Story Talk: Let’s Talk About Suicide

On 18 November 2021, we invited our story profiles and story subjects from our mental health series, Silent No More: Giving Voice to Mental Health.  We spoke to our story profiles Mahita and Sha (Shafiqah) from Living with Suicide, along with Narash (Narasimman) co-founder of Impart and Nyana, co-founder of We Hear You. They talked about suicide, their lived experiences and ways we can overcome this stigma for our community. 

The interactions between our panellists and audiences were very encouraging and they motivated us to share our Question and Answer session* with everyone. We’ve selected a few questions that we hope can help work towards breaking the stigma surrounding suicide. 

*The questions and answers below have been edited for clarity.

What are some general tips we can take to help someone with suicide ideation? 

Narash: Firstly, we need to understand certain warning signs people go through. Having these warning signs in mind can help us understand where people are and what they are experiencing. A lot times, there’s an incident that pushes from suicidal ideation to attempting suicide. There’s a difference between who have thoughts about suicide and those who attempt it.

According to research, one third of the people who have suicidal ideation goes on to attempting suicide. So how does that happen? 

Access to means to be able to do so. If there’s a plan that they have and they have access to what they need to execute on it, it means they’re more likely to be able to do it. Again, it’s really about the planning; they are planning to say their goodbyes. For instance, sending you a message to say thank you for everything. And the person is not crying for help or attention seeking, it’s a real emergency.

Usually when a crisis occurs, they may be exposed to suicide or suicide behaviour. When one person dies of suicide there are an estimate of 135 people who are affected by it. As long as there’s an exposure, there’s cognitive access. This means cognitively, they know someone who has done it so they can do it too.

And then there is impulsivity. And this is a factor that affects a lot of men - it’s that moment when they do what they do when the pain of leaving (their current situation) outweighs the pain of dying. There’s a certain level of pain sensitivity, the tolerance to pain. Many also have experienced trauma in their life and have lesser stress hormone cortisol than your average person. It’s biological and for them the pain is real. It's fearlessness about death, they’re not fearful about death anymore, and this makes them more at risk. They have a mental imagery of how they’re going to die or imagine what it would look like for them. 

The single best predictor of future risk is past suicidal behaviours or attempts. 

Identifying these warning signs is the first thing you can do. But at the end of the day, it’s about how we help. The simplest thing that I can share is that if you’re there for them at whatever timing. This usually happens at night because you’re likely to feel more depressed and lonely at night. And a lot of the times you’re more alone with your thoughts at night. That’s when they need the support. And if we’re able to just sit with them through their pain during this difficult time, it’ll help them a lot.

It’s also about reaching out to good therapy services. Having a good therapist to help process their pain and hopelessness can help make a difference.

We need to understand that it’s far more complex than we make it out to be. There’s no singular reason why someone will attempt suicide. We need to understand that everyone has their own unique story. It helps if we listen. We also can’t burden them to respond when we are reaching out to them for help. It might be difficult for them to respond, but letting them know that you’re there for them despite their responses or lack thereof is important.

Nyana: I think one of the things we miss is that suicide is a symptom of something that’s painful and what happened that leads somebody to have thoughts. A question that we need to ask is what’s happening to you, or what’s happened to you? What we know about suicide is that it’s rooted in early childhood trauma that we don’t talk about. Things like neglect, abuse and things we see around us. As children we were incapable of handling this and they have an impact on us. 

Suicide is a part of a person but it’s not the complete person. And it’ll take a lot for a person to reach out. When they reach out, what really connects them to another person is being  genuine and sincere. A connection. It’s not about lip service, it’s about literally being honest enough to say, look I’m not sure I can help you, but let me find someone who can. Because safety is not only for the person with suicide ideation, it’s about yourself as well, you need to keep safe. 

This is a really important conversation to have when we talk about suicide first response. It’s difficult to help a loved one because we’re so invested. We don’t know how to help with their pain and that increases my pain and anxiety - that is inadvertently put on you. And it’ll become a loop. That’s why it's important to get professional help and get the right support for your loved one. Like Narash said, it’s very complex because it’s about human connection. We might treat others differently because of our own biases and attitudes towards suicide. There are many possible ways to get more insights, more knowledge. Get trained in suicide first response or read more about mental health to able us to love our loved ones in the manner in which they need in that moment. 

Sha: These are incredible points. I think it’s really important to just listen. Many of us are born with an urge to solve problems. So whenever someone tells us they have a problem, you want to solve it for them. But I don’t think that’s the point. It’s really important to just be there for that person and to not ask them any questions. A lot of times I don’t tell people I’m feeling suicidal because I don’t want them to ask me why. The answer is I don’t know. Sometimes I just feel it. And by you asking me this question, It’ll make me not want to talk to you in the future.

How can we prevent suicidal thoughts when we are in the middle of a toxic situation we can’t avoid?

Sha: In my opinion, in this situation it can get hard to avoid suicidal thoughts. Some of these thoughts are going to come to us, but what are we going to do with it? Are we going to let it take control of what we’re going to do? Or are we going to find help? Or let it go by like a wave? Like for me, because I have borderline personality disorder, having suicidal thoughts is like second nature. But that doesn’t stop me from actually letting myself know that I’m still in control of my body. I can decide what I want to do with it. 

