As a clinical psychologist, I probably think about suicide more often and in different ways than most. I’ve read the research. I’ve been trained to ask the hard questions. I am all too familiar with the frustrating gaps in our knowledge base: what causes it, who is at risk, how do we prevent it? I understand the stigma and misconceptions surrounding it, and I know, firsthand, the collateral damage that stems from it.
May 27, 2011 was the worst day of my life. I lost one of my favorite people on this planet to suicide. This week, sadly, my world was yet again touched by this tragedy, and I feel compelled to write these letters.
To the Grievers,
I feel your pain. I, too, have lost a loved one. I know the initial shock as your mind strives to process the news that seems so unfathomable, so impossible. We know that it happens, but we just didn’t see it coming.
I know the heartbreak that sets in as the shock wears off and you realize that your person is gone. This is not a bad dream. You’re awake, and it sucks. I know the deeper layer of heartbreak that comes with the realization of just how much pain your person must have been in. The weight is crushing.
You’ll want to go down the If Only path, but don’t. That will only result in endless loops of anguish and no real clarity. Know that it is not your fault.
You may be struggling with wanting to understand WHY this happened. Know that you may never fully understand your person’s state of mind or the factors that led to their death. You may never have a satisfactory explanation.
Know that it’s ok if you feel angry, but understand what happened. In the mind of someone who dies by suicide, they are a burden to others and do not belong. You and I know that’s not true, but in their mind, riddled with the insidious lies of Depression, they did not. They believed, TRULY believed that that their existence caused pain and that the world would be better off without them. From their perspective, their last act was a selfless one or one of mercy to end suffering. That’s the tragedy of suicide.
You feel lost and stuck as the rest of the world continues on like nothing has changed…but things will never be the same. The waves of grief that crash over you now, buckling your knees and taking your breath away, will gradually slow down. They will begin to come less often and with less intensity.You’ll find yourself feeling (almost) normal for increasing periods. You’ll stop feeling like you’re drowning, but it will never completely stop hurting.
Know that you WILL be ok. It’s going to hurt…a lot and for a long time. There’s no way around it and no way to avoid it. But know that you CAN get through this loss.
Be in Peace,
To the Contemplators,
I feel your pain…at least I want to. I want to listen, to wrap my arms around you, to tell you that you are NOT alone, that people care, that this will pass, that life CAN get better, that there IS hope, that NOTHING is unforgiveable or irreversible.
Know that brains lie, and yours is no exception! Question it. Challenge it. Fight back! You DO have worth! Things CAN get better! It will not always feel like this. These thoughts and feelings will pass if you can hang on. You are strong. The fact that you’re still here is a testament to that. Even the strongest need a hand sometime, though, so share your burden (and know that YOU as a person are NOT a burden). It will be easier to carry, possible to endure, with help.
There is always someone there. If not a family member or friend, call the confidential National Suicide Prevention Lifeline anytime, 24/7, at 1-800-273-TALK (8255).
Please find some tiny ray of hope and cling to it like the life raft that is. Things can get so much better!
Be in Peace,
To the Rest of the World
I feel your pain…even though you do not…yet. You may feel a mixture of judgment or disbelief when you think about suicide. “That’s only for the mentally ill/attention seekers/weak of heart. It will never happen to me.” Or “My loved one would never do that.” Or you don’t think about suicide at all. You’ve been lucky. It hasn’t touched your world yet, but it will.
Someone dies by suicide every 12 minutes in the US—every 40 seconds worldwide—and for every completed suicide, 20+ more attempt. Suicide is the 17thleading cause of death worldwide, 10thin the US, and 2ndfor teens and young adults. Rates are on the rise, with a startling 24% increase over the past 15 years, and 1 in 5 teens seriously considers suicide. That’s 20% of our youth!
Yet, there is so much stigma, so many misconceptions and unhelpful attitudes around suicide. What if we likened it to cancer? Like cancer, suicide does not discriminate on the basis of gender, race, or socioeconomic status. There is no stereotypical face of it and no one single path that leads to it. For some, it is a sudden, intense phenomenon that takes life rapidly and with little warning. For others, it is a war waged internally for years. And, like with cancer, what if we did not blame the sufferers, even if their actions seemingly contributed in part to the outcome, and instead understood that they, tragically, lost their battle?
Suicide is not a selfish or cowardly act. It is not due to a lack of discipline or religion or to a weakness of character. It is caused by a number of factors, a perfect storm of biological vulnerabilities and environmental elements that results in circumstances that are beyond someone’s ability to cope. In that final moment, there is no alternative, no way out. Like when a heart no longer has the capacity to keep beating during a heart attack, they die of a brain attack.
“Suicide is just a cry for attention or a cry for help,” you may say. Maybe it is sometimes. That brave soul is fighting for their life! LISTEN TO THAT CRY! Help if you can.
I urge you to be kind to others. You can not tell by looking at someone if they are struggling with suicidal thoughts or who they’ve lost to suicide. Arm yourself with education and compassion. Suicide is a public health issue and affects us all.
Know that it’s ok to ask someone about suicide. There’s a common misconception that asking someone if they have suicidal thoughts will implant the idea. That’s a myth. If someone is not suicidal, asking about it will NOT cause them to be. And, if they are, asking about it may just save their life. By asking and listening without judgment and without anger, you’ll let them know that the door is open to talk about it, that you are a safe place for them, and that you will help them take the first steps toward preventing it.
Be in Peace,
To Z and the Others Who Lost Their Battles,
I can’t feel your pain…it’s too overwhelming and unbearable. My heart breaks that you suffered alone. Seven years later it’s still hard to imagine—and live in—a world in which you don’t exist. Know that I love you and that my life is better because you were in it. Be in peace.
About the Author:
Ashley Smith, PhD, began studying and treating anxiety disorders in graduate school. She earned her PhD in clinical psychology from the University of Nebraska-Lincoln in 2007. As part of that training process, she completed an APA-approved predoctoral internship at Children’s Mercy Hospital and Clinics before joining the staff at Omaha Children’s Hospital to help develop their dedicated anxiety services. In 2009, she relocated to Kansas City to serve as a senior staff psychologist at the Kansas City Center for Anxiety Treatment before starting a private practice in 2017.
In addition to direct clinical work, Dr. Smith is actively involved in other scholarly activities. She has been an adjunct assistant professor in the Department of Psychology at the University of Missouri-Kansas City and has provided supervision, trainings, and consultation for students and other professionals. She has several publications (see below) and maintains active involvement in professional organizations like the Anxiety and Depression Association of America. She regularly presents workshops and trainings on a local and national level and has been involved in planning and producing local and national conferences.
Dr. Smith strives to provide top-notch care in a collaborative and supportive manner. You will find her to be direct and knowledgeable, open and honest, and enthusiastic about guiding you through your journey.