May 29, 2020

Suicide is a topic that is still to this day very touchy, and one of the most vulnerable subjects to talk about. It is even harder to talk about troubled youth who turn to self-harm and suicide ideation.

The most vulnerable age group is those between 15 and 24 years of age, according to Crisis Services Canada (CSC).

CSC says an average of 11 Canadians die every day by suicide. In addition, for every one person who commits suicide, seven to 10 other people are affected.

Overall, suicide is the second leading cause of death for all youth. The first is uncontrollable accidents.

Statistics experts believe there could be a “contagion” effect, where one suicide attempt causes a chain reaction.

The Child Mind Institute (CMI), an American non-profit organization devoted to transforming the lives of children who suffer with mental health and learning disorders, says there are many reasons a youth may be feeling suicidal.

It could be due to the loss of someone significant like a family member, pet or significant other. It could also be due to chemical imbalances in the brain, bullying, abuse of alcohol or drugs or many other things.

In a song by All Time Low titled Therapy, there is a particular line that resembles the pain of hiding what’s going on in someone’s head, always playing the “I’m OK” game and keeping to oneself in fear of judgment.

It goes, “I’m a walking travesty, but I’m smiling at everything.”

Inside suicidal behaviour and ideation

One Waterloo, Ont., resident, who didn’t want her name used, knows all too well the pain of putting on a brave face every day, hoping for something better. We’ll call her Jill Mathers, a pseudonym.

“On my lowest day, it looked dull. I could be as normal as possible around people, but once I was home alone in my room it was darkness,” Mathers says.

 “I would be in bed, covers over my head, lights off and the door closed. No music would play, and no TV watching. I used social media, but not enough to really say I was using it,” she says.

It was around age 12 or 13 Mathers remembers feeling suicidal for the first time.

Photo by Scott Webb via Unsplash.

“I don’t think I fully understood the intent of what those words meant. I would be out in the schoolyard with friends or in the classroom, getting upset and angry with certain people and the things they would say or do sparked a reaction I didn’t fully understand. I would say I wanted to hurt myself, or kill myself because I was getting physically and emotionally abused by certain people. What they said made me think about myself in a way that wasn’t positive, and from those thoughts grew a feeling of maybe what they were saying was true, so why be here,” Mathers says.

She says, looking back, it felt more like a phase that would pass, but eventually the thoughts took over completely.

“I wondered what was wrong with me, why bad things happen to me, why I now have this empty space in my life,” Mathers says.

“To certain people I would say things like, ‘Oh, I’m going to cut myself because you think I won’t,”‘ she says.

“At first, I think I was just connecting my thoughts and actions to how other people would react to me, to see if they would stop their actions towards me.

“As time went on, I was bullied and I started to hurt myself even more behind closed doors,” Mathers says.

“The thought of it being just a phase turned into real life.

This is a re-enactment of someone who would self-harm while cowering in a bathtub. Melissa Burks/ Spoke.

“I can remember taking a shower, sitting on the bathtub floor letting the water hit my back, trying to get my body and mind to relax. In the shower is where I inflicted self-harm,” she says.

If she wasn’t using the razor blades in her household to inflict harm, she would find shards of dirty glass outside instead.

Mikayla Goving, co-ordinator for Skills for Safer Living in Kitchener, a 20-week program for individuals with suicidal ideation or having experienced suicidal attempts, says people inflict self-harm to feel something.

“What happens with suicidal behaviour is you’ve got this deep pit of pain and you want it to end. And so, you cause harm to yourself in order to make that emotional pain end.”

Mathers’ emotions, she admits, can get the best of her.

To her younger self, she wishes she knew what she knows now.

“Reach out when you feel darkness coming,” she says.

She lost the first significant person in her life when she was in Grade 8.

Her grandmother, who had helped raise her since birth, died from kidney failure.

Two years later in the summer of 2010, Mathers’ mother passed away from cervical cancer.

“At times, I would think to myself, my mom is going to come home, I am going to call my mom, but then reality sinks in and hits me like a brick wall. She is gone. … It led me down a dark road.”

