Chronic Illness and Suicide Prevention
by Briana Livelsberger
Note: I am not a trained psychologist so there is a lot I could be missing. In addition, most information in this article is based on what I’ve seen and heard from others with chronic illness.
Since September is Suicide Prevention Month, I wanted to talk about something I don’t often see discussed on social media among the general public. While many recognize that poor mental health, bullying, poor environment, and feeling alone are possible factors, I haven’t seen many bring up how chronic illness can also be a factor that leads someone to commit suicide. Though the Suicide Prevention Lifeline does mention this, they also don’t have a list of resources for those who are thinking about committing suicide who have physical health issues outside of deafness or hearing loss.
I’m not sure why this isn’t brought up in mainstream media much but there are many important factors that I feel make this a major issue within the chronic illness community. You see, while an individual with chronic illness isn’t defined by their disease, their disease has an impact on every aspect of their life. They may not be able to complete work as quickly as their colleagues or peers. They may often miss school or work due to pain, sickness, appointments, or hospitalizations, causing them to fall behind in classes and feeling lost. Falling behind in work adds to financial stress since chronically ill individuals have many medical expenses and missing work makes them fear being fired, which would make it difficult to pay those expenses. They may not be able to participate in activities that “healthy” individuals can. There is also the fact that many with chronic illnesses are socially isolated. This social isolation can occur from recurrent and/or long hospital stays in which they aren’t able to see others often. But social isolation can also occur because others who don’t have chronic illness often don’t understand what it entails. They might ask how someone is doing but then cut them off or seem uncomfortable when a chronically ill individual answers honestly. Chronically ill individuals often have to cancel plans because of flare ups of symptoms or unexpected ER/hospital visits. After a while, “healthy” and “well-intentioned” friends may stop inviting chronically ill individuals, saying something like, “I didn’t want you to feel bad if you had to cancel again.” In addition, when someone doesn’t confide in a chronically ill friend, saying that they didn’t want to “bother” them, it can make a chronically ill individual feel even more alone. This pain, worry, isolation, and limitation can lead to depression as well as other mental health issues.
However, even though it is common for chronic and mental illness to go hand in hand, it is in an individual’s best interest to not be diagnosed with a mental illness. Why? Because an official diagnosis of depression, anxiety, or another illness will make most doctor’s appointments an uphill battle. While there are many doctors who believe that some individuals with chronic illnesses are “imagining” their pain and symptoms already, many more believe this when one has a mental health condition. The presence of depression/anxiety becomes a way to invalidate what a person is feeling, doctors often saying, “It’s in your head,” and recommending psychiatric help instead. Any good psychiatrist would be able to understand that a chronically ill individual’s physical health issues aren’t a result of their mental health issues. They will understand that the physical health issues as well as medications used to treat the physical symptoms often causes mental health issues. A good psychiatrist would know that it isn’t likely for someone to have a chronic illness and not have some struggles with mental health. But if one sees a mediocre psychiatrist, individuals are often further invalidated.
Knowing that something is physically wrong but being treated like their symptoms aren’t real can cause even more problems on top of the symptoms. And those who pretend that they are okay mentally in order to keep doctors from dismissing their chronic illnesses often end up needing to cope with their feelings with little or no outside help. Both of these scenarios create stress from trying to repress either how they are feeling physically or emotionally, causing someone to develop or have worsening depression.
Other factors that can exacerbate these issues is their living situations, relationships, and whether they belong to other minority groups. If one does not feel secure in their living situation or does not have their own space, it adds to the stress already present and/or can make one feel like a burden. In addition, if an individual does not have support in the form of family or friends, they may feel like they are on their own and that no one cares. If one is a part of another minority group, such as the LGBT+ or POC communities, doctors are more likely to dismiss symptoms of both physical and mental health issues. All in all, anyone with chronic illness can be made to feel like they are alone in how they feel and become depressed or anxious from not being able to express their feelings.
The warning signs of suicidal thoughts may not stand out as much to those around individuals with chronic illness due to the fact that some symptoms (such as insomnia) can be a result of pain or their diseases. As a result, it may be harder for others to catch. However, this doesn’t mean that it’s not happening. Among young individuals, the likelihood of suicidal thoughts increases by 28% while the likelihood for suicide plans increases by 134% in those who have chronic illness. In addition, the likelihood of attempting suicide increases by 363% (University of Waterloo). However, it is also common for people to think that committing suicide when one has a chronic illness is acceptable. But there is a difference between one deciding to die when given a limited time left and knowing that the end could be both painful for the individual and the individual’s family versus someone with a lifelong condition deciding to end their life even though they aren’t at the end stage of their disease. As a result, it is important to know how to prevent suicide and what to do if someone is displaying possible signs of suicidal thoughts.
How can we prevent suicide within the chronic illness community? We can ask how someone is feeling and genuinely listen. Asking and listening shows others that we care about them and that they aren’t alone in the challenges they face (Lim). It seems simple but it is one of the most important things one can do, since a sense of loneliness is often one reason why one thinks about suicide.
It is also important to know how to recognize the risk factors that can lead someone to suicide. According to the Suicide Prevention Lifeline, some of these risk factors include: lack of social support, feeling isolated from others, inability or fear of getting help, losing someone, and relationships ending. These show up constantly within the chronic illness community.
As stated earlier, one with a chronic illness can be in situations where they feel like they don’t have support and are alone in facing their diseases. There is also the fact that it is difficult to get the right kind of help because many doctors will pin all physical symptoms to the mental illness. It is also common to see a lot of announcements in which others in the community have died, possibly causing some to wonder why they are still alive when someone else isn’t. As a result, it is not surprising that having a chronic illness increases the chances of suicide.
It is also important to recognize the signs that someone may be considering suicide. These signs include: mood swings, anxiety, hopelessness, feeling like a burden, talking about wanting to die, and seeking ways to kill themselves (Suicide Prevention Lifeline). These signs also go hand in hand often with chronic illness. Any time something happens in the body related to chronic illness, it can set off the autonomic nervous system, causing one to feel and appear anxious. In addition, mood swings can occur because of this anxiety or insomnia or stress. Feeling like a burden is also common, especially among those who require assistance from others in order to complete day-to-day activities. Hopelessness occurs easily, especially if the chronic illness is one that is life-long, making one feel like they can’t escape it. But there can also be more subtle signs that people may overlook when a person is considering suicide. These can include: talking less if they usually talk a lot, withdrawing from the world, seeming to be more emotionally distraught, and spacing out more often. However, these signs are also common when coping with chronic illness. As a result, it’s important to listen to what a person is saying in order to understand if they might be thinking about suicide or not. Talking about wanting to die and seeking out methods to do so are clear signs regardless of chronic illness. However, if one with a chronic illness decides that they want to end their life, they often stop taking care of themselves or give up. This could be in the form of refusing to take medication anymore, refusing to see doctors, and/or refusing to undergo other treatments. For many with chronic illness, these behaviors can lead to death quickly, since a lot of chronic illnesses have tricky symptoms and complications.
However, if you are chronically ill and are considering suicide, know that you aren’t alone. There are many support groups for chronic illness with a lot of people who know what you’re going through. And while I, myself, am only a series of words on your screen, I know that there are always better days ahead. It may not feel like it, especially since most things hit all at once, but there are. I don’t know what forces move this world but, whatever it is, there is a reason for your existence. You are here. You are strong. You are valid. And you are a force capable of shifting the world around you. Your life is worth everything, and I hope you will be able to see that.
National Suicide Prevention Hotline: 1-800-273-8255