“Disclosing suicidal thoughts is challenging for the bravest and strongest people in our society,” Dr. Shauna Springer, PhD, a leading expert on psychological trauma, military transition, suicide prevention, and close relationship, tells Parade.com. “Many of the warfighters I’ve served would rather be pinned down in a firefight than take off their emotional armor and risk this vulnerability with their loved ones, as Meghan did so bravely with Harry. Without his support, her struggle would likely have been unsurvivable.” All this to say: Markle’s decision to open up to her husband about her mental state was crucial for her, and her decision to take these thoughts public was even more important in terms of changing the way that we talk about suicide. With such an important conversation finally out in the open, we decided to ask mental health experts what they wish people understood about suicidal thoughts. Here’s what they had to say.
Just because you want the thoughts to go away, doesn’t mean they will
Suicidal thoughts are incredibly uncomfortable, and many people hope if they ignore them, they’ll eventually go away. But according to Juanita Wells CADC-II, ICADC, Director of Clinical Development at New Method Wellness, an addiction treatment center, that’s rarely the case. Luckily, there’s a lot you can do about it. “These thoughts can very well be cognitive distortion and you can learn to challenge negative thinking patterns,” she says. “I wish people understood just because you want them to go away doesn’t mean they will. You will need to learn new skills to challenge suicidal thoughts.”
Asking about suicidal ideation will not act as a trigger
Often, people worry that if they ask about suicidal thoughts it will encourage someone to act. But that simply isn’t the case, according to Dr. Indra Cidambi, MD, Psychiatrist and Medical Director of Center for Network Therapy. “Family members are often afraid to ask loved ones whether they are experiencing suicidal thoughts due to the fear of actually planting that seed in the individual’s mind,” she says. “That is simply not true. Asking if they are contemplating suicide and identifying how the individual is feeling at the moment helps to identify if they are feeling hopeless or overwhelmed at the moment. It actually could provide the person an opportunity to talk and think about solutions to their problems. It also shows the individual that someone cares.”
Medication can help
Like suicide, there’s a stigma around taking medication for mental health struggles. While this should always be done under strict medical supervision, medication can really help. “Clozapine, an antipsychotic medication, has specific FDA indication for reducing the risk of recurring suicidal behavior for patients with schizophrenia or schizoaffective disorder,” says Dr. Cidambi. “Also, individuals can work with their doctors to find the right combination of medications to address other chronic mental health issues or substance use disorders.”
If someone has not expressed suicidal thoughts to you, there are still behavioral cues to look out for
“Isolating, increased risk-taking, giving away treasured possessions, increased drug and alcohol use are all behavioral cues,” says Dr. Cidambi. “As for emotional and verbal cues, look for apathy, irritability, anger, being shamed or humiliated, mood swings, talk of being a burden to family or society, wishing they won’t wake up the next morning, feeling that their life has no purpose.”
Suicidal thoughts are on a spectrum
Dr. Ziv Cohen, MD, a board-certified clinical and forensic psychiatrist and founder and medical director of Principium Psychiatry, notes that suicidal thoughts are not “all or nothing.” “It’s important to realize that suicidal thoughts are on a spectrum, from normal fleeting thoughts that are not a cause for concern all the way to thoughts which constitute an emergency,” he says. “It is normal to have fleeting thoughts on occasion about death or one’s own death. However, if the thoughts are persistent AND accompanied by an impulse to hurt oneself or planning how to hurt oneself, the thoughts constitute a potential emergency and one should seek professional help. It’s therefore important to talk in detail with a person if they mention having suicidal thoughts, not to be afraid to ask for details. It could save their life.”
Suicidal thinking is not “weakness”
According to Dr. Springer, suicidal thoughts often arise during times of overwhelming pain. “We all walk dark valleys at times,” she says. “And when we do, we need responsive support, not shame or judgment. Sometimes our pain has a very faint voice, and when it does, this is when we need safe people to hear it. In my observation, unaddressed shame is more commonly associated with suicidal thoughts than depression. Based on my patients’ stories of crisis, shame is often the most dangerous component of mental warfare.”
Stigma is lethal
One of the main reasons mental health experts are so relieved that Markle opened up about her suicidal thoughts is that her admission could save a lot of lives. “Those who suffer from PTSD were once told that it is “all in their head,’” says Dr. Springer. “Now we know that it is literally in their head, and visible on a brain scan. We now understand that trauma causes a biological injury. By changing the way that people view challenges like post-traumatic stress from a mental illness to an injury, we can eliminate mental health stigma. After healing the brain, it becomes so much easier to change the psychological components of trauma. Talk therapy gets real traction when we first help people get calm in their own bodies.” Next up, here are the best mental health podcasts of 2021.
Sources
Dr. Shauna Springer, PhD, a leading expert on psychological traumaJuanita Wells CADC-II, ICADC, Director of Clinical Development at New Method WellnessDr. Indra Cidambi, MD, Psychiatrist and Medical Director of Center for Network TherapyDr. Ziv Cohen, MD, a board-certified clinical and forensic psychiatrist and founder and medical director of Principium Psychiatry
