Wednesday, December 3, 2014

Take talk of suicide seriously

Originally published:

"Patty is gone" was what I heard when my sister, Maureen, called me on Dec. 3, 2012. My first thought was that Patty had left the care home and was heading back home. No, Patty had taken her life that morning.
I did not have the opportunity to say goodbye. This was something our family and her doctor had given a zero to 5% chance of happening. Suicide had been discussed with Patty, and she had given her "guarantee" that suicide was not an option.
Her wonderful psychiatrist believed that Patty's strong, lifelong Catholic faith would deter her from suicide. I held her hand at Mass the day before. Little did we know she would be gone the next day.
So, after 67 years, we live on with the great memories while wrestling with the mystery of suicide. There won't be any new memories. Lives have changed.
In retrospect, I have come to the realization that instead of assigning a 5% chance that Patty would commit suicide, it should have been a 95% chance. This is easy for me to say one year later.
However, this is not about me or Patty's family. It is about the millions of families that deal with mental illness on a daily basis. They must talk about suicide with each other constantly. They must be direct, open and honest in communications.
Patty was feeling trapped. She wanted her unbearable pain to end. Ninety percent of people who commit suicide in the United States suffer debilitating mental illness, according to the National Institute of Mental Health. The reasons people choose suicide are multilayered, and there is no easy explanation.
What was she thinking? How long had she planned it? Did she have a plan? Why did she do it at that time? Could we have done anything to change her mind? These are some of the questions we now ask.
One of our father's favorite words was fakery. The definition of fakery is the inclination or practice of misleading others through lies or trickery. How long did Patty's fakery go on? Everything makes sense when one is suicidal.
Could we have prevented her suicide? This is the question that will be with our family forever with no answer. I find some solace in believing she was determined to commit suicide. I may be deceiving myself, but I need to find some positives in this tragedy.
Should we have been trained to recognize the signs and symptoms of suicide? Yes. Patty had a special relationship with her doctor. She saw him often, and he had guided her successfully through her previous bouts of depression. This time was different. Four months of pacing, non-eating and total withdrawal had consumed her. We discovered that drugs are not always the answer to make people better. There is no magic cure for depression.
Americans are not prepared to talk about mental illness or suicide because of the stigma. It leaves us with emotional, moral and religious scars. Suicide brings with it an ache, a chaos and a darkness. There is no reason to feel blame or shame: 45.6 million American adults are living with mental illness.
How can someone truly recognize the signs that a loved one may be contemplating suicide? Nobody can predict a suicide. You must be prepared to help someone you love who one day may have a suicidal crisis. Take all talk of suicide seriously. Constantly ask the direct questions, "Are you thinking about suicide?" or "Are you having suicidal thoughts?" Do not treat the threat lightly, even if your loved one jokes about it. They are expressions of extreme distress.
Get your loved one help immediately by taking him or her to the emergency room, calling 911 or the police department, calling a suicide hotline or calling the doctor. Do not leave the person alone. Make sure he or she has no access to means of harm; this includes cords of all kinds.
With a shortage of psychiatric beds, patients must be considered a danger to themselves or others for inpatient admission. Patients must communicate their dangerousness or distress in order to guarantee that they will be admitted for further treatment.
The idea of certainty in our life is an illusion in place so we can function in everyday life. But nothing is certain. Suicide throws out this notion of certainty and forces us to realize that life is a gift. Remember the 95% rule.