Show Notes:
Today we are finishing our series on suicide risk prevention, and in some ways we’re wrapping up in the place I intended for us to start. Today we’re talking about what it is like to be the person in the deep dark hole. We’re going to talk about the slippery slope that tends to send us into the hole, how to recognize the hole we’re in, ways to work at intervening to try to find a ladder back out and resources and supports that can help to do that
What leads us into the dark hole: Suicide does not happen in a vacuum. By and large, it doesn’t come out of thin air. It is most typically the “last resort” option that someone can perceive in an effort to cope with too much for too long. For some it is a means of escaping the heaviness of the world. For others it is a sense of controlling what I can in a world where I feel as if I control very little. It often feels tied to a sense of helplessness and hopelessness, and sometimes a belief that the world would be better off without me. Getting to that place doesn’t just happen, like one day I’m totally fine and the next day life isn’t worth living. Most often it is a gradual wearing down of my sense of capacity, control and hope for a future that feels meaningful.
When we face gradually additive stressors, we don’t tend to notice the impact these are having on our mental health and wellness as dramatically as we would if one terribly catastrophic thing were to happen. The gradual and cumulative effect adds a little bit and a little bit and a little bit until we feel so overcome that we can’t continue.
For many on the front lines the problem is a bit convoluted. On the one side, you are a normal person. You have normal people problems. Problems that can in their own right be pretty stressful. Children who are sick or have special needs, elderly parents you are supporting, financial strain, and the zillions of day-to-day life stressors, big and small, that we’re having to navigate. Then, you have the problems you face as a result of the work you do. Your Tuesday is being present for someone’s worst day, on repeat. You are exposed to suffering, desperation, pain and so much more within conditions that can feel toxic and/or dysfunctional. All the while you are seen to be this kind of noble person with a noble profession, that can make us feel somewhat restricted from being permitted to fall apart or be human in some of the spheres we’re in. We’re busy, trying to coordinate and negotiate the intersection of our normal people lives with our professional lives. Oh, and our professional lives colour everything. What we see, hear, know and are exposed to in the work taints how we feel and engage outside of the work. We get more guarded, vigilant, hyper-aware – we’re tuned into risk and threat and work to be ready to jump into action no matter what venue we’re in. And to manage all of that, there’s the numbness. The thing that gives a break from feeling the intensity of it all piling up…but not really. Not really, because it’s still all right there. And I have to do it all again tomorrow.
The pace and complexity of navigating these multiple facets of who we are and what our lives are composed of, along with hereditary predispositions, can move us toward physical and psychological health concerns. Sleep is disrupted, appetite, coping behaviours like substance use or screen time, fatigue, irritability, mood swings… We can gradually move down this path and into spaces like burnout, compassion fatigue, vicarious trauma, posttraumatic stress disorder, depression, anxiety, and so on.
Now, this slippery slope of gradual compounding stressors and the associated mental health concerns I’ve just listed do not in themselves mean that someone will become suicidal. However, the risk for suicide increases exponentially when stressors are high, coping is low, and mental health concerns have become present. The risk increases further if we have had any previous experiences of suicidal ideation or actions, as well as if we know someone who has attempted or died by suicide.
Unfortunately it is common that those in First Response and Front Line Work don’t know what to look for. We hear a lot of the right buzzwords about breaking the stigma, getting help, seeking support – blah, blah, blah. But not being given clarity around what it looks like to need to do these things. We look around and it seems like everyone is struggling, so we assume this is just how it is and we keep on going. We silence ourselves, sometimes even from ourselves, to keep putting one foot in front of the other. And we can march ourselves right into that deep dark hole without a clear path out. So tired by the time we get there that we can’t muster the strength to look for a path out. That’s the helpless, hopeless place.
I don’t want that for you. For any of you. It’s why we need to have these conversations – need to confront the uncomfortable things in an effort to equip ourselves. I want you to be the person who does know. The person who saw the indicators and did something about it BEFORE it got so deep and dark.
Knowing what to look for: we need to get really clear about the things that lead us into the dark hole. The thing about life is that it tends to keep moving – which can be part of the problem we find ourselves faced with. We get caught in meeting the day-to-day challenges, along with the big and small stresses that show up along the way, in tandem with a career that is predictably unpredictable. The nature of life continually moving along, is that we can get a bit dragged along for the ride, leading into some perpetual version of survival mode. We can be so caught up that we fail to notice the forest for the trees – we lose track of how we’re doing, whether our lives feel in alignment with what we want or like or would hope for. These pressures and tendencies to feel stuck by the cumulative weight of life can happen for many in the work, but this can be exacerbated by a hereditary predisposition to mental or physiological health concerns, as well as any amount of experiences throughout our lives of trauma or more severe stress. When we have overlap of these kinds of risk factors, it is going to be important to have awareness of what we need to be looking for – our own personal indicators and risk factors that let us know that we’re not doing so well, need support or otherwise need to attend to what’s happening.
For example, if I know that I have family members who struggle with depression and anxiety, that I have a family member who has attempted suicide, that I have some early life exposure to stress, that I have my own history of struggling with low mood sometimes, and that on top of my work right now I am also facing stress related to separation or financial concerns or something like that – the interaction of these multiple risk areas and stressors can quickly add up to feeling unable to cope. As these add up, we can grow increasingly helpless and hopeless, overwhelmed and out of control, disconnected and devalued. This is the place where risk becomes significant, particularly if we begin to pair this with planning or fantasizing about methods to end our lives, beliefs that others in our lives would be better off without us, untreated acute mental health concerns, and access to lethal means. As these factors combine and layer on top of one another, the day-to-day life stuff can easily tip the scales and the exposure to suffering within the work can sit differently. We can start to see ourselves in the stories of those we work with, or wish to trade places with those we are serving. Those can be some solid indicators that we are pretty deep in the hole.
