Following Robin Williams’s tragic death, the media exploded with opinion pieces on why people commit suicide, the stigma that keeps people from talking about it, and what might have driven someone as talented as Mr. Williams to take his own life. I was (and still am) a big admirer of Mr. Williams, and reading about him was painful. I was particularly struck by an incident on the set of “Mork and Mindy” in 1978, where, on a break between takes, Williams saw a rope dangling from the rafters offstage. Jokingly, he pretended to hang himself with it, and announced, “The series is called ‘Mindy,’ now.” I wondered whether suicide is a permanent fixture in the minds of many people, sometimes a whisper and at others times a shout, sometimes a joke and sometimes a serious plan, but always available as a means to escape from intolerable pain, anxiety, and hopelessness.
David J. Miklowitz, Ph.D.
Professor, UCLA School of Medicine and University of Colorado, Boulder
Suicide is the 10th leading cause of death in the United States. Suicide among elderly men (a category which, although hard to believe, included Robin Williams) has always been high, particularly among those who abuse alcohol or other substances. About 20% of us will have a suicide within our family, and 60% will know someone who dies by their own hand. But beyond the epidemiological data are some truisms about the way our society handles people with suicide: few talk about it, and when they do it’s mainly with their therapists or psychiatrists. Friends and family members often fear that bringing up suicide and asking about it is as good as telling the person to do it.
As a friend or family member, what should you do if you learn – either through their behavior or their words- that one of your loved ones feels suicidal? If a therapist is nowhere to be found and you’re the only one there, what do you do? No one answer will fit all of humanity, but here are a few guidelines:
1. Ask the person whether they feel like killing or harming themselves. Being direct is usually better than beating around the bush. You may not get a clear answer but at least it’s now on the table for discussion.
2. Find out how serious the person is. Do they have the means to carry it out (i.e., access to guns, pills, knives, high places, etc.)? Have they chosen a time and a place? The more vague the plans, the lower the threat, but take all plans seriously.
3. If she or he is in psychiatric treatment, notify the doctor. The doctor may not be able to share information with you, but will surely want to know if his or her patient has had an increase in self-destructive thinking. If there is no doctor, consider calling the National Suicide Prevention Lifeline, 1-800-273-TALK.
4. Express your concerns and worries to your loved one in an empathetic, accepting and non-judgmental way. To use a cliché, let them know you are there for them.
5. Remind him or her that suicidal thoughts and feelings – while possibly understandable in the circumstances – are not the only option and will not last forever.
6. Avoid saying overly cheerful or dismissive things like “Oh, things will get better…you’ll find another boyfriend…we all have crosses to bear…we only have one life to live.” It’s better to just listen and paraphrase what the person says they are feeling (e.g., “I know you’re feeling hopeless, and nothing feels like it’s working. Anything I can do to help?”)
7. If you have ways of decreasing access to the means to hurt oneself, make sure to do so. Take away the pills, lock up the guns and ammunition, hide the knives and stray ropes .
At the Sutherland Center, we work with people with bipolar disorder, a mood disorder that increases risk for suicide. We emphasize that it’s not just about keeping the person alive; we strive to help people create a life that they believe is worth living. Sometimes that means helping people remember what already gives their life purpose, such as their kids, parents, pets, job, personal goals, or spiritual or religious beliefs or communities.
Reasons for living and hope for building a better life can become increasingly dim as depression takes over, and the whispers of suicide become louder. When that happens, it nearly always helps to have someone there to keep you company and remind you why you’re still alive.