robin Williams. While the death of any individual–or any individual, period–by suicide or other means can be haunting and painful for those who remain. The death of someone who seems to “have it all,” can be even more puzzling and saddening.

The Centers for Disease Control’s (CDC) most recent data indicates that Caucasian men between the ages of 45-64 are at the highest risk for committing suicide in America–men much like Robin Williams. While there are many factors that may contribute to this, it is important to know the indicators that an individual may be suicidal.
Some of these include:
Social withdrawal
Depressed or significantly altered mood for two weeks or longer
Increased substance use
Comments such as, “I won’t be around much longer,” or, “Everyone would be better off without me,” or other statements indicating feelings of worthlessness and hopelessness
Comments about harming self
Giving away belongings, especially treasured items
Significant changes to sleep, appetite, and concern for appearance or hygiene
A history of suicidal behavior
A history of traumatic experience
Diagnosis of a chronic and debilitating condition
One of the most overlooked factors is an unexpected calmness or even elevated mood in a person who has previously exhibited some of the aforementioned symptoms, especially if that person has recently attempted suicide or experienced a major trauma or loss.

Robin Williams suicide illustrates the truly debilitating nature of depression and related conditions. Despite being a prolific, gifted, renowned, and financially successful performer, he was overwhelmed by a painful and isolating condition that ultimately claimed his life. Like any illness left unchecked, depression can consume you–literally. A 2012 study by H.J. Kang and colleagues at Yale indicated that depressive symptoms can literally cause your brain to shrink by shutting off certain receptors and eventually culminating in loss of mass in the prefrontal cortex, the area of the brain that is associated with higher-level thinking and personality. A person struggling with depression can literally lose him or herself.

The loss of such a famous individual to suicide has prompted a robust and necessary public discussion related to suicide, depression, and other mental health concerns in the last few days. Depression is so often considered at the individual level that we may forget the impact it has on partners and families, too. Loved ones may feel anger, despair, sadness, anxiety, shame, or fear when someone dear is struggling with a disruptive psychological state. This can create a vicious cycle if left unaddressed. Talking about your concerns to your family member can be uncomfortable and difficult, but it can be the first step to healing.
Some simple and gentle approaches may be:
“You don’t seem yourself lately. Are you doing okay?”
“I’ve been concerned about you lately. I want you to know I am here for you.”
“I know your experience/loss/trauma has been very challenging for you. Do you want to talk about it?”

If you or someone you know is struggling with depression, anxiety, suicidal thoughts, or another seriously disrupting psychological state, please do not hesitate to seek help. Healthcare professionals, especially in the field of behavioral health, are trained to help you with these issues through research, clinical practice, and motivation to promote well-being.

The National Suicide Prevention Line is 1-800-273-8255. You can also call 9-1-1 or go to your nearest emergency room or mental health center.


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