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The following is a very challenging piece to read and contemplate. Many of us have experienced being caught off guard by someone’s suicide. I think as we read this, we should be aware of the challenges faced daily by those suffering and making choices to suicide as well for those who remain with the pain of loss from suicide.

When someone famous — in this case, a technologist — takes their own life, a lot of hand-wringing and second-guessing occurs. It’s called survivor guilt, and virtually anyone who’s ever known someone who’s died by suicide has gone through it.

“Why didn’t I see the signs?”

“Why didn’t I just listen more?”

“Why didn’t I just reach out and ask him if he needed some help?”

The list of unanswerable questions is never-ending.

But here’s the thing — you can’t always see suicidal intent. You can review all the checklists and warning signs in the world, but if a suicidal person is clever and dedicated enough to his or her goal, you’ll never see it coming.

Because feeling suicidal isn’t the same as when someone cries when they’ve physically hurt themselves. The crying, if done at all, is done on the inside — far removed from everyday life.

Clay Shirky, a well-meaning technologist himself, wrote about how we should just take better care of each other.

What a great sentiment.

But psychologists know that sentiments like this last for a time — in the moment of pain and grief — and then, for most people, fade away. It’s not because we’re unfeeling automatons who go through life forgetting the importance of human contact. It’s precisely because we’re only human that compassion fatigue can set in. You can literally wear yourself out by trying to look out for everyone else in your life.

The Suicidal Mind

People who are suicidal usually go through a set of stages with their suicidal thoughts and feelings. Most people who are suicidal don’t just wake up one day and say, “Hey, I’m going to kill myself.”

Instead, what happens is depression is mixed with hopelessness — a feeling that these bad things will never change — often accompanied by a sense of feeling trapped. Like there’s no way out of the circumstances of our life.

The feeling starts off small, as just a thought nugget — “Ending it would solve all my problems, wouldn’t it?” The more hopeless the situation appears to be (it doesn’t matter whether it is or not in reality), the more these thoughts start to take on a life of their own.

For most people, suicidal thoughts are the start and end of their suicidal intentions. Having an occasional suicidal thought even when you’re not depressed is not unusual and no reason to panic.

But for a small group of people, the suicidal thoughts don’t end or lessen with time and depression treatment. They get worse. They start to grow out of control, as the person moves from just thinking about ending their lives as an abstract concept, to starting to think about concrete ideas of how to do it (and do it successfully).

As these thoughts grow and a plan takes shape, people who are suicidal engage in some common behaviors. They start to give away some of their possessions (especially stuff that means a lot to them). They start to act more reckless than usual, perhaps driving in a manner unlike themselves, perhaps engaging in behavior you’ve never seen them do before. Their mood may vary widely as they wrestle with the internal demons that only they can see, and that only they can fight.

The Catch

There is, however, a small catch.

Some people are smarter than others, and some people know about these warning signs (thanks Internet!). So some smart, suicidal people can be ready to end it and give virtually nothing away to their loved ones or friends.

Worse, people who are hackers and technologists often code alone, game alone, and socialize primarily through technology. Which is great for goal-directed communication, but lousy for picking up on the subtle, non-verbal cues that often tell more of the real story of what’s going on with a person.

Reaching out and offering a helping hand is a good start. But for someone who’s already made the decision, it will not be enough. Especially if they’ve kept the worst of it inside, away from everyone.

Offering the helping hand through technology — through a tweet, a text, or a passing comment — isn’t as helpful as actually talking to the person you’re concerned about. Face-to-face if possible.

What a person really needs is an immediate intervention. Not just from a crisis hotline.1 But from a real person (yes, even a professional), in their face-to-face world, to help them through the chaos and hopelessness.

Yes, they need the love and support of their friends and family — but that will never be enough. Because if we could treat and solve mental illness through just love and paying better attention to other people’s needs, psychologists and psychiatrists would be out of business tomorrow.

The Crux

Clay Shirky says:

The warning signs are well known…

The useful responses are well-known too…

And that is exactly the problem. Most of us know this stuff — even people who don’t deal with mental health issues everyday. If it’s so well-known, why do we continue to do such a lousy job in helping stop 30,000+ people from taking their own lives each and every year in the U.S.?

I don’t have the answer.

But I do have one answer — let’s stop treating mental illness like a second-class disease that is mocked, ridiculed, and discriminated against every day in this country. It’s the punch line to an endless array of bad joke in countless online forums and blogs. Let’s elevate and properly fund the mental health system to be equal to that of our general health care system.

Let’s stop sweeping people who are suicidal under the rug and pawning them off on volunteers to deal with.2 While most are well-trained and fairly well-equipped, it sends the message that we, as a society, don’t take this problem seriously — by putting the people who are in the greatest emotional and psychological need in the hands of non-mental health professionals.3

And yes, by all means, reach out to your friends, your loved ones, and check in with them as much as you can.

But realize that you don’t always have the power to change another person’s life — only they can. What you can do is help them understand and use their own power to get help.

Footnotes:

  1. Although crisis hotlines do what they can with what little resources our society bestows upon them. [↩]
  2. Yes, that’s right, most suicide hotlines are staffed by volunteer laypeople. [↩]
  3. And sadly, crisis hotlines’ quality varies considerably, as these stories from real life people tell. [↩]
Dr. John Grohol is the founder & CEO of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues — as well as the intersection of technology and human behavior — since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.