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An Interview with Thomas Joiner, Ph.D. on Why People Commit Suicide

David Van Nuys, Ph.D. Updated: Mar 13th 2009

download this podcast read the transcript

Thomas Joiner, Ph.D.In this edition of the Wise Counsel Podcast, Dr. Van Nuys interviews Thomas Joiner, Ph.D., a clinical psychologist, professor of psychology and researcher of the troubling topic of suicide. Dr. Van Nuys became aware of Dr. Joiner after receiving a brochure for the annual conference of the American Association of Suicidology, which will take place in San Francisco, April 15-18, 2009, several weeks in the future at the time of this writing. Dr. Joiner will be speaking at this conference, and Dr. Van Nuys suggests that attendance there would be a good way for local mental health professionals to educate themselves on this important topic while earning continuing education credits necessary for continued licensure.

Dr. Joiner cites two motivations that drew him towards the study of suicide. As a young research psychologist, he saw career opportunity in the study of suicide, after realizing that though it was the most lethal symptom associated with major depression, it was also the least well studied aspect of that disorder. His father's suicide, which occurred in Dr. Joiner's third year of graduate school further reinforced his interest. He speaks about suicide in a very personal voice as a "foe to be defeated", and in an important way has been able to channel his grief in a professionally meaningful and societally beneficial manner.

Suicide is simultaneously a huge public health problem and also a rare event. In the USA approximately 30,000 people suicide each year. Across the world, 1,000,000 deaths a year by suicide are estimated. Suicide is highly associated with the occurrence of a variety of severe mental disorders such as Major Depression and Bipolar Disorder, Schizophrenia, Borderline Personality Disorder and Anorexia, but the fact remains that the vast majority of people who develop these disorders do not suicide (though they may frequently experience suicidal thoughts). It has not been possible to predict with great accuracy who is at risk for actual suicide and who is not, or to know how to offer protective interventions which can reduce the risk of suicide in vulnerable populations (beyond the need to treat the mental disorders which so exacerbate or create the suicidal conditions in the first place). Accordingly, Dr. Joiner's work has been focused on trying to improve our ability to predict who is at risk and to identify the best ways to prevent actual suicides from occurring.

Dr. Joiner has proposed a new theory of why people suicide which he believes is more accurate than previous formulations offered by writers like Edwin Schneidman, Ph.D. and Aaron Beck, MD. According to Schneidman's model, the key motivator which drives people to suicide is psychological pain. In Beck's understanding, the key motivator is the development of a pervasive sense of hopelessness. Dr. Joiner suggests that these are correct understandings but are also too vague to be useful for predictive purposes and not capable of offering a complete motivational picture.

Joiner proposes that there are three key motivational aspects which contribute to suicide. These are: 1) a sense of being a burden to others, 2) a profound sense of loneliness, alienation and isolation, and 3) a sense of fearlessness. All three of these motivations or preconditions must be in place before someone will attempt suicide. Psychological pain and a sense of hopelessness correspond roughly to Joiner's concepts of burdensomeness and alienation, and contribute to the content of much suicidal ideation. These are necessary but not sufficient preconditions for a suicide act, however. So long as a person remains fearful of death and the actions and consequences of the activities that will create death, the actual act of suicide is unlikely.

Joiner notes that the incidence of suicide increases linearly with age; the older you get, the more likely you are to suicide. If I (Dr. Dombeck) understand him correctly, the way he thinks about why this is so is because as people age they are also more likely to develop (based on various life experiences) the fearlessness which transforms the simple desire for death into a plan for action. Joiner talks about the heightened incidence of suicide in professions that deal daily with death and violence, such as people in the military and physicians.

Dr. Van Nuys asks Dr. Joiner whether genetics or a tendency towards "thrill seeking behavior" might play into who is at risk for suicide. Dr. Joiner reports that research has established that there is definitely a genetic contribution to suicide, but that it only can explain about 35% to 40% of the variance that goes into suicide. The research suggests that the major way that the genetic predisposition seems to express itself is by influencing how the neurotransmitter Serotonin functions within the brain.

Dr. Van Nuys asks Dr. Joiner to talk about the warning signs that suicide may be of concern. Dr. Joiner reports that the best predictive signs are often fairly clear but overlooked until hindsight provides the necessary context for interpreting them properly. People are at risk for suicide when they communicate about their desire to end their lives or to kill themselves. Other warning signs include dramatic mood changes, the combination of agitation and insomnia/sleeplessness, and the giving away of prized possessions.

The best and most effective way to prevent suicide from occurring is to treat the mental disorders that are almost certainly present and driving the situation. Generally, the best modern treatments for these various disorders will combine psychiatric medication with some empirically validated (e.g., scientifically "proven") form of psychotherapy such as cognitive behavioral therapy.

Family and friends can help a person who is considering suicide by being alert for warning signs (as mentioned above), and by patiently and persistently encouraging that person to get mental health treatment. Dr. Joiner mentions the (USA) National Suicide Prevention Lifeline (1-800-273-TALK) which makes crisis counselors available to people at risk for suicide and also concerned family and friends. Dr. Van Nuys notes that people are often at a loss for how to respond to grieving family members who have just sustained a loss due to suicide. There is something about suicide that leaves many people feeling paralyzed about how best to respond. Dr. Joiner encourages people to treat a loss by suicide just as they would any other death, which is to say, by offering support to the bereaved. The right thing to do is to show up at the funeral and offer condolences; to check in emotionally with the bereaved and offer support, and to stay in contact with the bereaved after the funeral. The wrong thing to do is to remain paralyzed.

