Suicide: A Permanent Solution To A Temporary Problem
By Stephen K. Peeples
An older local doctor killed himself in a murder-suicide in Bridgeport in August. A middle-aged man hung himself at home in Santa Clarita in September. A man of undetermined age was found dead in his car on the remote Ridge Route in October, and officials ruled it a suicide. There were nearly 20 other deaths by suicide in 2011, according to the Santa Clarita Valley Sheriff's Station.
This year, a local teen tried to take her own life in Saugus in March, but was stopped in time, and got help.
And although Bob Wachsmuth of the Juvenile Intervention Team at the SCV Sheriff's Station has seen no teen suicides this year, he counts four local young men ranging in age from 23 to 40 who have died by suicide so far in 2012. "All were addicted to drugs," he said.
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"They didn't see any other way out of their substance abuse problems," said Cary Quashen, who was acquainted with two of the four in his role as founder/CEO of the ACTION Family Counseling drug and alcohol rehab centers in the Santa Clarita Valley.
"People don't kill themselves or try to because they really want to die, they just want to stop the pain they've been suffering," he said. "They feel that everything around them is falling apart. Emotionally, spiritually, physically, you name it — and they just see no way out."
Quashen is also an expert on suicide and its prevention, both for ACTION and as the executive director of the Behavioral Health Unit at Henry Mayo Newhall Memorial Hospital, which is a 23-bed acute psychiatric facility open 24 hours a day, seven days a week to anyone who is feeling suicidal, for whatever reason. And it's confidential.
More Than Drugs and Alcohol
Drug and/or alcohol addiction are far from the only problems that some people find overwhelming or insurmountable, to the point of "ideation" (what suicide prevention experts call thinking about or even planning suicide), or actually acting upon such thoughts. And the reasons people want to take their own lives tend to vary with age.
For young people, they include problems with boyfriends or girlfriends, with parents, and school (from grades to bullying). Among adults, it might be the breakup of a marriage, the death of a loved one, financial problems, the loss of a job and/or a home. For older adults, it can be loneliness or a debilitating or terminal physical illness. Mental illness including schizophrenia and bipolar and anxiety disorders may also contribute to suicidal tendencies in any age group.
Crises like those can spiral into the kind of deep depression mental health experts say is the most common factor leading to suicidal thoughts or actions.
"When it comes to adolescents, we know the brain isn't even completely developed till the mid-20s," Quashen said. "And the part of the brain that's not developed is the frontal lobe, which helps you make your decisions and rationalize. So when kids are going through anything (emotional) — we've had 13-, 14-year-old girls and boys who just don't know how to cope with a relationship issue, and they get so overwhelmed and depressed that they think about suicide. We've had many that made attempts. Fortunately, we've saved many of them, but here and there we lose them, which is tragic."
Depression and Suicide in the Santa Clarita Valley
Not surprisingly, depression plays a significant role in many local suicides.
Lt. Mark Hershey of the SCV Sheriff's Station has tracked local suicide reports since his assignment to the station in 2008, and has compiled information going back to 2007. He said there were 21 SCV residents who took their own lives in 2007, 19 in 2008, 27 in 2009, 24 in 2010 and 21 last year.
"We have about two a month in the Santa Clarita Valley," Hershey said. "That's very high, to me, and very sad. Some of them I understand, some I don't."
Hershey said he's read every report of suicide since he's worked in the SCV, and sees three basic groups of issues.
"One, they're depressed. They might have a psychological issue or money problem or something like that," he said. "Another is really bad health, usually terminal illness or some really bad injury they've been fighting a really long time and they're ready to give up. And the last reason is relationships or divorces or break-ups. The bad health thing is usually older people, and the kids are much more swayed by relationship break-ups, growing up or trying to get a job or whatever. And their access to the drugs that are out here makes it one step easier to suicide."
The Larger Picture, Age and Gender
On a national scale, more than 36,000 people die by suicide each year, according to the National Center for Health Statistics for the year 2009 (the latest available data). Suicide is the fourth leading cause of death for adults ages 18-65, the third among young people 15-24, and the 10th in the overall population.
The same stats show more than 60 percent of those 36,000-plus people suffered from major depression, which affects nearly 10 percent of Americans 18 years or older, or more than 24 million people.
More than 30 percent of patients suffering from major depression report having suicidal thoughts, and an estimated 11 nonfatal suicide attempts occur per suicide death. That's almost a million each year trying to kill themselves.
