‘A complex event’
Potential suicide victims each have their own set of problems
and triggers, but most cases have common danger signs
By James Tilson
Part 2 of a 3- part series
“Suicide is a complex event,” says Cathy Davis, suicide prevention specialist for the Utah Office of Education, who has been traveling the state for the past four years talking about suicide and how to prevent it.
Each potential suicide victim has his or her own trajectory of events that come together to create a crisis, she says. “It’s no one simple, set cause.”
Nevertheless, in interviews with the Sanpete Messenger, local therapists, relatives of people who have committed suicide, and people who have contemplated suicide themselves, identified several factors and themes that seem to crop up repeatedly in suicidal ideation and completed suicides.
They included mental illness, substance abuse, a family history of suicide and loss of social connections.
Among young people particularly, feelings of not being successful, bullying, absorption with social media and knowing others who have committed suicide seem to be predictors of suicidal ideation.
And among veterans, who account for a disproportionate share of suicides in Utah, post-traumatic stress disorder may be a precursor to suicide.
Some research even suggests higher altitudes, which mean there is less oxygen in the air than at lower altitudes, help account for higher suicide rates in Utah and other mountain states than in the nation as a whole.
One of the more obvious factors is mental health issues. According to the National Violent Death Reporting System (NVDRS), mental illness was a factor in 52 percent of suicide deaths in Utah in 2013-2014.
Mary Pipes has lived in Manti for more than 25 years and raised five successful children in Sanpete County. But her husband and the children’s father killed himself in October 2008.
Before his death, Jim was being treated for clinical depression, paranoia, schizophrenia and borderline personalit
y disorder, Pipes said. “It was a cocktail that was a no-win situation.”
Pipes relates how when Jim was first diagnosed and began treatment, he showed immediate
improvement. “Holy mackerel, he was a different person,” she says.
But in time, he stopped taking medication and began to refuse treatment. His conditions worsened, and his suicidal ideations returned and got stronger.
Another pervasive factor is substance abuse. According to the Utah Department of Health (UDOH), 37 percent of males and 42 percent of females who committee suicide 2014-2016 had an alcohol abuse or drug abuse history.
Rachelle Holbrook, suicide prevention specialist at the Snow College Counseling and Wellness Center, has experienced substance abuse and suicide in her family.
Her cousin, who was 27, suffered from alcohol and drug abuse. “He had gone to counseling for it, and appeared to be doing better. The night before he died, he called his parents, told them he had a new job and was enjoying it. When his roommate called the next morning to say he had died of suicide, it came as a complete shock.”
Holbrook says she has learned that in many cases when a person has made the decision to commit suicide, the person feels better. The turmoil in the person’s live seems to have been resolved. A sudden improvement in mood or functioning in someone who has contemplated suicide may be a warning sign, she says.
Jason Smith (not his real name) is a drug addict who is now clean. However, he was in the throes of addiction several years ago when he took an amount of heroin that could have killed him.
“That time was one of the darkest times of my life,” Smith says. He was in violation of his probation, and the 6th District Court in Manti had issued a warrant for his arrest. And he was in what he calls “a really unhealthy relationship with another addict.”
Smith, a long-time Sanpete County resident, found himself in Provo in a series of flop houses. His girlfriend wound up getting arrested on her own warrant (although the police inexplicably did not find his warrant when they arrested her). Suddenly, he was on his own, and all his belongings had been stolen.
He normally used heroin, not meth. But that night, he was so depressed he did meth. He decided to return to Sanpete County and turn himself in, and found a friend to give him a ride back to the county. The friend “handed me a bag of heroin far too big for someone in a bad place.”
When he got home, Smith felt “things were as bad as they could possibly get.” The methamphetamine affected his thinking. “I normally don’t consider suicide,” he said. “There’s a lot of suicide in my family, so I’ve always been very averse to it.”
In his altered state of mind, Smith decided to take the entire bag of heroin. He knew he was going to turn himself in the next day. “I was not purposefully trying to kill myself. I was trying to get higher than I had in years, and I was willing to accept the risks.”
Luckily, Smith did not overdose, was eventually accepted into Sanpete County’s drug court program and is now a productive member of society.
Family history of suicides
Another factor that may play a part in suicidal ideation is a family history of suicide. Pipes’ husband’s mother had died of suicide in 1981. She also suffered from mental illness. Pipes describes her as a “delightful lady,” but said “you could tell she’d had a rough life, (that) something wasn’t quite right.”
Since her husband’s death, Pipes has educated herself on mental illness and causes of suicide, and knows about the connection between the two. But at the time, she was not aware of the connection, and after both her mother-in-law and husband killed themselves, she thought “That’s just life.”
Loss of social connection
A loss of a relationship is nearly as prevalent a factor in suicidality as substance abuse. The UDOH cites “intimate partner problems” as a factor in up to 39 percent of suicide deaths in Utah.
It might be the break up of a relationship, the loss of a family member or general loneliness. “And then there’s a sense of hopelessness,” says Allen Riggs, director of the Counseling and Wellness Center at Snow College. “People can feel their life has too much stress or too many demands for them to handle. For these people, suicide becomes a way out.”
Lack of social support or even social stigma has particular meaning for LGBTQ youth. Their risk “is a minimum of double the normal risk [for youth], it may be even more,” Riggs says.
“Their community is judged, they have a small social group and more rejection. They have a harder time finding a life partner, creating more loneliness.”
