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April’s here, and those of us here in the northeast are prepared: the days start to get longer, the sun warmer, the early spring foliage — the tulips, the daffodils — in deep bloom. The days when I stand in front of my dresser weighing my options, asking myself whether it’s safe to wear shorts yet, are finally here. I’ve been aching to feel the fresh, new warmth on my skin for months. I’m ready to throw my winter coat to the back of my closet in revolt.
It’s also just about that time of year when whatever trauma or disorder that lives deep in my brain reemerges, like a bear from its den, and starts to go into self-destruct mode. It’s when I start to think about suicide.
I know a thing or two about suicide, both personally and academically, and one of those things is that I’m not alone with this particular counterintuitive brand of spring fever.
I’ve survived a suicide attempt, and I live with fairly regular, persistent suicidal thoughts. In the spring of 2013, those thoughts bloomed red, in sync with the budding foliage and paired with the work of writing a piece about my divorce that dredged up a bunch of painful crap and made me relive every agonizing moment where the vows I'd held so dearly were ripped to shreds.
I spent every torturous moment wondering, Why is this happening again? Why now? I've moved on. I’m finally in a good relationship. I love my work. I was happy. I couldn't sleep. I stopped being able to focus. I lost my awareness of my surroundings, to the point where I almost walked in front of a moving car because I didn't think to look both ways.
This particular episode lasted nearly two months, and almost cost me that good relationship — the first and only healthy relationship I’ve ever known.
Instead of picking up and leaving, my partner — now my wife — said, "Look, you've been trying to maintain your health solely with therapy all this time, and it's not working. I know you hate meds, but you've got to try something new, or I don't know if I can do this." She didn't expect me to figure it out alone, either.
She came to therapy with me so that we could block out a plan. My therapist, Dr. Evans, suggested two things: DBT (Dialectical Behavior Therapy) or medication. I'd quit my meds cold turkey in 2006 after my suicide attempt because the side effects were awful, and I'd since I'd just tried to kill myself, I didn't exactly have faith that they were working. But even more than meds, I hated the idea of laying my baggage out for an entire group of strangers, so I made an appointment with a psychiatrist.
When I went to the psychiatrist, she validated all of my feelings about my experiences with medication. She said, "It sounds like you're resistant to SSRIs."
She blew my goddamn mind with that statement. I didn't even know that was possible — at the very least, I didn't know it was something a psychiatrist would openly acknowledge. Not to a patient.
She gave me a list of three medications she thought might work for me, and we discussed pros and cons. Then she asked if I wanted the script.
I said, "I'll take it, but I'm not filling it until I do more research and feel comfortable that this won't make things worse."
I ended up filling the prescription.
I had plans to leave for Cambodia the next week, and I decided that I wouldn't start the meds until I got there. My wife is a speech-language pathologist and has spent several summers embedded with a medical NGO, visiting remote villages and working with children with developmental disabilities. I went along as a documentarian. It made sense to me to wait, because we'd be there for three weeks and my responsibilities would be minimal. I could relax, I could adjust, and I'd have time to deal with any side effects that popped up.
Twenty-four hours after we arrived, I took the first pill. For the first time, after years of experimenting, after giving up completely, and absolutely fearful of trying again, the medication had no side effects.
At 30 years old, I discovered what a normal range of emotions feels like.
I woke up every morning to the sound of monks chanting at the temple nearest our apartment, and I felt absolutely in awe of all of it. I got a Khmer magic tattoo from an ex-monk. I asked him to imbue it — and me — with mental strength. After we finished, he took me to his altar in the next room and blessed it.
This was my first time out of the country, and I got to explore the Angkor Wat temples I'd been dreaming about for years. I got healthy again. I got to move on.
I don't have delusions that I'll ever be fully free from these chains. It’s an affliction I don’t ever think will leave me; on the other hand, the older I get, the better I know my body, the better I can see the warning signs, and the easier it is to reach out to my support system.
Fact: Suicide rates in the U.S. are highest in April.
