Chances are at some point in your life, you or someone you know has had thoughts of suicide. Stress financial hardships, chemical imbalances, drug abuse, or just an overall feeling of hopelessness are all suicidal triggers. But, did you know that in combination with drug abuse, a victim of child abuse has an increased risk of suicide?
A lot of times we live in the moment and don’t understand the consequences of what a child endures after the abuse ends. The emotional and mental scars last long after the physical wounds heal. It’s extremely important to fight for the prevention of child abuse, but, we can’t neglect the support needed for the children and adults who have already experienced it. It is a lonely place to be. Lend your support, lend your ear, a hug, whatever means you have and whatever it takes. Be there for someone. Help them get through to a brighter side.
I’m always looking for articles that contain the latest studies and news on child abuse and foster care – especially when it comes to the long term effects. I found one this morning that caught my eye:
Screening for “severe to extreme” abuse in childhood could help public officials and care providers reduce suicides, say researchers
“A five-year study that tracked more than 1,600 drug users found that severe abuse in their childhood—emotional, sexual, and to a lesser extent physical—significantly elevated their risk of attempting suicide.
For health professionals, the message from a new study in the American Journal of Public Health is clear: Asking patients about a history of childhood abuse can directly help assess their risk of attempting suicide. The evidence, authors say, shows that childhood abuse can have life-and-death consequences for the rest of a person’s life.
The longitudinal study of more than 1,600 drug users in Vancouver, Canada, found that “severe-to-extreme” abuse—particularly emotional or sexual—contributed significantly to the risk of future suicide attempts, even after accounting for a wide variety of other suicide-related factors. Less severe abuse, and physical or emotional neglect no matter the degree, did not contribute significantly to suicide risk.
“This study show that all of forms of childhood abuse, be it emotional, physical, or sexual, are important risk factors for suicide to various degrees,” says study lead author Brandon Marshall, assistant professor of epidemiology in the Brown University School of Public Health. Marshall began the work while a doctoral student at University of British Columbia and continued it as a postdoctoral fellow at Columbia University’s Mailman School of Public Health.
“Care providers and health professionals should screen for these types of abuse and intervene whenever they see a situation of severe abuse, regardless of what type it was.”
To assess each subject’s history of childhood abuse and neglect, the researchers used the well-validated Childhood Trauma Questionnaire (CTQ) that produces a distinct score for each of five trauma categories (sexual, physical, and emotional abuse, and physical and emotional neglect). When each participant entered the study, the researchers were able to quantify each participant’s self-reported degree of childhood trauma.
The study was part of two larger National Institute of Drug Abuse-funded studies led by University of British Columbia researchers—the Vancouver Injection Drug Users Study and the AIDS Care Cohort to Evaluate Exposure to Survival Services. Staff including trained nurses followed up with participants every six months during the study period. Among the questions was whether the subject had attempted suicide.
Over the course of the study 80 participants reported 97 suicide attempts. While that may seem like a low number out of more than 1,600 people, it is a rate of suicide attempts about five times greater than in the general population.
“I didn’t think there’d be enough power to show these relationships but there was and I think that demonstrates how detrimental childhood trauma can be,” Marshall says. “We saw extremely strong associations, which suggest that abuse has lasting mental health impacts well into adulthood.”
The researchers accounted in their analysis for many other factors that also predict suicide risk, such as depression, prior suicidal ideation, or homelessness. They made several specific findings specific to abuse and its degree:
- Only “severe-to-extreme” abuse (a CTQ score above 15) resulted in a significantly elevated risk of suicide attempts—2.9 times for emotional abuse, 2.8 times for sexual and 1.6 for physical—compared to “none-to-minimal” abuse.
- Among the 1,634 participants, 23 percent reported suffering “severe-to-extreme” sexual abuse, 25 percent suffered that degree of physical abuse, and 32 percent endured that degree of emotional abuse.
- Nearly 200 participants were “lost to follow-up,” in some cases possibly because of a completed suicide. A statistical method that accounts for participants who dropped out raised the suicide risk from emotional abuse to 3.5 times, and physical abuse to 2.0 times. The risk from sexual abuse dropped slightly in that analysis to 2.5 times.
The best long-term public health strategy to reduce suicides would be to prevent child abuse in the first place, Marshall says, but his hope is that health providers can still make an impact through secondary prevention—identifying victims of such abuse and providing treatment meant to mitigate their elevated suicide risk.
