We Need to Talk About Suicide

If you’ve been following the news in the United States, you probably heard about the high-profile suicides of Kate Spade and Anthony Bourdain in June 2018. Less widely publicized, however, was the suicide of Honduran asylum seeker Marco Antonio Muñoz, who took his own life on May 13, 2018 in a holding cell after Donald Trump’s “zero tolerance” policy separated him from his wife, Orlanda de Muñoz, and their 3-year-old son. Muñoz and his family were seeking asylum because, after de Muñoz’s brother was murdered, they feared for their own lives.^[1] Spade and Bourdain’s deaths prompted a lot of conversations about suicide; Muñoz’s did not. But Muñoz’s death brings attention to the relationship between trauma and suicide that we don’t discuss frequently enough.

We need to talk about suicide, and we need to talk about it differently than we often do.

Suicide rates in the U.S. have been rising since 1999 and accelerating since 2006.^[2] Utah has the fifth highest suicide rate in the nation, 46.5% higher in 2014 than it was in 1999.^[3] In 2016, there were more than twice as many suicides as homicides; it is the 10th most common cause of death in the U.S. and second most common among people aged 15 to 34. Rising rates of suicide in the U.S. ask us to build resilience to the traumas experienced by people in our own communities. Our efforts should, in the long run, seek to eliminate the sources of trauma through political and community action. In the short run, we can work to provide resources and support for people experiencing trauma.

Is trauma related to suicide?

Researchers have connected psychological trauma with suicide.^[4] Though it remains unclear whether trauma causes suicide,^[5] study^[6] after^[7] study^[8] finds that experiencing trauma increases risk of suicide. On the other hand, building resilience to trauma reduces risk of suicide.^[9] 

What causes trauma?

Trauma is the experience of distress that overwhelms our ability to cope. Trauma used to be narrowly defined; for a long time, people believed that trauma was caused only by particular catastrophes such as:

• Rape and sexual assault
• Violent crime, including witnessing such crimes
• Natural disaster
• War
• Child abuse and neglect
• Illness or injury

However, there are many possible causes of trauma, including:

• Racism^[10] 
• Homelessness
• Colonization^[11]
• Transphobia and homophobia^[12]
• Incarceration^[13]

By expanding our understanding of trauma itself, we can better understand the breadth of the problem and the number of people affected who need to heal.

What are the warning signs of suicide?

A common misconception of suicide is that it is unpredictable. In fact, there are many identifiable warning signs, such as the 12 warning signs listed below, that can help us to better determine who needs additional support. Even though knowing the warning signs empowers us to help our loved ones and the people around us, it is important to keep in mind that we can’t always prevent suicides.

1. Feeling like a burden
2. Being isolated
3. Increased anxiety
4. Feeling trapped or in unbearable pain
5. Increased substance use
6. Looking for a way to access lethal means
7. Increased anger or rage
8. Extreme mood swings
9. Expressing hopelessness
10. Sleeping too little or too much
11. Talking or posting about wanting to die
12. Making plans for suicide^[14]

If you recognize these signs in yourself or someone you know, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

Chat at www.suicidepreventionlifeline.org

How can we prevent suicide?

The CDC recommends five steps^[15]:

1. Ask
2. Keep them safe
3. Be there
4. Help them connect
5. Follow up

The best way to prevent post-traumatic suicides would be to eliminate the phenomena that cause the trauma in the first place. Our shared effort to prevent rape, to fight racism, and to stop child abuse, for instance, is an important part of creating a world where people do not experience “slow death—the debilitating ongoing-ness of structural inequality and suffering.”^[16] As Jasbir Puar says, we must “ask what kinds of ‘slow deaths’ have been ongoing that a suicide might represent an escape from.”^[17] In the meantime, we can practice self-care [link] and heal [link] after trauma to build our own resilient hope.

Written by Kristen Cardon

References

Alessi, Edward J. and James I. Martin. “Intersection of Trauma and Identity.” In Trauma, Resilience and Health Promotion in LGBT Patience, edited by Kristen L. Eckstrand and Jennifer Potter, 3-14. Springer, 2017.

