It’s time to attack suicide from a different angle
By microgen
CW: This article contains sensitive content that may be distressing to some readers. Please be mindful of your comfort level before proceeding.
I lost my brother to suicide twenty years ago. I was 14 at the time. He made three attempts before he passed away.
While working in a sandal factory, he experienced an accident with a cutting machine and lost part of his finger. Losing his finger meant losing his job, and losing his job led him into a deep depression. As his depression worsened, he developed psychosis, at which point he was sent to a psychiatric hospital for treatment. He returned home with a diagnosis of schizophrenia and a prescription for psychiatric medication.
I remember the first time it happened. It was a rainy night when he hurt himself with a knife. I discovered the scene first and immediately yelled for my dad, who rushed in and quickly provided first aid to stop the bleeding. Fortunately, the injury was recoverable, and his life was saved. Later, when my dad asked him about what happened, he said he didn’t know why he did it. It’s an action without awareness.
I once judged him, thinking he deserved the tragic incident. Now, though, I’m left judging myself for hating him instead of showing him empathy. No one offered him that, and this might have been a contributing reason for his death.
My brother deserved empathy, not further stigmatization, and most particularly not from his own family. I am ashamed I added to the trauma he withstood and to the overall stigma surrounding suicide.
As I grew up and was further exposed to similar incidents down the line, my perception began to change. And now, after studying psychology, behavioral science, and neuroscience, I believe the suicidal incident was not a deliberate action — it was an unconscious act that occurred during a state of psychosis.
An alternative opinion on psychosis
In his book, Waking Up: A Guide to Spirituality Without Religion, Sam Harris defines psychosis following the contemplative perspective,
“From the contemplative point of view, being lost in thoughts of any kind, pleasant or unpleasant, is analogous to being asleep and dreaming. It’s a mode of not knowing what is actually happening in the present moment. It is essentially a form of psychosis.” ― Sam Harris, Chapter 3: The Riddle of the Self.
From this perspective, and in my opinion, we’re in psychosis every day if we are lost in thoughts, whether we have mental health issues or not.
When approached with this belief, suicidal people are the same — lost in thoughts of self harm, and unaware of everything around them, including their own actions. Their desperation increases as they struggle, in vain, to control what are fundamentally uncontrollable compulsions.
The difference between my brother and those with healthy minds is his ability to quickly lose touch with reality. He is vulnerable and susceptible to external stimulation. If there is any suicide-related external input, it can trigger him and increase the risk of suicide.
To reduce the number of deaths by suicide and to continue breaking down the stigma surrounding its survivors, it is imperative we understand the correlation between psychosis and suicide risk.[1]
What causes this severe overwhelm?
Those living with depression, schizophrenia, bipolar disorder, and other mental illnesses can be highly sensitive to external stimulation. All it takes is a sound, smell, or sight, and even one that may seem benign to others, to trigger a traumatic memory. Once triggered, a person may experience distressing, invasive thoughts.
Though they develop in the subconscious mind, which stores and processes the thoughts, emotions, and behaviors we aren’t yet aware of, once triggered, our subconsciousness can autoload too much raw data all at once. This dangerous, overwhelming flood of thoughts into the conscious awareness can cause emotional turmoil capable of overburdening the brain. This intense activity may trigger psychosis, resulting in a loss of awareness.[3]
While in this unconscious state, a person may behave in ways they are both unaware of and in minimal control over, potentially including self-harm or the harming of someone else.
A person who attempts suicide in a psychosis of this nature cannot know what happened or what they were thinking. They can’t control their behavior — they are essentially submitting their body to the control of the unconscious.
The guilt trap
Guilt becomes a trap, one that can lead us to judge the very morality of suicide attempt survivors. This is a critical problem, as a judgmental approach only serves to intensify the guilt in those still fighting, potentially leading to more suicidal thoughts. This cycle of self-harm and guilt is a major of the contributing factors behind repeated attempts during the course of a person’s struggle with suicidality.
