Most of my clients do not want to complete suicide. Some of them contemplate death because they see dying as a way out – an escape from the anguish of living with a mental health condition or a difficult life situation. I’ve had clients tell me “I wish that I can sleep through all of this and wake up when everything is OK”. The wish here is not to stop experiencing life in its’ entirety, but to rest and come to experience a life that is more serene and joyful.

Suicidal ideas present themselves when a person feels that they have tried everything in their power to feel better, but don’t. What I’ve learnt in my years of working with people who have suicidal thoughts is that human beings have a tendency to use the same mechanisms of support, many times over, in order to ease their discomfort. This can include smoking, drinking, going on holiday, calling a friend, overeating or taking medication. Whatever it is, our method of choice is usually the one that is the most successful in providing us with effective relief from emotional pain. But life throws a number of different curve balls at us and using the same method of comforting ourselves when facing different life problems is like using a bandage to treat both a sprained ankle and a toothache. We need more supplies in our first aid box! This is what I support my clients to do in therapy. That, and to offer hope when life turns into a seemingly never-ending journey of emptiness and despair.

It is important to mention that depression is a major contributor to suicide deaths, which number close to 800,000 per year [globally] (World Health Organisation, 2017). The percentage of people battling depressive disorders in Malta was estimated to be 5.1% in 2015; over 22,000 people on our tiny island (World Health Organisation, 2017). Depression is a word that has now become part of social discourse thanks to awareness campaigns, social media and numerous celebrities who have spoken out about their experience of it. Having said this, I find that this condition is still not fully understood and the label overused. This is a problem, particularly for people experiencing depression.

It is helpful to know that apart from the low mood, changes in appetite, sleep disturbance and irritability, people who are depressed are struck by feelings of worthlessness. We feel guilty for not performing as well as we used to at work, for not being good enough parents and for not having the energy to complete everyday tasks, like meeting friends, showering or getting out of bed. We judge ourselves for being lazy and inept at a time when what we need most is to replenish energy stores and find the will to live. What most people don’t realise is that these feelings of guilt and helplessness are a symptom of the condition and not a realistic account of who you are as a person. That type of reasoning is the same as saying that you will never able to walk again because you recently broke your leg.

When we are feeling our worst, we need to remind ourselves that depression is not permanent, but suicide is. Promoting help-seeking behaviour is our challenge as professionals and our responsibility as community members. The way we talk about depression and suicide, even in passing, can determine whether someone will reach out for help or not, particularly in the case of men, who account for 88% of suicide cases in Malta (Bonnici, 2018). In fact, research suggests that men are about four times more likely than women to die from suicide (CDC, 2013), however, women are more likely to express suicidal thoughts and to make nonfatal attempts than men (SAMHSA, 2013).

Your support can change lives and save lives. So “if you’re in difficulty, never be afraid to ask for help. There’s no shame in doing so. The only shame is missing out on life” (Johnstone, 2012)

References

Bonnici, J. (2018, February). Why do men account for 88% of suicides in Malta.

Centers for Disease Control and Prevention (CDC). Web-based Injury Statistics Query and Reporting System (WISQARS) [Online] (2013). National Center for Injury Prevention and Control, CDC (producer).

Johnstone, M. [World Health Organisation] (2012, October 12). I had a black dog, his name was depression [Video File].

Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-49, HHS Publication No. (SMA) 14-4887. Rockville, MD: Substance Abuse and Mental Health Services.

World Health Organisation (2017). Suicide – Our World in Data.