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David Lim, M.D., Ph.D. - Chief Medical Officer
September 14, 2017 - 1:45pm

Chronic illness increases risk for suicide — here's how to help

Let’s say you have a friend who threw out his back a long time ago and is now dealing with ongoing pain. When you see him, you normally ask how he’s doing. What if he mentions feeling irritable or having trouble sleeping, due to the pain? Would it occur to you to ask if he is feeling down or depressed? While it’s not always obvious, it could be a signal or sign that your friend is in need of support. Asking what they’re experiencing and showing that you care might possibly mean the difference between life and death.

Living with a chronic condition can be all-consuming. You’re forced to forego favorite activities due to the disabling effects of chronic illness or pain and simply maintaining a "normal" life becomes an incredibly time-consuming effort. It’s overwhelming — and no wonder that one-third of people with a chronic illness also develop a mental health condition. Coping with depression, anxiety, or substance use not only adds to the frustration and stress, but also impairs one’s ability to properly manage his or her care. It’s a vicious cycle.

A recent study published in the American Journal of Preventive Medicine found a link between seventeen physical health conditions and heightened suicide risk — this ranged from a moderate association between the most common conditions such as hypertension and back pain to significant risk among patients with traumatic brain injury, HIV/AIDS, sleep disorders, or the presence of more than one physical condition (e.g., having both asthma and diabetes). Sleep disorders are a particular area of focus: nearly 19 percent of those who died by suicide had been diagnosed with a sleep disorder. Many of us know someone who has mentioned having trouble sleeping—issues like this may contribute to depression or even thoughts of suicide, especially when they’re also managing a chronic illness or pain.

This week is Suicide Prevention Week — if you’re worried about a friend, family member, or co-worker who is dealing with a chronic condition and may also be struggling emotionally, take a few minutes to reach out and start a conversation about what they’re going through. You can make a difference by showing them you care. Here’s how to start:

Ask how they’re feeling. Most of us aren’t experts in mental health. That’s OK. Remember that asking someone if they are depressed, or having thoughts of suicide, will not cause them to act on it. Asking that question can help start a conversation about the issues they’re coping with, and allow you to talk to them about seeking help from a doctor or therapist.

Take time to listen. When we’re talking about helping someone deal with co-occurring physical and mental health issues, which may increase their risk for suicide, it’s important that you not only ask the question but also really listen and pay attention to what they’re saying.

Let them know they’re not alone. Often, people managing physical and mental health challenges will say they feel they’re “the only one.” Let them know you understand what they’re going through is tough, and that it’s OK to feel frustrated, upset, or scared. Reassure them that other people have successfully overcome similar issues, and that help is available.

Learn the warning signs. Many people who are at risk for suicide exhibit warning signs. Learn what to look out for, and if you’re worried someone may be suicidal and in need of immediate support, call the National Suicide Prevention Lifeline at 1-800-273-8255, chat with a responder online at SuicidePreventionLifeline.org, or reach out to the Crisis Text Line by texting START to 741-741.

Showing that you care, listening, and helping connect someone in need with a professional who can provide appropriate treatment and support, can make a big difference in helping someone live a happier, healthier life.