By reaching out, she could finally let out some of her worries and emotions.

She faced a huge curveball, being forced into a “mother figure” role at a young age, taking care of her four younger siblings who didn’t yet know what death meant, and didn’t know that their mom wasn’t coming back.

She wasn’t able to experience childhood as much as she liked, but the times when she did, she knew she could still be a kid and enjoy herself.

Mathers had a friend named Emma, also a pseudonym, who lived within a 10-minute walking distance. They hung out daily, had sleepovers and walked to and from school. Emma became a huge rock in Mathers’ life.

To this day, they are still best friends. They recently reminisced about one of their funniest childhood memories.

One night at a sleepover, where it must have been around 2 a.m., Emma was in the kitchen looking for something to eat when Mathers started to chase her and gently smack her with a wooden spoon. It was a race around the kitchen and living room, laughing while trying not to wake up their aunt who was upstairs.

Moments like those helped Mathers see the beauty in life, making memories and seeing a brighter future.

Recently, her aunt, who she’s lived with most of her life, was put into a medically induced coma to try to help with the many underlying health complications and unknowns including randomized seizures.

On January 30, 2020, she lost her battle.

She was Mathers’ third significant loss.

But this time around, Mathers immediately turned to her friends like Emma for an outlet and comfort, having learned her coping method at age 16.

Her father had connections to the Hospice of Waterloo Region where she did therapy in a family setting and a group setting for others who had also lost parental figures.

“I can honestly say that without the counselling sessions I wouldn’t have been able to survive the ongoing thoughts in my head,” Mathers says.

Now 25, she lives by the rule of never being afraid to reach out.

“Friends and family will always be there; they want to see you strive. Struggling is a part of life, but you don’t have to do it alone. Don’t ever be afraid of talking. Those who truly care will not judge you.”

Mathers says these days she is in a much happier place having learned so much.

“Now I’m not saying I don’t get sad or depressed because I do, but to say if any dark thoughts cross my path, I can happily and truthfully say no. I haven’t thought that way in many years.”

Understanding self-harm and suicide ideation

Mark Henick (right) addresses goers of Let’s Talk About It: Mental Health at Conestoga College’s The Venue in Kitchener, Ont. on Jan. 29. Melissa Burks/ Spoke.

Mark Henick, a Canadian mental health advocate and strategist, is famous for his Tedx Talk, “Why we need to talk about suicide.”

On Bell Let’s Talk Day 2020 he spoke at Conestoga College about his personal struggles growing up, mentioning his first suicide attempt was at age 12.

He told Conestoga listeners a common thing regarding those contemplating or attempting suicide is that family members see them in a different light. He says his own mother saw him as a good boy who had no underlying problems, and had no idea he felt so broken.

No one really understands that kids can feel that suicide is the only answer, especially at age 12 or under.

But why is it so hard to talk about?

In his speech at Conestoga, Henick talked about what it’s like being in that dark place.

“Something that you need to understand is that it distorts your world view and in really strange ways. It isolates and collapses you down into this tight little place where it’s actually harder to receive help. Now, the reason why that is, is because it’s self-preservation. You’re feeling scared inside your brain and your mind, which are doing things to try to protect you. But of course. it’s kind of counterproductive to what we need. So, when I first tried to or started expressing suicidal attempts, intensely, I should say, when I was 12 years old, nobody saw that coming. I was the introvert. I was a good kid, I self-identified as a smart kid. But what had been happening for the years prior to that was that my family had broken up, we moved into a new home. My stepfather, we found out very quickly, was abusive. … I didn’t have anybody that I really felt like I could talk to. I was a boy and my stepfather was kind of a hyper-masculine macho kind of guy, and we weren’t allowed to talk about our feelings. In fact, he said pretty frequently whenever he saw one of us upset or crying or expressing any kind of emotion that made him uncomfortable, to ‘suck it up … be a man, little boy.’”

Crisis Services Canada notes that men and boys are more at risk of suicide.

