10 Things To Know From Those Who Have Attempted Suicide

Suicide is one of the most common causes of death among Americans. To foster greater empathy and understanding for what someone who is suicidal may be going through, it's helpful to turn to suicide attempt survivors—people who attempted suicide but did not die.

Health spoke with three individuals who engaged in a suicide attempt. Here's what they wanted others—living with suicidal thoughts or not—to know.

You Can—and Should—Ask Someone Who Could Be Suicidal How They're Feeling

Barb Gay, former executive director of the Area Substance Abuse Council, Inc., a nonprofit substance abuse prevention and treatment agency in Cedar Rapids, Iowa, didn't tell anyone for years that she had attempted suicide.

"Part of it for me was I grew up in a home where we had a lot of secrets," said Gay, including physical and verbal abuse at the hands of her father. "We weren't supposed to be talking about what was happening at home, that was sort of a known fact."

Looking back, Gay could see that some of her behaviors and actions were attempts to break down the walls of staying silent. "I was reaching out to someone to help me. I wanted someone to say, 'Why are you doing that? What's going on?'"

Don't Be Afraid To Say the Word "Suicide"

It's okay to talk openly and directly about suicide. "A lot of people avoid the actual word," noted Diana Cortez Yanez, a lived experience consultant and peer support specialist with the Zero Suicide Institute. "In many cases, they're afraid they'll trigger something and maybe even make it so an attempt survivor would feel like doing it again."

In Cortez Yanez's opinion, this has been the biggest misconception about suicide. There's no evidence that talking about suicide gives someone the idea to end their life.

Talking about suicide can open paths of communication that a vulnerable person was looking for. "I'm not saying it's not a hard subject to bring up, but if we don't speak about it, that's where the scary part is," said Cortez Yanez. "It was a relief for me when people would bring it up. It gave me permission to open up."

Cortez Yanez added that avoiding the word can make it seem like you're pretending nothing happened, which amounts to a growing elephant in the room. Instead, "say something with love and concern, and try not to assume anything," said Cortez Yanez.

It's Okay If You Don't Know What To Say

Clifford Bauman, a chief warrant officer 4 in the U.S. Army National Guard and an Iraq War veteran who assisted in recovery efforts at the Pentagon on September 11, started speaking publicly about his 2012 suicide attempt.

Bauman noticed that some people treated him differently almost immediately. "People who saw me just the day before? Now they don't know how to talk to me," recalled Bauman. "That can create its own stress."

In many instances, it's simpler than you might think to get help for someone who is having suicidal thoughts. It can be as straightforward as offering to call a crisis center or hotline together. The people answering will likely be able to walk you through additional steps you can take to assist the vulnerable person, added Gay.

It's also fine to come right out and say you're unsure how to handle the situation. "People don't want to say the wrong thing," said Cortez Yanez. "You could say, 'I don't know what to say, and I'm afraid, but I do care about you.'"

Rather than trying to find perfect solutions, just be attentive. "Offer the basic compassion and listening that many of us do every day anyway," said Gay.

Talking Openly About a Suicide Attempt Can Jeopardize the Person's Career

Gay, who is also a member of the Suicide Attempt Survivor Task Force of the National Action Alliance for Suicide Prevention, remembered worrying about her career before revealing her suicide attempt publicly for the first time.

"I thought that it was something [that] if I shared with others, it would jeopardize my abilities," said Gay. "Are folks going to look at me, like, 'Really? That's the person we've got making decisions, and she already has struggles in her life?'"

In the military, people dealing with suicidal thoughts have often worried that seeking help would let their teams down or result in losing their security clearance, said Bauman. "I have maintained my clearance to this day, but those are stigmas that are tough to break," added Bauman.

Bauman said his suicide attempt and consequent treatment probably delayed a promotion by about a year—but he wasn't in a place to be promoted anyway.

"I was so messed up, I probably wouldn't have gotten promoted either had I not gone to get help," explained Bauman. Ultimately, counseling made him a stronger soldier and man: "It may take a little while to become successful, but you need to get yourself right [first]," said Bauman.

Mental Health and Careers

People feel their jobs may be at risk due to an attempted suicide for many reasons. However, individuals with mental health conditions have protections and rights in the workplace, including:

• Protection against discrimination and harassment as a result of their condition
• Privacy rights about their condition
• Legal rights to get reasonable accommodations for performing and retaining their job

Additionally, an employer cannot fire you, force you to take leave, or reject you for a job or promotion just because you have a mental health condition. You can only be refused or removed from a job if you objectively cannot perform the job's tasks or would be deemed a safety risk.

An employer must also keep your condition confidential if you disclose it. You can share your condition on your own with coworkers. However, you may need to share it if you want to use leave under the Family and Medical Leave Act (FMLA).