People shouldn’t be made to feel guilty for surviving. In my opinion, no one has permission to judge the actions of others if made in an unconscious state. This way of thinking serves nobody because the feelings of guilt can lead to subsequent suicidal ideation.
What about criminal behavior? Should we excuse ourselves from hurting others deliberately? No. This way of thinking does not excuse purposeful harm. This is within a separate context, and it is referred to as ignorance in Buddhism because the person is not, by definition, aware of their unconscious mind.
It is important for society to label suicide as the “epidemic” it is. We need to view it as a disease whose predominant danger is the intrusive thoughts it wages within the mind rather than simply reacting to its deadly outcome. If approached in this light, less guilt will be manufactured by the survivors, the stigma will lessen, and the deadly cycle of suicide may finally be truly stunted.
On suicide survivors and bereavement services
After the death of my brother, my mother lost her valiant fight against blood cancer. My brother’s death may very well have affected my mother’s health and even contributed to her death. Under the weight of this compounding grief, my eyes widened even more, but this time, to how we care for the bereaved.
Bereavement services are a necessary and often overlooked initiative. It’s important to improve the quality and accessibility of bereavement services for families and friends affected by the loss of a loved one to suicide. We should refrain from judging survivors and their loved ones alike; this only compounds the issue. Instead, it’s imperative we look into the deep truths of the suicidal incident. We need to ask about their experiences, and we need empathy and compassion instead of further stigmatization.
With this approach in mind, research will shift to a suicide-attempt, survivor-focused approach. Analyzing their experiences and the psychological aftermath that follows is the key to deepening our understanding of this tragic disease, whose prevalence continues to climb.
I am among the bereaved of a loved one lost to death by suicide. I understand the depth that loss can drag us to. I know, intimately, how sharp the pain caused by this stigma is. Our grief should not be exponentiated by the judgement of others; the death already cut us deeply enough.
“He who dies and yet does not perish has longevity.” – Lao Tzu
People with mental illnesses of all types need sympathy. Just imagine the good that would come from a global increase in understanding within social, cultural, and religious contexts. Instead of being shrouded in shame, suicide survivors could instead take pride in the unique gift they have to offer— the opportunity to help others with similar struggles, the opportunity to save lives down the line, and the ability to live the rest of their lives with serenity instead of guilt.
This article is dedicated to my brother and to all the gifts he gave.If you feel at risk of suicide, consider calling the confidential National Suicide Prevention Lifeline at 1–800–273-TALK (8255) for English, 1–888–628–9454 for Spanish, or call or text 988. Global support in 44 languages is available from Befrienders Worldwide.
[1] Huang X, Fox KR, Ribeiro JD, Franklin JC. Psychosis as a risk factor for suicidal thoughts and behaviors: a meta-analysis of longitudinal studies. Psychol Med. 2018 Apr;48(5):765–776. doi: 10.1017/S0033291717002136. Epub 2017 Aug 14. PMID: 28805179.
[2] Reinders AA, Nijenhuis ER, Paans AM, Korf J, Willemsen AT, den Boer JA. One brain, two selves. Neuroimage. 2003 Dec;20(4):2119–25. doi: 10.1016/j.neuroimage.2003.08.021. PMID: 14683715.
[3] Yun RJ, Krystal JH, Mathalon DH. Working memory overload: fronto-limbic interactions and effects on subsequent working memory function. Brain Imaging Behav. 2010 Mar;4(1):96–108. doi: 10.1007/s11682–010–9089–9. PMID: 20503117; PMCID: PMC2854358.
My Schizophrenic Brother, Mind-wandering and DMNLet’s Talk About Suicidal Thoughts
Dear Survivors, Suicide Isn’t the Killer; Suicidal Thoughts Are was originally published in Invisible Illness on Medium, where people are continuing the conversation by highlighting and responding to this story.