The data also shed light on the resilience of the human spirit and the tragic limits of that resilience.
“There might be a level of resiliency in people who have experienced more minor forms of abuse, but very severe cases were linked with multiple suicide attempts,” Marshall says. “These results will allow us to focus future intervention efforts.”
In addition to Marshall, authors on the paper are Sandro Galea of Columbia University’s Mailman School of Public Health, and Evan Wood and Thomas Kerr of the Urban Health Research Initiative at the British Columbia Centre for Excellence in HIV/AIDS and the University of British Columbia–Vancouver.
The National Institutes of Health, the Michael Smith Foundation for Health Research, and the Canadian Institutes of Health Research supported the study.
If you are feeling suicidal, please know that there are other options. It may not seem like it, but there will be brighter days.
Coping with suicidal thoughts: the first steps
Step #1: Promise not to do anything right now
Even though you’re in a lot of pain right now, give yourself some distance between thoughts and action. Make a promise to yourself: “I will wait 24 hours and won’t do anything drastic during that time.” Or, wait a week.
Thoughts and actions are two different things—your suicidal thoughts do not have to become a reality. There’s is no deadline, no one pushing you to act on these thoughts immediately. Wait. Wait and put some distance between your suicidal thoughts and suicidal action.
Step #2: Avoid drugs and alcohol
Suicidal thoughts can become even stronger if you have taken drugs or alcohol. It is important to not use nonprescription drugs or alcohol when you feel hopeless or are thinking about suicide.
Step #3: Make your home safe
Remove things you could use to hurt yourself, such as pills, knives, razors, or firearms. If you are unable to do so, go to a place where you can feel safe. If you are thinking of taking an overdose, give your medicines to someone who can return them to you one day at a time as you need them.
Step #4: Take hope – people DO get through this
Even people who feel as badly as you are feeling now manage to survive these feelings. Take hope in this. There is a very good chance that you are going to live through these feelings, no matter how much self-loathing, hopelessness, or isolation you are currently experiencing. Just give yourself the time needed and don’t try to go it alone.
Step #5: Don’t keep these suicidal feelings to yourself
Many of us have found that the first step to coping with suicidal thoughts and feelings is to share them with someone we trust. It may be a friend, a therapist, a member of the clergy, a teacher, a family doctor, a coach, or an experienced counselor at the end of a helpline. Find someone you trust and let them know how bad things are. Don’t let fear, shame, or embarrassment prevent you from seeking help. Just talking about how you got to this point in your life can release a lot of the pressure that’s building up and help you find a way to cope.”
Maybe you have a family member or friend you are concerned about. Do you know the signs? Be there for them! Let them know there are other options, that they are loved and supported and that you will help them through this.
Know the warning signs:
|Talking about suicide||Any talk about suicide, dying, or self-harm, such as “I wish I hadn’t been born,” “If I see you again…,” and “I’d be better off dead.”|
|Seeking out lethal means||Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt.|
|Preoccupation with death||Unusual focus on death, dying, or violence. Writing poems or stories about death.|
|No hope for the future||Feelings of helplessness, hopelessness, and being trapped (“There’s no way out”). Belief that things will never get better or change.|
|Self-loathing, self-hatred||Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden (“Everyone would be better off without me”).|
|Getting affairs in order||Making out a will. Giving away prized possessions. Making arrangements for family members.|
|Saying goodbye||Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won’t be seen again.|
|Withdrawing from others||Withdrawing from friends and family. Increasing social isolation. Desire to be left alone.|
|Self-destructive behavior||Increased alcohol or drug use, reckless driving, unsafe sex. Taking unnecessary risks as if they have a “death wish.”|
|Sudden sense of calm||A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to commit suicide.|
If you spot the warning signs of suicide in someone you care about, you may wonder if it’s a good idea to say anything. What if you’re wrong? What if the person gets angry? In such situations, it’s natural to feel uncomfortable or afraid. But anyone who talks about suicide or shows other warning signs needs immediate help—the sooner the better.
Talking to a person about suicide
Talking to a friend or family member about their suicidal thoughts and feelings can be extremely difficult for anyone. But if you’re unsure whether someone is suicidal, the best way to find out is to ask. You can’t make a person suicidal by showing that you care. In fact, giving a suicidal person the opportunity to express his or her feelings can provide relief from loneliness and pent-up negative feelings, and may prevent a suicide attempt.