You can request reasonable accommodations, which are alternative ways of doing your job, in writing if it may help you work through your condition. You could also be eligible for leave under the FMLA if you cannot do your job with reasonable accommodation.

Suicidal Thoughts Aren't Necessarily About a Desire To Die

There are several warning signs that a person may be at risk of suicide, such as:

• Changing eating and sleeping patterns
• Engaging in risky behavior that could lead to death
• Having extreme mood swings or feelings related to anxiety or rage
• Saying goodbye to and withdrawing from friends and family
• Self-indicating that they are a burden
• Talking about, making plans, or looking for ways to attempt suicide

Other warning signs of an increased risk of suicide include talking about hopelessness, feeling trapped, or being in unbearable pain.

Thinking of Suicide May Not Be About Death

All three individuals who spoke with Health expressed different variations of a common theme: Their suicide attempts weren't as much about a desire to die as they were about making a particular kind of pain stop.

Bauman was overwhelmed with stress. During his suicide attempt, Bauman remembered feeling at peace for the first time in a year. "I didn't have to worry about the stress of what I was going through, the stress of what was going on at work, the stress of my family trying to figure out what was going on with me that I couldn't tell them."

Gay's intention was to live pain-free. "My experience wasn't necessarily that I wanted to die, I just didn't want to continue living with the amount of pain I was living with, especially because it was pain nobody could see," said Gay. "You start feeling…like there's no other [option]."

Cortez Yanez added a similar thought: "I didn't want to die, I actually wanted to live, but not with the same pain I was going through. That made suicide an option for me."

Suicidal Thoughts Are Isolating—But Feeling Connected Helps

One report found that 1.4 million adults had attempted suicide in the previous year. The same report also indicated an average of 10.6 million American adults had suicidal thoughts.

However, when Cortez Yanez first began having thoughts of suicide, she didn't realize other people had them too. "I thought I was the only person who was suicidal. I didn't hear a lot about it because of my religion and Hispanic culture."

Once a person begins to feel like there's no other option but suicide, this thinking pattern can start to feel like "tunnel vision," said Gay. "You don't see the opportunities as clearly when you're blinded by that kind of pain." Cortez Yanez agreed: "You're seeing through suicide-colored glasses."

How Connection Can Help

Sometimes all it takes to escape the tunnel or ditch the glasses—at least temporarily—is connection. A big component of supporting someone who has attempted suicide is ensuring that they feel heard and their feelings are validated.

You can take time to express sympathy for the person's situation without trying to find solutions to their problems. This can happen when, instead hearing the person talk, you're actively listening to them. Active listening entails:

• Acknowledging the speaker
• Keeping eye contact
• Maintaining good posture
• Responding verbally by asking questions or making clarifying statements
• Staying focused
• Summarizing what you hear
  

Additionally, speaking with someone can also be enough of a distraction that a moment of suicidal crisis can pass, said Cortez Yanez.

Connection helps in the moment, even if a person continues to be suicidal afterward, and it may be the bridge to getting help. Plus, social support—in the form of feeling like others are available to help them—has been shown to be a protective factor in preventing suicide.

"Even if you don't think so, there's somebody out there who cares about you," Bauman wanted anyone feeling suicidal and isolated to know. "Let them get the chance to tell you."

Sharing Stories of Recovery Can Save Lives

Attempting suicide felt like a "shameful, dark secret" for Cortez Yanez for a long time, but she said the chance to reach others with her experience changed her perspective.

"I found out I could help others to not only talk about their experience but hopefully not have an attempt and maybe even save a life," explained Cortez Yanez. "That was worth any shame or embarrassment."

Speaking openly about her five suicide attempts became Cortez Yanez's passion. "My going out there publicly and saying I've attempted suicide and survived [showed that] I am living proof that things can be different," added Cortez Yanez.

Like Cortez Yanez, some people with suicidal thoughts may have never encountered others who experience the same thing. Hearing from people who attempted suicide puts other faces to those thoughts.

How Sharing Stories Affected Others

"When you start sharing those stories, it helps people realize it's an experience that many people have, that you're not some odd person experiencing something others haven't," said Gay. "This is a human condition because other people have it, and it's a survivable condition, something that many people get through. That gives you that hope for surviving as well."

The day Gay shared her story with her oldest son, they were in the car together running errands.

"He was talking about something he had learned at school and said, 'Can you believe things like this really happen, Mom? I feel sad for people who aren't a happy family like us.' He opened the door for me to say, 'Not all happy people are always happy.'" After giving him the "parental-edited" version of her life's events, he said, "I didn't know it happened to real people—then people can be okay!" recalled Gay.

That hope is crucial, said Cortez Yanez. "Hope is the actual solution to suicide. When you're suicidal, you've lost all hope."