Bahk, Yong-Chun et al. “The Relationship between Childhood Trauma and Suicidal Ideation: Role of Maltreatment and Potential Mediators.” Psychiatry Investigation 14, no. 1 (2017): 37-43. doi: 10.4306/pi.2017.14.1.37.

Boscarino, Joseph A. “External-cause mortality after psychologic trauma: the effects of stress exposure and predisposition.” Comprehensive Psychiatry 47, no. 6 (2006): 503-14. https://doi.org/10.1016/j.comppsych.2006.02.006.

Briggs, Stephen et al. “Suicide and trauma: A case discussion.” Psychoanalytic Psychotherapy 26, no. 1 (2012): 13-33. https://doi.org/10.1080/02668734.2011.652657.

Curtin, Sally C., Margaret Warner, and Holly Hedegaard. “Increase in Suicide in the United States, 1999-2014.” Centers for Disease Control and Prevention, April 2016. https://www.cdc.gov/nchs/products/databriefs/db241.htm.

—. “Suicide Rates for Females and Males by Race and Ethnicity: United States, 1999 and 2014.” Centers for Disease Control and Prevention, April 22, 2016. https://www.cdc.gov/nchs/data/hestat/suicide/rates_1999_2014.htm

DeVeaux, Mika’il. “The Trauma of the Incarceration Experience.” Harvard Civil Rights-Civil Liberties Law Review 48, no. 1 (2013): 257-77. http://harvardcrcl.org/wp-content/uploads/2013/04/DeVeaux_257-277.pdf.

Linklater, Renee. Decolonizing Trauma Work: Indigenous Stories and Strategies. Fernwood, 2014.

Miroff, Nick. “A family was separated at the border, and this distraught father took his own life.” The Washington Post, June 9, 2018. https://www.washingtonpost.com/world/national-security/a-family-was-separated-at-the-border-and-this-distraught-father-took-his-own-life/2018/06/08/24e40b70-6b5d-11e8-9e38-24e693b38637_story.html?noredirect=on&utm_term=.7d6a5a74df3d.

—. “Honduran father who died in Texas jail was fleeing violence, consul says.” The Washington Post, June 11, 2018. https://www.washingtonpost.com/world/national-security/honduran-father-who-died-in-texas-jail-was-fleeing-violence-consul-says/2018/06/11/89c3c2ac-6daa-11e8-bd50-b80389a4e569_story.html?utm_term=.268fa92234dc.

Nutt, Amy Ellis. “Utah’s suicide rate has shot up 46.5% since 1999—making it the fifth-highest in the nation.” Salt Lake Tribune, June 7, 2018. https://www.sltrib.com/news/2018/06/07/suicide-rates-rise-sharply-in-utah-and-across-the-country-new-report-shows/.

Puar, Jasbir. “Coda: The Cost of Getting Better: Suicide, Sensation, Switchpoints.” GLQ 18, no.1 (2011): 149-58.

Roy, Alec, Vladimir Carli, and Marco Sarchiapone. “Resilience mitigates the suicide risk associated with childhood trauma.” Journal of Affective Disorders 133, no. 3 (2011): 591-94. https://doi.org/10.1016/j.jad.2011.05.006.

“Suicide rising across the U.S.” Centers for Disease Control and Prevention, June 11, 2018. https://www.cdc.gov/vitalsigns/suicide/index.html.

“Trauma and Suicide.” Centre for Suicide Prevention. https://www.suicideinfo.ca/resource/trauma-and-suicide/.

Vujanovic, AA. et al. “Posttraumatic Stress and Distress Tolerance: Associations With Suicidality in Acute-Care Psychiatric Inpatients.” Nervous and Mental Disease 205, no. 7 (2017): 531-41. doi: 10.1097/NMD.0000000000000690.

Williams, Monnica T. “The Link Between Racism and PTSD.” Psychology Today, September 6, 2015. https://www.psychologytoday.com/us/blog/culturally-speaking/201509/the-link-between-racism-and-ptsd.

Wortham, Jenna. “Racism’s Psychological Toll.” The New York Times Magazine, June 24, 2015. https://www.nytimes.com/2015/06/24/magazine/racisms-psychological-toll.html?_r=0.

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