The Reddit thread "Suicide survivors, what was your first conscious thought after you realized that you hadn't succeeded" has over 7,500 comments and stories from users, many detailing extremely personal and traumatic experiences with surviving suicide - also called "lived experience." Rather than attracting trolls and bullies, the thread drew an outpouring of support and compassion. To talk about the thread in more detail and discuss why the suicide rate in the U.S. is rising, we spoke to Christine Moutier, Chief Medical Officer at the American Foundation for Suicide Prevention.
ResearchGate: What did you think of the thread on Reddit titled "suicide survivors of Reddit, what was your first conscious thought after you realized that you hadn't succeeded"?
Christine Moutier: The feed itself has a very new and fresh quality to it for a number of reasons. Part of it is the level of intimate disclose to a public audience. The other part is the way people responded to it in a very compassionate and open-minded manner - some mentioned how much they were learning and how hearing inspiring stories of survival had helped them, or that they were going to use the testimonials to help someone they knew. The way they explained the impact the dialogue was having on them personally in that moment was so powerful.
RG: Do you think an anonymous and public forum like Reddit is a good place to share?
Moutier: There is something unique about this anonymous internet forum -it is thankfully very positive. Every single comment I read had that theme of encouragement, compassion, and a positive feedback loop for the individual with lived experience. You could imagine that it could go a different direction with the anonymity factor, because often people are not as compassionate and thoughtful online. There are web forums that are pro-suicide, they are horribly damaging to people.
RG: What are the benefits of sharing lived experiences?
Moutier: Every person who comes out and talks about their lived experience helps to reduce the sense of shame that tends to surround any discussion of suicide. Far more people experience suicidal thoughts and attempts than people realize, since people often don't speak about them publicly. Studies of the general population in the U.S. have found that about 15 percent of people have thoughts of suicide, and 5 percent have attempted at some point in the past.
RG: What are the best practices for friends, families and communities who know someone who has attempted suicide?
Moutier: Number one, never underestimate the power that your love and support can have. You might get overwhelmed by the enormity of the crisis that your loved one is in and lose sight of this. It's important to have a quiet, loving presence, where you say supportive things, for example "I want to understand what you're going through", and do more listening than talking. Avoid judgement or trying to find quick fixes. Helping them find professional support is also very important, even if that simply means researching with them, accompanying them to an appointment, telling them that you will think highly of them for taking this responsible step.
RG: How do people rationalize lived experience? There are a number of stories that paint a very mundane reaction to surviving an attempted suicide.
Moutier: People are unique in this area. Some have been working through the drivers of their suicidal thoughts, some have been in therapy for years, and so have a greater sense of self awareness for what just happened and what it means, and what they need to do next in their life. For others, they know they've been in distress, but they don't have a way to frame what they have just done.
There is also an environmental layer here - historically, we have mishandled suicide attempts and suicide risk. We have called people attention seekers and manipulators. We've completely minimized the very distress that drove the person to consider suicide. So that cultural layer is also at play, in terms of what might cause someone to just block or compartmentalize it and move on.
One other point is ambivalence - everyone who is in a suicidal state of crisis, even as they act in a suicidal manner, has a mixture of an intense desire to escape the pain that they are in, and an incredible desire to hold onto life, a survival instinct. That is why many people wake up and feel a sense of relief that they are still alive.
RG: This story seemed to connect with a lot of people. It's written by a girl who describes her difficulties accepting that her highly traumatic suicide attempt has failed, and the long process she went through to recover from her depression. Why do you think that is?
Moutier: The majority of people have experienced intense challenges in their life. Something in this story is common to the human condition - she talks about feelings of desperation, disgust, self-loathing, and being overwhelmed, even while she is attempting suicide. It is the juxtaposition between the face we put on to the world, and our internal feelings. I think anyone who is self-reflective at all is aware of this juxtaposition. Her own coming around to embrace life again and saying she is happy to be around beauty in the world, again this is a common human experience.
RG: Did you learn anything from this discussion?
Moutier: I did! This is our life at the American Foundation for Suicide Prevention and I was struck, not so much from the disclosures, but how others responded and the impact this had on the individual. The thread resonates and parallels what we experience when we host panels with people who talk about their lived experience (or their own suicide attempts). Which seems really surprising - you may wonder how a panel of people talking about their most private and frightening moments with a bunch of people can help, but in every instance the room is moved, and people are in tears or it starts the process of other people sharing. It makes me wonder if the thread is yet another indicator of the change that is happening culturally in America, in which people don't view suicide as harshly as they would've as recently as ten years ago.
RG: The United States Centers for Disease Control and Prevention recently release a report that showed suicide rates increased 24% between 1999 and 2014. Could you comment on why this is the case?
Moutier: Firstly, you have to think of suicide as a public health issue - it is one of the top ten leading yet preventable causes of death in our nation. It is the only one in that top ten that continues to be on the rise. It is the only one that has not yet had a significant investment from our federal government towards research, prevention, and awareness-raising efforts that we have seen make a difference for cardiovascular disease, cancer and HIV. From that perspective, we believe it will change once those strategies are employed, and we believe there is a readiness for this to happen. But we have to continue to advocate for investment from our government.
Between 1999 and 2014 some things in the environment changed, such as the downtrend in the economy and changes in attitudes towards treating depression. In the 80s and 90s, there was a big push to treat mental health issues as you would physical health issues, but unfortunately things took a turn for the worst after around 2002. Another factor is the increase in opioid prescribing habits - the access and availability of opioids just skyrocketed in that time period, leading to higher rates of opioid-related deaths.
And the last factor that could be coming to bear is what we think of as a cohort effect. The baby boomers are coming into the middle and older years of life. This population has unfortunately always had higher rates of suicide, substance abuse, and divorce, than earlier cohorts. That has probably continued to follow them, and, as they have aged as a cohort and now face health problems and the environmental changes I mentioned, the rate of suicide amongst middle-aged Americans has also increased.
This article originally appeared on ResearchGate News.