My name is Dr. Shauna Springer, but I go by “Doc Springer” within the warfighter community. For much of the past two decades, I’ve served the military and veteran community as a trusted doc. Recently, I’ve applied my work in support of first responders, a related “tribe” of protectors and defenders. Suicide is an emotionally loaded topic. Getting traction with mental warfare requires accurate information about suicide. Let’s explore five common myths about suicide while being mindful of the unique psychological landscape of protectors and defenders.
Myth 1: Suicidal thoughts are uncommon
The truth is that suicidal thoughts are common among warfighters and first responders. In one study, close to 40% of first responders had contemplated suicide nearly 10 times more than a typical American adult. [1]
Consider this. Students in medical school often develop a condition known as “medical students’ disease.” This happens because they’re continually immersed in studying all the things that can go wrong in the human body. As they learn about a range of new diseases, they can begin to feel that they have the symptoms of the diseases they’re studying.
Warriors and first responders operate in the arena of life and death, So, along the lines of “medical students’ disease,” anyone who deals with life and death on a regular basis is more likely to have thoughts of their own mortality, and some of these thoughts are bound to be self-destructive, especially during times of high stress.
I can validate this through my own experience working with countless warriors and first responders. In fact, I’ve never met a first responder or warrior who trusts me and does not acknowledge having some struggles with self-destructive thinking. I’ve come to believe that the emergence of dark thoughts is a normal part of the path of a protector and defender. So, if you’ve had these thoughts, you’re not alone or atypical. Understanding how common these thoughts are can help reduce the stigma of acknowledging them.
Myth 2: Only people with a mental illness die by suicide
People who die by suicide do not necessarily have a mental illness. In my work with military family members who have lost a loved one to suicide, I can think of multiple cases where someone with no pre-existing mental health challenge suddenly struggles with suicidal thinking when a loved one dies by suicide. Grief can lead to feelings of despair for survivors. Acknowledging that this is normal is important.
There are lots of other reasons why people who die by suicide may not have a mental illness. For example, conflict in the family is a common precipitating event that can lead to a suicidal crisis. In one group of 33 suicide attempt survivors, 64% stated that their attempt occurred in the context of a fight with a partner or family member. Most did not suffer from major depression or psychosis, and they frequently described the attempt as impulsive. [2] Another study of 30 firearm attempters found that 60% had had a relationship fight during the 24 hours before their attempt. [3] Again, to go back to the previous point, the fact that suicidal thinking is common suggests that many who struggle with dark thoughts may do so in the absence of a diagnosable mental health condition.
So, suicide does not necessarily come from or confirm the presence of a mental illness.
Myth 3: People who attempt suicide have long contemplated doing it
This myth holds that there is a long ramp-up time before there is a suicide attempt. In other words, people don’t die by suicide unless they’ve been thinking about it, usually privately, for a long time. Again, my work with survivors of suicide suggests that suicidal thinking can come very quickly during a perfect storm of stress and trauma. Research on the suicidal mind state also suggests that periods of acute suicide risk are often very short for many individuals. [4] The implication of this is that it is important to recognize any shift in ourselves around times of heightened stress and trauma. It is critical that we have the right people in place – to include trusted peers and trusted mental health professionals. That way, when we do encounter a perfect storm of stress in our lives, we’ll more readily be able to connect with our tribe. This is critical in the context of suicide risk that can sit in our blind spot until a perfect storm of stress hits.
Myth 4: If you prevent someone from dying by suicide, they will just re-attempt
This is not generally true. In most cases, people who are suicidal experience deep feelings of ambivalence. In other words, they feel both the pull of self-destructive thoughts and contradictory thoughts and feelings supporting their will to live. In my experience, when someone comes through the valley of mental warfare, they often feel grateful to be alive. There are many examples of people who have attempted suicide and who are now public advocates for suicide prevention.
So, while it is true that the best predictor of a future suicide attempt is a past attempt, it’s not true that someone who is suicidal will always be suicidal.
Navigating the suicidal mode can in fact be a defining moment. During times of crisis, we may gain greater clarity on our values and reasons for living. We may emerge from the valley of despair at much lower risk, based on the work we’ve done to shore up our defenses, strengthen our connections and remind ourselves that we are connected to a tribe of people who care about us.
Myth 5: Talking about suicide with someone at risk can put ideas in their head
There is no evidence that talking about suicide with someone who is in distress will plant ideas in their head. In fact, I’ve observed just the opposite. When people are struggling privately with dark and destructive thoughts, they usually feel relieved to be able to talk about this with someone who doesn’t judge them. The dark thoughts we hide can become lethal. But when these thoughts are brought into the light of day, we can openly evaluate them, and remember what keeps us in the fight. At the same time, how you raise the topic of suicide matters. The relationship you have with the person before you talk about suicide matters. And your ability to stand with them, regardless of how dark their thoughts are, can make all the difference.
If someone you care about is struggling, instead of giving them a phone number to call – whether that is the crisis line (988) or the number of a trusted mental health professional or organization – offer to make the call with them. Hold the connection and ensure that they feel you will continue to walk with them in the valley of mental warfare.
NEXT: Officer suicide is a pressing issue that requires more than conversation – it demands action. In this Policing Matters podcast, we discuss how data and support are key to tackling this critical issue. Listen to the full episode.
References
1. First responders: Behavioral health concerns, emergency response, and trauma. SAMHSA. May 2018. Accessed August 12, 2023.
2. de Moore GM, Plew JD, Bray KM, Snars JN. (1994.) Survivors of self-inflicted firearm injury. A liaison psychiatry perspective. Medical Journal of Australia,160(7):421-425.
3. Peterson L, Peterson M, O’Shanick G, Swann A. (1985.) Self-inflicted gunshot wounds: Lethality of method versus intent. American Journal of Psychiatry, 142:228-231.
4. Deisenhammer EA, Ing CM, Strauss R, et al. (2009.) The duration of the suicidal process: how much time is left for intervention between consideration and accomplishment of a suicide attempt? J Clin Psychiatry, 70(1):19-24.
This article, originally published on August 30, 2023, has been updated.