Pick your jaw up off the ground. Everything you’ve heard is wrong. The dark winter weather doesn't bring out the doom and gloom in the general populace. Suicide rates do not spike during the winter months. People aren’t killing themselves in record numbers on Christmas Day. Actually, suicide rates are lowest in December. George Bailey, our much-beloved suicidal protagonist in It’s a Wonderful Life, is an outlier.
Suicide rates start high in January, drop in February, then build to their highest peak in April, where an average of 118 people die by suicide per day. In May, rates drop again, then build through June to another peak in July. We see a steady decline through the rest of the year.
Interestingly, both National Suicide Prevention Month and World Suicide Prevention Day take place in September, putting a spotlight on suicide awareness in the fall months, when national suicide prevention organizations and advocates should be front-loading their efforts closer to the beginning of the year when the need is greatest.
Researchers have posited weather changes, social pressures, biological processes, environmental irritants, and more, as possible causes, but no one really knows why suicide rates spike in the spring.
What I've learned, from both personal experience and my time as a suicide awareness activist, is to perk my ears up around spring so I can spot the warning signs for suicide — not just in myself, but in my friends and family, too. Talking about feelings of hopelessness, futility, feeling trapped, or wanting to die; saying goodbye or giving away possessions; increased use of illicit substances or reckless behavior; extreme changes in behavior, especially sleeping and eating patterns; and a loss of interest in hobbies and activities are all warning signs for suicide.
When I stop sleeping, when I'm irritable and mean and crying all the time, when I start working less and watching more TV, when I start saying I want to cut myself, it's time to pay attention. There's a distinct possibility that things could escalate — and quickly — if I don't step up and say, "Hey, I need help now." Telling my wife or my mom or a friend reminds them to check in with me, and it keeps me accountable.
But I'm also an outlier. I talk about suicide every single day. It's the nature of my career, and it extends into my personal life.
More often than not, people at risk for suicide have never expressed those thoughts openly, out loud. They might not know how. They might fear being judged by those around them, leaving them silent and feeling alone. In my work for Live Through This — a series of portraits and true stories of attempt survivors across the US — I’m often the first person people have ever told their stories to. They know I won't judge them because they know I've been there, and being able to open up lifts a huge weight off the shoulders of someone who struggles with thoughts of suicide.
If you're worried about someone, you can make it much easier by asking directly: “Are you thinking about suicide?”
It's terrifying, but believe me, asking the question won’t plant the idea. If you’ve worked up the courage to ask, there’s a good chance the idea’s already come up for them. This is the first step to saving a life. It may be a scary, but it's a heroic act.
My wife asks me. She isn't fearless, but she fakes it enough to make it, and knowing I have someone in my corner willing to listen to me without judgment in my darkest moments has kept me safe on countless occasions.
Bottom line: regardless of which way the wind blows, whether it's a Monday, or when national awareness programs call attention to it, suicide is preventable every day, and every one of us has the power to save a life.
Here’s a list of resources to keep in your back pocket or on speed dial—you never know when you might need them (for yourself or someone else):
• National Suicide Prevention Lifeline: 1.800.273.TALK (veterans press 1 to access the Veterans Crisis Line)
• Trans Lifeline: 877.565.8860 (US) or 877.330.6366 (Canada)
• Crisis Text Line: Text “START” to 741.741 to talk to a trained counselor
• The Trevor Project: 866.488.7386
• TEEN LINE: 310.855.4673
The ability to recognize risk and ask the question are first steps toward reducing suicide rates that have only been rising for years, and though they may sound easy, they’re not. Being able to connect with people who are at risk for suicide is a real skill. If you’d like to practice these skills and be a total badass, many areas offer free Mental Health First Aid trainings. ASIST and QPR are more extensive, top notch training options, often offered in exchange for time volunteered at crisis centers and hotlines.
Special thanks to Amelia Lehto (Resource and Crisis Helpline Coordinator for Suicide Prevention at Common Ground in Detroit, MI), who contributed to this article.