Ways to start a conversation about suicide:
- I have been feeling concerned about you lately.
- Recently, I have noticed some differences in you and wondered how you are doing.
- I wanted to check in with you because you haven’t seemed yourself lately.
Questions you can ask:
- When did you begin feeling like this?
- Did something happen that made you start feeling this way?
- How can I best support you right now?
- Have you thought about getting help?
What you can say that helps:
- You are not alone in this. I’m here for you.
- You may not believe it now, but the way you’re feeling will change.
- I may not be able to understand exactly how you feel, but I care about you and want to help.
- When you want to give up, tell yourself you will hold off for just one more day, hour, minute — whatever you can manage.
- Be yourself. Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it.
- Listen. Let the suicidal person unload despair, ventilate anger. No matter how negative the conversation seems, the fact that it exists is a positive sign.
- Be sympathetic, non-judgmental, patient, calm, accepting. Your friend or family member is doing the right thing by talking about his/her feelings.
- Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important to you.
- If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head, you are showing that you are concerned, that you take them seriously, and that it’s OK for them to share their pain with you.
- Argue with the suicidal person. Avoid saying things like: “You have so much to live for,” “Your suicide will hurt your family,” or “Look on the bright side.”
- Act shocked, lecture on the value of life, or say that suicide is wrong.
- Promise confidentiality. Refuse to be sworn to secrecy. A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe. If you promise to keep your discussions secret, you may have to break your word.
- Offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your friend or loved one.
- Blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness, or lack thereof, is not your responsibility.
Adapted from: Metanoia.org
If a friend or family member tells you that he or she is thinking about death or suicide, it’s important to evaluate the immediate danger the person is in. Those at the highest risk for committing suicide in the near future have a specific suicide PLAN, the MEANS to carry out the plan, a TIME SET for doing it, and an INTENTION to do it.
Suicide prevention tip #3: Offer help and support
If a friend or family member is suicidal, the best way to help is by offering an empathetic, listening ear. Let your loved one know that he or she is not alone and that you care. Don’t take responsibility, however, for making your loved one well. You can offer support, but you can’t get better for a suicidal person. He or she has to make a personal commitment to recovery.
It takes a lot of courage to help someone who is suicidal. Witnessing a loved one dealing with thoughts about ending his or her own life can stir up many difficult emotions. As you’re helping a suicidal person, don’t forget to take care of yourself. Find someone that you trust—a friend, family member, clergyman, or counselor—to talk to about your feelings and get support of your own.
Helping a suicidal person:
- Get professional help. Do everything in your power to get a suicidal person the help he or she needs. Call a crisis line for advice and referrals. Encourage the person to see a mental health professional, help locate a treatment facility, or take them to a doctor’s appointment.
- Follow-up on treatment. If the doctor prescribes medication, make sure your friend or loved one takes it as directed. Be aware of possible side effects and be sure to notify the physician if the person seems to be getting worse. It often takes time and persistence to find the medication or therapy that’s right for a particular person.
- Be proactive. Those contemplating suicide often don’t believe they can be helped, so you may have to be more proactive at offering assistance. Saying, “Call me if you need anything” is too vague. Don’t wait for the person to call you or even to return your calls. Drop by, call again, invite the person out.
- Encourage positive lifestyle changes, such as a healthy diet, plenty of sleep, and getting out in the sun or into nature for at least 30 minutes each day. Exercise is also extremely important as it releases endorphins, relieves stress, and promotes emotional well-being.
- Make a safety plan. Help the person develop a set of steps he or she promises to follow during a suicidal crisis. It should identify any triggers that may lead to a suicidal crisis, such as an anniversary of a loss, alcohol, or stress from relationships. Also include contact numbers for the person’s doctor or therapist, as well as friends and family members who will help in an emergency.
- Remove potential means of suicide, such as pills, knives, razors, or firearms. If the person is likely to take an overdose, keep medications locked away or give out only as the person needs them.
- Continue your support over the long haul. Even after the immediate suicidal crisis has passed, stay in touch with the person, periodically checking in or dropping by. Your support is vital to ensure your friend or loved one remains on the recovery track.
For more information or suicide, its risk factors and prevention, please visit, HelpGuide.org
Thoughts, comments, questions? Please email me, Jennkaysen@gmail.com
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