You may be in a toxic situation that you can’t avoid, so I think the priority is to think about what you can control. And how can that help you with your situation?

For me personally, I will always first keep myself in check. If I feel like I’m going to be at a dangerous point in my life, I’ll let someone know before I get there. Because when I’m there, I probably won’t be asking for help. And that’s because I understand myself when I’m in a crisis. I think it’s important for you to know when you’re in that situation and how you’ll act. It’s ok to have suicidal thoughts, but what are going to do with it?

Narash: Sha I think that is so important. Safety planning is number one especially if you’re having suicidal thoughts and ideation, wanting to end your life. What you can do is write down and rate the level of suicide ideation you’re feeling, from one to 10. Ten being the worst you’re feeling and one being  the least suicidal thoughts you’re having. Through this grading system you can plan on what you can do. How can you cope with one or two or three? Will you cope differently? Or what about five or six? How will you cope then? What if it’s a seven, eight or nine? 

You will only know what works for you. I think it’s important to put that into a plan and to have people in your support network know what’s happening. For instance, let them know if you’re experiencing this, call them so they won’t be shocked. It’s important to know that they’re part of your safety plan so that the people around you are ready to better support you. From doing this you may be able to identify certain limitations in your support system. Where can I go? Can I accept that in certain situations and time some people may not be the right support. At the end of the day, having a certain plan in terms of how you’ll cope better will be important for you. 

Nyana: We don’t usually use the word suicidal, because suicides on the continuum. You could be anywhere between thoughts, planning, preparing or doing the behaviour. They are at different levels of intensity. But what both Narash and Sha shared about the safety plan is understanding what works for you; what’s unique to you. And i think what they’ve beautifully said is to let people around you know and be privy to what helps you, simply because you’re in a suicide world. Your rational brain is off and you’re only thinking from your emotional brain. You have no access to coping strategies. You have no access to information that otherwise is stored in your rational brain.

You need to have it somewhere on a phone, somewhere on your wall, somewhere with other people who you can reach out and say I am in my suicide crisis. At that point of time, you may not remember these coping strategies because your body has shut down. It’s disassociated. All we feel is the intensity of the pain, which is pure emotion. 

We know these things, but they don’t necessarily come handy when we’re in that moment. 

Mahita: I attempted suicide, I shouldn’t be here. But I am here. A lot of what they’re saying is very academic and logical, and it’s good. But also at the same time, there are people who want to die. They’re not going to ask for help because they don’t want help. They have access to help and it sounds practical. And why can’t we all do this? 

Because some of us don’t want to. We just want to die.

And I think that is something that people need to also accept. That there will be people who will attempt and will kill themselves. But no one should be blamed for it. It’s not why didn’t you see the signs? Why didn’t you see that the person needed help? We don’t let you see the signs because we don’t want to scatter plots. 

All I’m saying is: everything that everyone has said is true, it’s good. I agree 100%. But there’s also this dark side, which is also real. Understand that no one should be blamed. No one should feel that they didn’t help and that's why somebody died.

For those that have been left behind from suicide, what are some practical tools and actions we can take to break away from the stigma and prejudice around us?

Nyana: Stigma and prejudice, they are like chains around us. I don’t think stigma and prejudice is going to change anytime soon. What we can do for ourselves  is to find other survivors and create a safe space  to work through whatever it is that we’re experiencing where grief and loss is concerned. It’s a unique grief and loss. It’s not the same as losing somebody to a heart attack, not that the loss is less. But of course, it doesn’t come with the burden of what we could have done differently. With all due respect, whether we like it or not, whether the person chose it or not, there’s nothing we could do. It comes with the territory of being left behind that you ask yourself, what could you have done? And as humans we want to know that we could have helped a loved one.

I think the question is whether we want to support people who have lost loved ones to suicide. Our own understanding of suicide can increase and improve in order to not unconsciously or consciously create stigma or prejudice. We become conscious of our own contributions to the space.

What would you like people to say or not say when they know you have suicidal thoughts?

Mahita: It’s something that I choose to deal with on my own. Suicide ideation comes and goes, it weaves in and out, it’s very unpredictable. It doesn’t choose any given day or it doesn’t even choose any given situation. For me, it has never come from a place of pain. It comes from feeling overwhelmed. 

I’ve a small group of friends who understand or know as well as my husband and children. None of them will ask me because they say “what are we supposed to do?” And I said, you just have to leave me alone. I’m still here.

The fact is, I’m still here.

So allow me to process it myself. And if I can’t and if I have to go, I will go. No, it’s not your fault. It’s a very honest relationship. So for me, I know it’s a non-answer. I don’t want anyone to feel the burden of not doing anything. Yeah, there’s nothing they could do.

Sha: Not everyone has the same experience with suicide. We all have different reasons. We all have different ways of coping. And we need to respect that. The important thing is we have to know what the other person needs.

Personally, I like to desensitise suicide by talking about it. I’m like the complete opposite to Mahita. I just talk about it. And they’ll ask me, are you ok to talk about it? Yes I am. Sometimes at work, sometimes when I’m chilling with my friends, because I don’t think it should be a taboo. It’s not something that should be uncomfortable to talk about. 

If someone wants to talk about it, if they want to ask me about it, I’m cool with it. I want it to be the norm for me because I think that’s the only way we can break the stigma, by changing how we talk about it.