Monica Peterson, a former instructor at Snow and founder of the Snow College PRIDE club, saw the rejection first hand. Her sister (now brother, since he transitioned 10 years ago) was a lesbian Mormon in high school and college.
“I witnessed church leaders shame her publically. She had come back from BYU for the summer. One bishop had her read out loud a passage on homosexuality. It was awkward and inappropriate. He may have thought he was helping, but it was a public shaming.”
According to Peterson, her sister went through deep pain, which led to suicidal thoughts. “When I first found out she was gay, she was in her room crying. I tried to tell her I loved her, but she said, ‘Just get out, you don’t understand. I just want to die. Death would be better than this.’”
For some, especially teens and young people, the feeling of not meeting expectations of others becomes overwhelming, leading to suicidal thoughts.
“These people begin to feel that if they do not have ‘success’ in their life, then they have no meaning,” says Riggs, the director of the Snow College Wellness Center.
Combine feelings of failure with the difficulty younger people have of putting things in perspective and you have a dangerous combination. “Youth seem to have an inability to press the pause button,” says Davis, the suicide prevention specialist with the state school system. “Teens are more impulsive, and always react stronger to crisis.”
Holbrook, the suicide prevention specialist at Snow, says the Wellness Center especially looks out for the athletes on campus. “I can’t imagine it’s easy to be in the public eye. And at the college level, you are definitely in the public eye. There’s pressure, and an expectation to be strong. They feel like they can’t show any weakness, especially around their teammates. So they carry it as long as they can, and when they can’t anymore, it all breaks down.”
Bryce Thayne, a Manti resident and suicide survivor, says he started feeling suicidal
after some downturns in his life. “I was ending a relationship with a girl, and it was hard. I felt like I didn’t have anything going on for me. I had left Snow [College] because that didn’t feel right for me. I had no direction and I was alone. My choices were falling apart, nothing was working.”
Bullying can be a huge problem for youth. The UDOH finds that youth who were picked on or bullied at school more than once during the past year were 4.2 times more likely to have seriously considered suicide compared to peers who had not been bullied.
Lt. Gov. Spencer Cox, a native of Fairview and graduate of North Sanpete High School, recently opened up about his experiences with suicidal ideation as a teenager.
His parents divorced when he was 10 years old. In middle school, he faced bullying. At the time, he began to wonder “what would it be like if I wasn’t here anymore.” And then he began to think about how to do it.
Luckily, people around him could see he was struggling. He had withdrawn from peers, his grades were suffering, and he was often in a dark mood and uncommunicative. Those people reached out to him and helped pull him out of his destructive thoughts.
The role of social media on youth suicidal ideation must also be acknowledged. According to the UDOH, students who reported playing video games or using computers for non-school related activities for three or more hours a day were twice as likely to have considered suicide compared to youth who had two or fewer hours of screen time daily.
Riggs thinks youth use of social media may take time away from in-person interpersonal interactions. “They don’t have as much practice just talking to and socializing with other teens.”
And Dr. Doug Gray at the University of Utah thinks the “best selves comparisons” teens see on social media contribute to teens trying to reach an unrealistic standard.
Keyera Braithwaite, who is student body president at Manti High School this year, but who earlier lost a friend to suicide and when through a period where she herself felt suicidal, agrees with this assessment, too. She says social media leads teens she knows to try to emulate “social media influencers,” even when it’s the so-called influencers set a standard that is impossible to live up to.
PTSD among veterans
Another group unusually susceptible to suicidal ideation is veterans. The NVDRS found 14 percent of all suicide victims in Utah identified as veterans, including 51 percent of victims aged 65 and older.
According to Robert Buckner, a veteran and member of a local Veterans of Foreign Wars (VFW) and American Legion groups, says veterans of combat often have post-traumatic stress disorder (PTSD). But because of the “warrior culture” of military members, “they won’t seek help, won’t go to therapy, and their condition goes untreated.”
“I remember when Vietnam veterans came back and so many of them wound up homeless,” says Buckner. “Back then, the VA (Veteran’s Administration) really didn’t know what was going on. We’ve gotten better since then. The Utah National Guard is doing a good job at reaching out. Even so, the rate (among veterans) is high.”
Mark Best (not his real name) says his wife’s younger brother served in the military during Vietnam. When he got back, Best says, he was not the same. He was more withdrawn, and moody. After a fight with his girlfriend, he killed himself. Although the fight itself was not particularly serious, it was the stressor that proved to be his breaking point.
Dr. Brent Kious, a psychiatrist at the University of Utah, points to research led by Dr. Perry Renshaw, director of a mental illness research center at the Salt Lake City Veterans Administration Medical Center. Renshaw’s research shows suicide rates increase in locations where the elevation goes over 2,500 feet, even after controlling for factor such as poverty or the availability of guns.
The research is consistent with findings in other high-elevation countries such as Chile, Spain, Switzerland, Turkey and Korea.
At higher elevations, air has less oxygen. The brain does not produce serotonin as effectively as at lower elevations. Researchers have found serotonin helps to fight off the symptoms of depression and anxiety, issues that contribute to suicidal ideation.
Another theory is that with less oxygen, the brain is less able to store energy. The brain, even though it is a relatively small part of the body, uses up to 20 percent of all energy produced by the body. With less oxygen, the brains has less energy, which may affect brain functions.
Next week: Preventing suicide: What can be done and what is being done?