A topic very near to my heart. My middle brother, Jack, was lost to suicide in January of 2014. According to the CDC, 113 suicides occurred each day in the U.S. during the year 2013 – that was one death every 13 minutes. I would venture to say you don’t need to go as far as 6 degrees of separation before identifying someone you know who has died by suicide or knows someone who does. In an age of ceaseless social media posting, it is hard not to be acquainted with suicide, especially since suicide itself and mental illness are still so severely stigmatized.
Just last month, grunge singer/songwriter Chris Cornell was found dead in his hotel after playing a show in Detroit. He had been the frontman for grunge bands Soundgarden and Audioslave, was a member of Temple of the Dog, and also had a successful, albeit short-lived, solo career. His death was the third major death by suicide in the world of grunge music, joining both Layne Staley of Alice and Chains & Mad Season and Kurt Cobain of Nirvana. Even though it is not September (suicide awareness month), I wanted to share a message, by way of my own experience, about how important it is to talk frankly and deliberately about suicide. Chris Cornell’s death struck a painful nerve in me and put it on my heart to make suicide prevention a personal goal, especially after losing my brother.
I wasn’t keen on what living with mental illness looked like while Jack was alive. Jack was not very open with me about his mental illness (which, in courtesy of his dignity, I will only identify as bipolar disorder type I, although he had more than one diagnosis he was actively managing), nor did he open up much about his private life. Most of his time during his illness years was spent working towards personal goals: keeping his job as a dog walker in Northern Virginia, earning his B.S. in psychology, earning enough money to deck out his car with LED lights and a sound system, and of course murking zombies in the latest edition of Call of Duty.
The few people who knew about Jack’s inner demons can attest to the fact that he did not want to be a burden to anyone else. He felt it a personal conviction that he bear his cross quietly. For this reason, I believe Jack found unique (and quite humorous) ways to channel his mania and melancholy: terming words like “chi” to describe his current mood and making it more comfortable to talk about in public, choosing to take evening car rides alone so he could sing as loud as he needed, sleeping on the couch upstairs around people on “bad days” so he was at least in community with the rest of his family, smoking hookah in the hot tub to let off steam, and numerous others. All of these were healthy and appropriate coping mechanisms that allowed him to live five more years with his mental illness.
Jack, however, did not reach out when he felt sad. It was only during times of extreme emotional distress or psychological disturbance that he reached out to either my mom or his therapist for help. While he had plenty of ammunition in his psychological armory, Jack ultimately took his life without an easily identifiable warning. Since Jack was so quiet – and I was too shy to confront him about ways to help him – we both failed him in managing his illness appropriately. Hindsight is 20/20, and the overly scrupulous soul could maybe find small clues leading up to the horrendous moment, but who’s to say whether I, his therapist, or anyone in my family could have taken notice.
I have no problem admitting I could have done more for Jack. Being the awkward older brother, I wanted to have a normal relationship with him that wasn’t colored by his exceptional illness experience. I also didn’t want to waste each opportunity I had to spend with him talking about his illness because I knew that would become commonplace and very uninteresting to him and we would lose touch. During my college years, I even went through a period of prolonged quietude between Jack and me. The idea was to give enough space to make it seem like I wasn’t constantly worried about his well-being, when in reality it bothered me not having a firm grasp on his well-being.
“Since Jack was so quiet – and I was too shy to confront him about ways to help him – we both failed him in managing his illness appropriately.”
All of this to say that both Jack and I could have done more to help him navigate his sickness: Jack could have perseverated less about the status quo regarding mental health treatment and I could have been better about touching base frequently. Can you blame either of us? Our relationship probably seems very familiar and commonplace because I believe it is a common dilemma for many families with mental illness. Five years spent in the healthcare system has demonstrated to me that I have judged this correctly. In my opinion, the root of the problem boils down to an unfair and very dangerous stigma regarding mental illness. For this reason, I maintain that until those of us in healthcare can acknowledge mental health and treat it like a medical/surgical chronic illness, we will continue to lose members of our communities to preventable suicide.
Shameless plug: there are numerous outlets for learning more about suicide, suicide prevention, and of course how to identify a preventable suicide. Some of the signs and symptoms of an imminent or thoughtful suicide are listed on the National Institute of Mental Health’s website and can be found below (emphasis mine):
- Talking about wanting to die or wanting to kill themselves
- Talking about feeling empty, hopeless, or having no reason to live
- Making a plan or looking for a way to kill themselves, such as searching online, stockpiling pills, or buying a gun
- Talking about great guilt or shame
- Talking about feeling trapped or feeling that there are no solutions
- Feeling unbearable pain (emotional pain or physical pain)
- Talking about being a burden to others
- Using alcohol or drugs more often
- Acting anxious or agitated
- Withdrawing from family and friends
- Changing eating and/or sleeping habits
- Showing rage or talking about seeking revenge
- Taking great risks that could lead to death, such as driving extremely fast
- Talking or thinking about death often
- Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
- Giving away important possessions
- Saying goodbye to friends and family
- Putting affairs in order or making a will
Other resources that may be helpful include:
- CDC: Suicide Prevention
- National Suicide Prevention Hotline: 1-800-273-TALK (8255)
- The American Foundation for Suicide Prevention
- The Suicide Prevention Resource Center
- The Military Crisis Line (through Veteran Affairs)
- You Can Not Be Replaced (website for encouraging youth to think positively, reducing risk factors, and promoting positive self-esteem)
- Suicide Prevention, Awareness, & Support
- National Alliance on Mental Illness
“Until those of us in healthcare can acknowledge mental health and treat it like a medical/surgical chronic illness, we will continue to lose members of our communities to preventable suicide.”
It is my hope that every person – and especially those with a mentally ill family member – becomes sensible to the unique struggles that those with mental illness face. Just like how knowing how to successfully resuscitate a stranger in cardiac arrest is an unspoken folklore of American culture, so mental health awareness should be equally as important. It cannot be overstated that people fighting mental health illnesses are not alone, nor are the families helping them. Let’s make it a priority to end the stigma shrouding mental health & suicide and learn how to help those afflicted live purposeful, meaningful, prosperous lives. Every 13 seconds count.