• 10th September 2020 marks World Suicide Prevention Day. Recent statistics show that the rate of suicide amongst men in 2019 was the highest in two decades.

  • Psychotherapist Ondine Smulders reflects on what leads someone to suicide, what effect it can have on loved ones, and what you can do if you are struggling 

  • The Samaritans are available on 116 123, 24/7 – we also have therapists and counsellors available to support you – find yours here

Suicide wrecks lives. Reflect for a moment on the intense suffering of someone contemplating taking his or her life. Then think about the instant aftermath of their suicide. Now consider all the people who are affected by their suicide. The person who died ended their pain and despair, but it has not ceased to exist in this world. Instead the agony exponentially reverberates among their family, friends, colleagues, and community because – as Donne wrote so eloquently and beautifully – No man is an island, entire of itself; every man is a piece of a continent, a part of the main ... Any man’s death diminishes me, because I am involved in mankind (Meditation XVII) 

According to the ONS’s latest data, 5,691 people committed suicide in 2019 in England and in Wales. Although the vast majority were men (76%) and many of them middle aged, suicide can affect any of us be that actors, bankers, builders, doctors and carers, the privileged or the underprivileged, the young and the old.

As we face another winter of Covid19-related lockdowns, I cannot help but wonder how it will affect us. I reflect on those among us who struggle with their mental health. How will they cope with further social isolation, the accompanying stress, the health anxiety, and lack of support, important catalysts for deterioration in mental health? I also worry about those who are less well off, or those whose circumstances will be reduced by the post-Covid economic slump that has started to send huge numbers of people home with little prospect of finding meaningful employment (ever) again. Will we act surprised if next year’s ONS suicide data show an increase, indicating that more people felt that they no longer had a future, believing that nobody cared if they lived or died?

Suicide is not a pure medical and biological issue; it is so much more, containing important psychological, social, and cultural aspects. Struggling with suicidal thoughts and making plans to kill oneself is associated with a wide range of difficulties that can cause depression and trigger suicidal plans. These include the struggle to manage basic existential anxieties, for example feeling lonely or powerless, an identity crisis, or experiencing major life transitions and adversities, to name but a few. Many studies have shown that an increase in the unemployment rate is associated with to rise in the number of suicides. With many thousands already dying by suicide every year, I feel uneasy about an excess wave.  

What can we do to prevent suicides?

Are we doing enough to save the lives of those among us who struggle with suicidal despair? As a society, should we try harder to save their lives, and in the process our own lives? A therapy client who opens up about wanting to end their life is not typical—many people who think about suicide receive limited or no support. Engaging with someone who is in so much pain that it could trigger suicide is key as we may help him or her to reject his or her ending. Talking about suicide in an open and non-judgemental fashion does not lead to more suicide, but suicides that are not addressed can trigger more suicides (as shown in Bridgend in Wales where 26 young people committed suicide between 2007-09).

Tomorrow is World Suicide Prevention Day 2020 but you, dear reader, you may well think so what? Perhaps you are thinking of ending your life or you suspect that someone you know is planning to commit suicide, what to do?

I trained in existential psychotherapy, a model that is philosophically based rather than taking a medical/behavioural approach. Many 20th century philosophers have debated how life is essentially meaningless, and yet there can be no doubt about their unanimous conclusion: all life is worth living, every single life. We may feel alone and isolated but life is lived in a web of connections, we are constantly interdependent with hundreds of people. We are always part of a world, be that our family, our group of friends, our neighbourhood or town, our country, and in the moment of our distress, we are also part of the community of sufferers because even in that state you are not alone—many people stumble along the dark side of life at any given moment.

We not only owe it to the others in our life to stay alive, we are also making a gift of life to our future self if we remain alive. All things pass, the good and the bad times, and in the future you may feel differently, perhaps even a little more content. You may feel grateful that you struggled through the night to see another sunrise.

What to do if you are feeling suicidal

All easier said than done you tell me, and I agree. Where to start? Think about what you need to do today to stay alive. Take it one day at the time. Think in very small steps, nothing major, be patient. Small steps can lead to big changes down the road.

You may want to shut down and keep your emotions wrapped up, but that makes it harder to reach out to others and for others to reach you. So consider getting in touch with someone you trust, who will listen without judging you. If that feels like too much today, maybe you can connect to someone by text or use social media to find other people who are struggling and sharing? Listen to their stories. They may remind you that you are not alone. 

Apart from talking, writing about your pain and sharing with others what you are experiencing can provide some comfort. Reflect on your triggers, your moods, your thoughts, and the situations that drive you to your dark place. Then contemplate how you have managed in the past. What did you do to prevent hurting yourself? Did other people or social events help you cope? Being with others and of use to others may provide relief. Cultivate your family, friends, neighbours, and colleagues. Supportive relationships with others will help you stay the course of life. Or, think about helping others through volunteer work in your community, at your work, at school, or in your club. Down the road, you may also consider trying something new like taking a class, learning a new language, joining a sports club or book reading group.

Last, but not least, when you are in an immediate crisis, contact the Samaritans 24/7 by phone, email or text, or another crisis hotline on 116 123. You can also get in touch with your GP or go to your local A&E. Beyond the immediate crisis, consider getting in touch with a therapist to help shine a little light on your darkness. Psychotherapy aims to empower the client so that they may find meaning in their lives, perhaps giving them new reasons to live for and making their suffering a little more bearable.

Ondine Smulders is a verified welldoing.org existential psychotherapist in London and online

Further reading

The shocking statistics of male suicide

Coping with grief after a loved one's suicide

Suicide prevention: how can you help

Young women, perfectionism and suicide: is there a connection?

Are more men seeing therapists?

Men need to talk about suicidal thoughts