While the National Center for Health Statistics data showed teen suicides spiked in the '70s, they generally leveled off in the '80s and early '90s, and have steadily decreased since then.
Meanwhile, the National Institute of Mental Health reported that adult suicides have increased, and older Americans are disproportionately likely to die by suicide. In 2007, of every 100,000 people 65 and older, 14.3 died by suicide, higher than the national average of 11.3.
"Adult suicide is actually higher than adolescents, which is pretty frightening," said Quashen, who recently devoted an episode of his weekly "Families in Action" radio program on AM 1220 KHTS to the topic.
"Getting old is hard enough, and a big piece of getting old is the loneliness that comes with it," he said. "We also don't want to burden people around us. We really need to not isolate (ourselves) as we get older, just as when we're younger. We need to involve our children, and not worry about inconveniencing people. We have loved ones — we need to talk to them."
By gender, women suffer from depression twice as much as men, and the ratio of suicides is almost four men to every woman — 79 percent to 21 percent — according to the latest (2009) figures from the Centers for Disease Control.
About the gender gap, Hershey said, speaking as a guy, not a cop, "It's my opinion that women have a better support system. Guys usually don't want to talk about their feelings to other guys or to whoever, and they can't get it out. They can't get that support. And if someone's around, and someone's listening to them, (men) don't really have the opportunity. I think women can talk to their women friends and other people, and they're a little bit more open to counseling and putting their feelings out like that."
Signs and Clues of Depression
The good news about depression is that it's among the most treatable of psychiatric illnesses, according to the American Foundation for Suicide Prevention. Between 80 and 90 percent of people with depression respond positively to treatment, and almost all patients gain some relief from their symptoms.
But first, depression has to be recognized, and as early as possible, by parents, family members, friends, teachers, doctors, and not ignored, or brushed off as "kid's stuff." Then there needs to be intervention and treatment.
What to look for? The Suicide Prevention Foundation defines clinical depression as a condition present if at least five or more of the following symptoms exist during a two-week period; at least one of the symptoms must be depressed mood or loss of interest or pleasure in usual activities:
- Depressed mood;
- Loss of interest or pleasure in usual activities;
- Change in appetite or weight;
- Change in sleeping patterns;
- Speaking and/or moving with unusual speed or slowness;
- Decrease in sexual drive;
- Fatigue or loss of energy;
- Feelings of worthlessness, self-reproach or guilt;
- Diminished ability to think or concentrate, slowed thinking or indecisiveness;
- Thoughts of death, suicide or wishes to be dead.
The Foundation lists more factors that point to an increased risk of suicide in people who are depressed:
- Anxiety, agitation or enraged behavior;
- Drug and/or alcohol use or abuse;
- History of physical or emotional illness;
- Feelings of hopelessness or desperation.
"The major sign or symptom is when somebody says to us, 'I feel suicidal,'" Quashen said, speaking primarily about the teens and young adults he encounters, but generally, as well. "'I don't feel like living,' 'Life's not worth it,' 'You'd be better off without me' — those are serious statements we need to pay attention to.
"I hear from parents a lot of times that it's a manipulation," he said. "Manipulation or not, when somebody states that, we need to run with that. I've seen many kids say it as a manipulation, and in my 30 years of doing this, follow through. So when somebody says anything like that, pay attention to it, get them to a professional immediately. Take them Henry Mayo's Behavioral Health Unit, call our 800 number, call 911, but do something. Do not leave that person alone.
"When they're starting to cut on themselves or burn themselves, that is a clear cry for help," he said. "Adolescents, especially, sometimes don't know how to say. 'Hey, Mom, hey, Dad, I'm hurting.' So, they act it out. They ditch school, start drinking, use drugs, throw temper tantrums, get violent, punch holes in walls, disappear for a day or two."
Quashen noted other less obvious signs of impending crisis parents should watch for. "Pay attention to when our kids start isolating. When they lock themselves in their bedroom, and don't want to be part of what's going on at home. When grades start dropping. When they're not social anymore, their eating habits change and they're not eating. Or they're sleeping too much.
Quashen also suggested parents and teachers watch out for signs in stories and poetry young may write for themselves or share with friends, or even for school.
"If it's dark and gloomy and talking about death and dying, that's something else we really need to pay attention to," he said.
"For any of those signs, you really need to get professional help immediately," Quashen said.
Listen, Talk, Help, Not Hassle
But according to the Suicide Prevention Foundation, only one in three depressed people in all age groups actually does get help, which as Quashen noted is readily available in our community. The other two-thirds continue to suffer.