It’s a commonly known fact that our childhood shapes us, even when we aren’t realizing it. For Henick, it really created a pattern of suicidal attempts, which he goes into full detail in his talk, including the time a random man in a brown jacket strolled along and saved his life. While Henick was standing on a ledge, the man talked to him and kept him occupied until enforcement showed up and brought Henick to safety.

As the CMI states, in both Mathers’ and Henick’s cases, sudden changes indicated that these then-kids would struggle in the coming years.

The CMI says once it’s noticeable someone is sad, withdrawn from reality, more irritable, anxious, tired, and no longer partaking in joyful activities, that you should be concerned.

Why we need to help kids from an early age grow

Photo by Kevin Gent via Unsplash.

Shelly Burke, a certified counsellor in Courtland, Ont., who got her degree from Vancouver College, suggests educating younger kids about mental health could really benefit them, regardless of how difficult it may be.

“It’s getting down to the nitty-gritty,” she says.

Burke says there are many reasons why a youth may be feeling so lost and alone in the world, leading to the ideation of harming themselves, or worse.

It could be due to race, being unsure of sexual identity, trauma, family problems; the list goes on.

So how do we teach them what they’re feeling is OK?

“As a counsellor, you’re very protective of that innocence in a child, and you’re trying to navigate between what the parents think is best. But you’re also looking at what the children’s behaviour is, and what do they need? What do they really need to flourish and maybe get through a hard time,” she says.

She talks about the Sigmund Freud’s structural model of the psyche, the ego and the super ego.

“These are kind of the transitional periods where you’re born so innocent and you’re born without prejudice and you’re born without any trauma, you’re born just free of all that negativity stuff. … When you’re a child, you don’t know how to express yourself. So, your anger is what comes out. And usually with anger, that’s like a huge SOS, especially in children because they don’t know how to relate or correlate anything that’s going on. And they haven’t been able to learn how to grasp those things yet. So, it’s like an extensive distress code,” Burke says.

She describes it as being a huge red flag, because as an adult we know how to rationalize, but as a child we think we know best.

“I think that’s probably why maybe they feel more misunderstood because they can’t relate and they can’t express themselves properly,” Burke says.

“It’s important to give them choices. Not always be told what to do. But as a parent, that’s your goal. for many different reasons, safety concerns, that kind of thing. But giving them that freedom of choice also builds confidence. I think when you give them the freedom of choice, it teaches them responsibility. It also teaches them how to make a decision.”

Burke says in order to prevent later-in-life chaos in children, we need to start talking to them at a young age and educate in ways they’ll understand.

“You have to find a way to relate to them, and listen to what they are saying. And if they talk about colouring or if they talk about some other aspects that they really liked, and you really go towards that and kind of work around that kind of thing, something that they can speak to, or hockey or something, put it in a metaphor, or an example of what they can relate to,” Burke says.

Many of us have heard of the tale, The Boy Who Cried Wolf, which is a story of a boy wanting attention so badly he constantly yells he’s in danger, so people will come to his aid.

Eventually, people stop coming as they realize he is not in any danger.

One time he truly is in danger, but because he’s cried and begged so many times, no one believes him anymore, and no one helps him.

If there is someone in your life who is like this, do not take it lightly. They may be crying wolf, as this is how they ask for help.

Realize the signs, and see that you should be cautious at all times because you truly never know what could be going on in their head.

It’s all about putting yourself in someone else’s shoes.

The warning signs

Photo by Austin Chan via Unsplash.

Burke says she follows an acronym on viewing warning signs – IS PATH WARM?, a mnemonic device created by the American Association of Suicide Analogy.

I is for ideation.

“This is like threatening to hurt or kill themselves or looking for ways to die or speaking about it,” she says.

S is for substance abuse.

“It’s one thing if you know somebody smoking pot a couple of times a week and they’re just using it to relax. But if they start moving to, you know, a gram of cocaine or you start to find needles in their drawers because of heroin,” she says these substances are commonly used to cover up self pain and hurt.

P is for purposelessness.