There Is No One Type of Suicidal Person

Suicide can affect anyone of any age, gender, ethnicity, or socioeconomic status. In the wake of celebrity suicides like the deaths of Kate Spade and Anthony Bourdain, Cortez Yanez saw many people react with shock and surprise.

"It's a misconception that it can't touch certain people with all this money, or a goal to live for, or children. People feel that you're missing something, and that's why you're suicidal. But as we can see in [celebrity] cases, it's more internal, and that's your reality, whether or not other people think that's serious enough to want to die," said Cortez Yanez.

That's part of what drove Bauman to speak publicly about his suicide attempt: He was the first active-duty military officer to do so. "I choose to go out and speak about my suicide attempt not to say I'm unique, but because this could happen to anybody in the audience."

You can watch a video Bauman made with the Department of Veterans Affairs on the topic.

What Are the Risk Factors for Suicide?

There are many risk factors for suicide, including:

• Chronic pain
• Direct or indirect exposure to others' suicidal behavior
  
• Exposure to family violence, including physical or sexual abuse
• Family history of a mental disorder, substance use, or suicide
• Mental disorders, including depression or substance use disorder
• Personal history of substance use and suicide attempts
• Presence of firearms in the home
• Recent release from jail or prison
• Social isolation

Even if someone has risk factors, that does not mean they will attempt suicide. What's more, it's not always easy to determine who will act on suicidal thoughts.

What Are the Protective Factors?

There are a number of protective factors for suicide, including:

• Personal factors: Ability to cope and problem-solve effectively, possession of reasons for living, and strong cultural identity
• Relationship factors: Support from and connections with individuals close to you
• Community factors: Connections at larger levels (e.g., at school, in the community) and consistent, high-quality healthcare
• Societal factors: Decreased lethal means access for individuals at risk for suicide and society-based objections to suicide through culture, religion, or morals
  

Different People Benefit From Different Treatment

For people at risk for suicide or who have had suicidal thoughts, various effective and evidence-based treatment options are available.

• Brief interventions: These are actions like safety plans for reducing suicidal thoughts and behaviors and follow-up phone calls for support.
• Collaborative care: This is team-based mental healthcare that may include behavioral healthcare management, a primary care provider, and mental health specialists.
• Mediations: Individuals and healthcare providers collaborate to determine what medication or medications will be most helpful for a treatment plan.
• Psychotherapies: Talk therapies like cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) can be helpful for individuals who have attempted suicide.

The coping skills she learned in DBT especially have helped her recover, believed Cortez Yanez, adding that her volunteer work in the suicide prevention community, a balanced diet, and antidepressants played important roles in her ongoing wellness.

Gay said she hoped that one day, people would be able to casually mention they're off to see a therapist in the same way they mention going to the dentist.

In the meantime, anyone can check their reaction to hearing about therapy, medications, or other mental health treatment and work on being more accepting of that part of someone's life.

Engaging in Self-Care

Swimming, eating well, and taking time for herself helped Gay with her mental well-being. Also, Gay would listen to positive and uplifting songs when she needed a mood boost and sought out caring family and friends when she needed to talk.

Bauman, who was diagnosed with PTSD after his suicide attempt, said it was all about finding balance. "I tell people they need to find activities they enjoy with others and themselves."

Bauman would go on short runs with his older son but reserved his long runs for solo outings, for example. "PTSD really doesn't go away; you have to learn to deal with your triggers."

Even if a Person Is No Longer Suicidal, Bad Days Still Happen

As with a physical condition like heart disease or diabetes, people who have attempted suicide may need continued care. "It's not like I'm a survivor and everything is perfect," said Gay. "It's ongoing, it's forever, you do what you need to be well, and you always have to check in on it."

Cortez Yanez said she was considering checking in professionally again. "I'm thinking about seeing a therapist for a 'touch up' because my life is so different now. There are a lot of things in my life now that I didn't have for so long when I was suicidal, like working full time."

Sometimes after several suicide prevention speaking events, Bauman said he'd find himself reliving traumatic events in his mind. In 2013, after a photo shoot involving the hats, boots, and gloves he wore on 9/11, for example, he went back to counseling. "I see a therapist when it starts to wear on me," said Bauman. "You have to be in a good place just to speak about your experience."

Even if a person is no longer feeling suicidal, there are some lasting effects—especially from emotional, physical, and economic standpoints.

"Living as someone who has attempted suicide means that I'm someone who is more likely to have recurrent issues or to die by suicide," added Gay. "It's not unlike knowing your genetic makeup; you have to know your past to really be in control of what your future will be like."

A Quick Review

Suicide attempt survivors want others to know that suicidal ideation can affect anyone. Everyone who attempts suicide is different, and bad days still happen for those individuals. Still, it's okay to talk about suicide, offer support with active listening and building connections, and share stories of recovery from a suicide attempt.