So how do we help our loved ones when they feel suicidal, or act out or otherwise display signs they want to hurt themselves, or try to hide their deep depression by maintaining a pleasant facade?
Start by listening, and not saying something judgmental or insensitive, like, "Snap out of it," or, "Whaddayou, crazy?"
"'Hey, get over it! Life's not that bad!'' is not the right thing to say," Quashen said. "It's, 'Hey, let's deal with this, take care of business, let's get some help.' That's the right thing to say. Then you do it."
"I have a student right now who's very depressed and comes in on a weekly basis talking about suicide," said Kim Goldman, executive director of the SCV Youth Project, and like Quashen works closely with at-risk youth every day. "And I want to shake her and say, 'It's not that bad!'
"But the truth is, it's not my place to determine whether it's that bad or not," Goldman said. "My job is to give her better coping (skills), to give her better balance to communicate with her parents, to make sure she is in a safe environment, that she doesn't have things at her fingertips that could harm her. It's so sad, and a lot of people don't talk about it. A lot of people don't know about it."
Suicide Less a Taboo Topic
That's because suicide has long been a taboo topic in our society. And for the survivors, there's been a lot of emotional pain, shame and guilt associated with a loved one's suicide. But In recent years, taking one's own life, or wanting to, or attempting to, has become recognized and treated more as a mental and/or public health issue, with the confidentiality afforded to doctor-client privilege, and not necessarily a law enforcement issue (unless perhaps the death happened in public or others' safety was at risk). So public dialog about and sensitivity to suicide has slowly increased as stigma has decreased.
Recent high-profile suicides of public figures like "Soul Train" creator and entrepreneur Don Cornelius and former pro football star Junior Seau have been treated with relative sensitivity by their fans, the general public, and the media.
There's an increasing understanding and compassion for loved ones left behind, that for them, suicide is not painless (apologies to "M*A*S*H" themes song composer Johnny Mandel).
"Imagine the pain that family's going through," Quashen said. "People grieve in different ways, and it takes time for them to do whatever it is that they need to do. But for some people, it takes longer to talk about it, and for some people, they go on a mission right away and want to help. Either way, there's no wrong way to deal with it."
"The people who are left behind often don't know how to process it, so, they just don't," Goldman said. "It's hard. One of my board members — her son committed suicide about 10 years ago, and it took her about three years to finally admit to anybody that it happened. She didn't want to talk about it. She was embarrassed, ashamed, just grief-stricken, until she got involved with the Youth Project and saw how many other kids were affected and were contemplating (suicide). She is (now) far more outspoken about it, and her family speaks out about it because of the devastation that it leaves behind."
"I think the more we talk when we have problems, the more relief we get," Quashen said. "If somebody in our house or somebody is depressed or suicidal, the first thing we don't want to do is not talk about it. We definitely want to approach that person and find out what's going on and get them professional help. What we don't want to do is hide our heads in the sand. If something's going on, we need to pay attention to it and deal with it."
That Permanent Solution is Not the Answer
"In life, we all get hit with all kinds of stuff," he said, "and sometimes it feels like it's overwhelming and will never get better, but that's simply not true. We can deal with anything if we're willing to go through the pain, but we can deal with nothing if we're dying."
As poet Robert Frost wrote, "The best way out of a problem is through it."
Or as musician George Harrison sang, "All things must pass."
"So unless we're talking about terminal illness, suicide is a permanent solution to a temporary problem," Quashen said. "It's not the only option. There's always somebody here in this valley who can help."
Here are some key resources for help and further information. (LINKS TO BE ADDED)
Resources — Santa Clarita Valley:
ACTION Family Counseling
Henry Mayo Newhall Memorial Hospital
SCV Youth Project
SCV Child & Family Center
Resources — L.A. County
The County Department of Mental Health is part of the countywide, multi-agency Partners in Suicide Prevention (PSP) Network that includes the Los Angeles County Office of Education, Los Angeles County Department of Public Health, Los Angeles Unified School District and the Didi Hirsch Suicide Prevention Center, among others. The PSP Network's mission is to promote public and professional awareness, education, training and engagement regarding suicide and suicide prevention, intervention and post-vention in L.A. County.
In September, the county held a Suicide Prevention Summit of experts from mental health, hospitals, education, police and fire as well as advocates, providers, researchers and survivors to collaborate and chart a comprehensive strategy for suicide prevention during the next decade.
Resources — National
National Suicide Prevention Lifeline: 800-273-TALK (8255)
National Center for Health Statistics
American Foundation for Suicide Prevention