“Usually in life, you have a purpose, you have a goal, you have a drive, you have ambition. But if you start to give up all those things that mean something to or that you’ve worked hard for, so like no sense of purpose, that becomes a red flag too especially if it’s a complete mood change in someone that you really see being a driven person.”

A is for anxiety.

“I think it’s just a need to fit in, which can manifest in so many different ways. And it might not have been so prevalent when I was growing up, but now with social media and the aspect of having access right at your fingertips – everybody’s life is in front of your eyes. So, what you don’t have and what other people have … you might not have a family that sits down to dinner every night because everybody’s on the go,” Burke says, adding some might just need to feel like they are connected to others.

T is for trapped.

She says it’s like there’s no way out.

“You start to feel like the walls are caving in.”

H is for hopelessness.

“Hopelessness about the future, feeling like nothing’s going to change no matter what you do.”

W is for withdrawn.

“That’s a big one. It’s a very hard thing to follow because teenagers and preteens want their own space. So, does that mean they want their own space? Or does that mean that there’s an underlying problem that you have to look a little further into?”

A is for anger.

This is often the first emotion, along with rage, and indicate something is wrong. “You know, seeking revenge or feeling like somebody’s going to get uncontrolled anger is different than just being angry.”

R is for recklessness.

“Doing things without thinking like giving away your furniture, selling things off, giving somebody your beloved poster like you’re starting to pass things off.”

M is for mood changes.

“So that’s like dramatics and that that goes back again to like, outbursts of anger, where you just know that somebody’s not able to control that rational side of the brain.”

In today’s society, Burke says it’s crucial to educate yourself on the warning signs, prevention and causes, and to truly listen to others in order to help those considering suicide.

“There’s just so much pressure when you graduate high school. Are you supposed to go to college or do you feel pressured to go to college? Or, can you just take a year off and work and figure it out? But a lot of friends are going to college, so do you want to be the one left behind? It’s all about feeling that confidence in yourself to make your own decision. … I think with parents, it just really stems back to you are parents, but you’re also a friend,” Burke says.

She urges parents to watch how your children behave.

The same goes for friends and family. IS PATH WARM? should be used when checking up on all loved ones.

Breaking the stigma, and learning to open up

Photo by Fabian Møller via Unsplash.

“One of the things we know is that the more hopeless and helpless people feel, the more likely they are to choose to hurt themselves or end their life. Similarly, if they feel a lot of guilt or shame, or if they feel worthless or have low self-esteem,” says the CMI on how stigma plays a role in suicidal thoughts and ideation.                                                        

The stigma of feeling worthless may also come from bullying. Bullying makes people feel bad and ashamed about themselves, and asking for help seems frightening as bullying could intensify.

The lack of support and feeling that there is no way to get help can be a huge hurdle for many.

“I think that we are still looking at mental illness as a stigma. We need to continue to help everyone know that reaching out and talking is never shameful, and that reaching out is a sign of strength. We need to stop judging and brushing off those who are trying to reach out. The attitude shown while having a conversation shows the kind of attitude someone will have towards those reaching out. We need to promote the strength talking has,” Mathers says.

Recognition and advice

If you or someone you know is contemplating self-harm and suicide, there are characteristics and things to look out for and things you can do to help.

If you are worried about someone, ask, how are you doing? Those experiencing thoughts won’t be the first to talk. Knowing the reason why thoughts could be occurring lead to suicidal solutions.

Notice the signs: lost of interest in something, feeling tired in more ways than one, pulling out of social events, skipping school, behaviour changes, etc. Try out: IS PATH WARM?

If you are experiencing thoughts, noticing the signs yourself is also key. If you realize you are sleeping more, changing eating habits, avoiding important events/ dates and school, ignoring personal hygiene, etc., it’s important to stop and ask yourself why. Put the thoughts into context, it could help get to the route of the problem.

Skills for Safer Living

The Skills for Safer Living program, in Kitchener since 2011, is a 20-week skills-based group and a peer support group for individuals with recurring thoughts and behaviours about suicide. Each group consists of up to 12 people.

Designed using dialectical behavioural therapy, cognitive behavioural therapy and emotional regulation therapy, it helps those suffering recurring suicidal behaviours.

