Suicide Prevention: Bipolar and Suicide

Many with bipolar disorder have suicidal thoughts. If you're in a suicidal depression, here are some suggestions. Also, how to prevent suicide over the long-term.

"Notwithstanding, all we have to live for, the brain in crisis has a perverse way of having us think the very opposite."

Bipolar disorder and depression kill. Simple. Some fifteen percent of us who suffer from major depression will die by our own hand. Many more than that will make the attempt. And many more still will die by "accident" or "slow suicide" through reckless behavior or personal abuse and neglect.

According to the Centers for Disease Control, suicide is the 9th leading cause of death in the US (more than 30,000 a year). Women will make the most attempts, but men will be by far more successful, by a margin of four to one. In teens and young adults, suicide is the 3rd leading cause of death, after accidents and homicides, more than all natural diseases combined.

Suicidal depression does not discriminate. It affects both the strong and the weak, the rich and the poor. War heroes have been taken down. So have survivors of the Nazi death camps. As have successful business people and artists and mothers and those with everything to live for.

We are talking epidemic numbers. At any given moment, five percent of the general population is suffering from a major depressive episode. Over the course of a lifetime, major depression will strike 20% of the population, numbers comparable to cancer and heart disease.

We are talking battlefield odds. Those with major depression have an 85% survival rate, but the prospect of finding ourselves in the lucky majority brings us only small relief. The experience has exposed us to our worst vulnerabilities, and deep inside we no longer trust what tomorrow may bring. We may still be walking and breathing, but we have been as close inside death as this side of life permits, and our minds will never let us forget it.

We ponder the fates of the unlucky minority, and sometimes we say a prayer. We contemplate the tortures their brains exposed them to and know for a fact that no God would ever hold judgment against them. For the time being, we are the lucky ones, but tomorrow that may change.

Still, we do have a certain amount of control in managing tomorrow. We who have survived know what we are up against - and can plan accordingly. Following are some common sense guidelines:

Preventing suicide over the long term:

• Cultivate friends or family members you can call on should you find yourself in crisis. If you have no friends or family you can trust, then seek out a support group, live or online.
• About posting your cry for help on the Internet: choose your site or mailing list very carefully. If you are new and posting to a very busy list, your appeal may be lost in the shuffle. At the opposite end, your message may go completely unread on bulletin boards with little or no traffic. It may take a few weeks before you establish a presence on a particular list or board. By then, you will probably be on email or ICQ terms with some of the members.
• Look up the numbers of various local suicide hotlines and keep them where you can find them. Familiarize yourself with the Internet crisis and suicide sites and bookmark the ones you like.
• Establish a close relationship with your doctor or psychiatrist. Ask yourself: is this someone you can call on in the middle of the night? Or, if not, will someone be there to respond to your call?
• Remove all guns and rifles from your home. According to the Centers for Disease Control, 60% of all suicides are committed with a firearm. This is not an anti-NRA message. We're just being sensible, that's all.
• The same principle that applies to firearms applies in part to medications. The tricyclic and tetracyclic anti-depressants can be fatal in overdose. You may want to switch to a different anti-depressant if you don't trust yourself. If you must keep certain medicines in the house, it may be advisable to turn them over to a loved one.
• Watch your thoughts and feelings very carefully. You may be able to pick up subtle signals in your mind before a full-scale crisis overwhelms you. Actually visualizing the act should set off every warning bell.

In an Actual Crisis:

All too often, a suicidal depression catches us alone and off-guard. Notwithstanding all we have to live for and all those who care for us, the brain in crisis has a perverse way of having us think the very opposite. To those of you who are in this state right now:

• Promise yourself another 24 hours.
• Now call a trusted friend or loved one or a crisis hotline. Remember, there is no shame in reaching out.
• Your other option is calling your psychiatrist or getting yourself to the emergency room.
• Time is of the essence. Do not delay in seeking help.
• Be persistent. Do not be put off by the bad practices of some of the health system's gatekeepers. You are there to get help and you are there to get it NOW.
• Finally, take comfort in the fact that help is on the way. Your brain at the moment may not allow you to think hopeful thoughts. But it cannot keep out the knowledge that others are hoping on your behalf. This may be that precious one inch of life you can hold onto at the moment, the one that can eventually lead you to a tomorrow worth living.

About the author: John McManamy is diagnosed with bipolar disorder. He is an authority on the subject of bipolar having written a book and many articles on the subject. Click the link to purchase his book Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn't Tell You...That You Need to Know.