“The sort of basic goal is to reduce the intensity, the frequency and the duration of crisis episodes,” say Goving, the co-ordinator.

Crisis episodes are situations where someone’s behaviour or actions could lead to putting themselves or others at risk of harm.

“It’s not a cure, but for a lot of people it does sort of gradually over time, by practising the skills that we teach, can help sort of reduce some of the crisis episodes and for some people who have done the program eventually sort of erase it all too.”

Meaning, over the time of the program, people learn coping techniques to help with crisis episodes, and learn to accept what happened and move on.

Skills for Safer Living is all about looking out for the best interest of yourself, and knowing how to maintain safety should an episode arise.

It’s done through three modules, the first being planning for the crisis.

“We do a scale of intensity, which is sort of like looking at the intensity of your feelings that day and being prepared for if your intensity goes up to a place where you know that you might engage in unsafe behaviours. What are some coping strategies you can include? Who are people to talk to or not talk to, at different places at your scale of intensity, that kind of stuff,” Goving says.

The second module is around emotions.

“One of the biggest takeaways from a lot of research on suicidality is that individuals who engage in recurrent, suicidal thoughts or behaviors have a low emotional literacy. … We do a lot of work on talking about how do you feel in different emotions like you know, the upset stomach, the sweating, the different physical reactions that can come with different emotions.”

The third module focuses on naming the emotions.

“We pass around different feelings wheels and emotional literacy is a big piece of it. There’s a term called psych ache where it basically means that you’ve got this big black ball of emotions and you don’t know what to do with it,” she says.

The final module is all about the relationship with others.

“We find that for some people, once the emotional literacy piece is further developed, the relationship becomes much, much more easier to work through because you can then express yourself to people in your life,” Goving says.

She adds articulating your feelings will allow the emotional pain to go away, allowing you to open up easier about your feelings.

Examples of where to get help

Photo by Shalom de León via Unsplash.

Remember first and foremost, this needs to be your choice, and not someone else’s.

Try talking to a trusted friend or adult, or even try a counsellor if the first two aren’t an option.

Find local counselling in your area. There is also:

Crisis Services Canada: Call 1-833-456-4566, available 24/7/365, or text “Start” to 45645, available 4 p.m. to midnight ET. Standard texting rates could apply.

Kids Help Phone: 1-800-668-6868.

Here 24/7: Provides addictions, mental health and crisis services in Waterloo, Wellington and Dufferin. You can call Here 24/7 at 1-844-HERE-247 (437-3247), TTY: 1-877-688-5501 or visit www.here247.ca for general information about accessing their services or those of the 11 Here 24/7 partner agencies.

If finances are an issue, many of these places offer free support. Make sure you check or ask when inquiring.                      

Educate yourself

Here is a list of sites to help get the learning going.

https://cmhaww.ca/programs-services/  – The Canadian Mental Health Association (CMHA) offers focused programs and services for all ages.

https://www.suicideinfo.ca/ – A branch of the Canadian Mental Health Association, they are dedicated to being an education resource on suicide and provide information, knowledge and skills to those at risk of suicide.

Check out: https://www.suicideinfo.ca/workshop-category/prevention/

https://www.crisisservicescanada.ca/en/ – Crisis Service Canada, stemming from the Canadian Distress Line Network (CDLN), is a national network designed to help with crisis and prevention, focused on strengthening service delivery and making sure all matters are addressed when it comes to gaps in mental health.

Things to remember

Photo by Jude Beck via Unsplash.

“Life is so beautiful. … Every life is precious. We should be doing whatever we can to help each other strive,” Mathers says.

“Emotions are human. It’s what makes us human. There’s not a person out there who doesn’t feel any emotions, even if they’re able to hide it,” Goving says.

As for self-care, it’s all about trying different things and seeing what works.

It could be a quiet area in the house dedicated to relaxing and calming down, but it could also be anything that you know eases you, like reading a book or listening to music in the dark.

For anyone who needs it, remember, it does, can, and will get better. 

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