Dr. Joiner goes over several myths associated with suicide and works to dispel them.

Suicide is not a cowardly act but rather one that takes great fearlessness to accomplish. By noting this he does not mean to romanticize suicide, but instead simply to represent it accurately.

Neither is suicide an instance of "anger turned inwards". From the suicidal person's perspective, killing one's self is frequently seen as an an altruistic act - the removal of a burden to others. Joiner does not buy into this self-perception of burdensomeness, but he does understand that this is how suicidal people tend to see their actions.

Another myth Joiner is concerned about is that antidepressant medications cause suicides. In Joiner's opinion, though there are cases where suicides have been linked to antidepressant use, this connection has been "overblown" by the media such that physicians are now increasingly afraid to prescribe antidepressants to suicidal patients. Joiner notes that the evidence is clear that antidepressant use on the whole decreases the incidence of suicides by the means of treating the mental disorders like depression that contribute to suicidal impulses.

Dr. Joiner notes that the research on suicide barriers for bridges like San Francisco's Golden Gate Bridge shows clearly that such barriers prevent suicides. There is no evidence to support the idea that suicidal people are determined to kill themselves and will simply go somewhere else to complete their suicide. In locations where barriers are in place, the overall rate of completed suicides decreases. He is strongly in support of a suicide barrier for the Golden Gate Bridge and sees as morally outrageous the argument that the barrier's construction should be delayed on account of expense or aesthetics.

In his closing remarks, Dr. Joiner hopes that listeners will offer compassion to suicidal people and their families, and that they will encourage (with patience and persistence) suicidal people to get mental health treatment for their symptoms. The combination of psychiatric medication and cognitive behavioral therapy (or other scientifically supported psychotherapy) is effective even though it can be a struggle to find the right combination of therapies to provide relief.

Links Relevant To This Podcast:

About Thomas Joiner, Ph.D.

Thomas Joiner, Ph.D.THOMAS JOINER grew up in Georgia, went to college at Princeton, and received his Ph.D. in Clinical Psychology from the University of Texas at Austin. He is Distinguished Research Professor and The Bright-Burton Professor in the Department of Psychology at Florida State University, Tallahassee, Florida. Dr. Joiner's work is on the psychology, neurobiology, and treatment of suicidal behavior and related conditions. Author of over 385 peer-reviewed publications, Dr. Joiner was recently awarded the Guggenheim Fellowship and the Rockefeller Foundation's Bellagio Residency Fellowship. He was elected Fellow of the American Psychological Association, and received the Young Investigator Award from the National Alliance for Research on Schizophrenia and Depression, the Shakow Award for Early Career Achievement from the Division of Clinical Psychology of the American Psychological Association, the Shneidman Award for excellence in suicide research from the American Association of Suicidology, and the Award for Distinguished Scientific Early Career Contributions from the American Psychological Association, as well as research grants from the National Institute of Mental Health and various foundations. He is editor of the American Psychological Association's Clinician's Research Digest, editor of the Journal of Social & Clinical Psychology, and incoming Editor-in-Chief of the journal Suicide & Life-Threatening Behavior, and he has authored or edited fifteen books, including Why People Die By Suicide, published in 2005 by Harvard University Press, and Myths and Misunderstandings About Suicidal Behavior, in press, also with Harvard University Press. Largely in connection with Why People Die By Suicide, he has made numerous radio, print, and television appearances, including write-ups in The Wall Street Journal, Men's Health, and The Times of London, a radio interview on the Leonard Lopate Show in New York, and two appearances on the Dr. Phil Show. He runs a part-time clinical and consulting practice specializing in suicidal behavior, including legal consultation on suits involving death by suicide. He lives in Tallahassee, Florida, with his wife and two sons.

    Reader Comments
    Discuss this issue below or in our forums.

    Mental illness not - Chloe - Jun 26th 2014

    it is not always mental illness. Sometimes one's circumstances become overwhelming and when all happiness or even any prospect for it dissipates what is the point? 

    A couple of suggestions from someone who nearly died after a serious suicide attempt - Karen H. - May 10th 2011

    I just listened to two of the absolute best programs I have ever heard on the subject of suicide: this excellent interview with Dr. Joiner, and another great Wise Counsel episode featuring Dr. Nancy Rappaport.

    I am a 52-year-old woman who's had major depressive disorder (diagnosis later changed to bipolar disorder) since the age of twelve, and who very nearly died from a suicide attempt in 2005. I agree 100% with all of the points that Dr. Joiner made on this program, and I'm grateful to him for pointing out some important truths about suicide (and repudiating some misconceptions and myths about it) which many other suicide experts don't bring up -- for example, the fact that most suicidal people feel that they're a huge burden to their loved ones, and that their loved ones would be much better off without them, and that the idea that suicide is some sort of hostile or angry act or a way to get revenge is a myth.

    After having read and listened to quite a few articles and programs about suicide, I'd like to make two points based on my own experience -- just a couple of suicide-related facts that I think  would be helpful for experts to keep in mind when they write or speak on this subject: First, families and friends of people who may be seriously considering suicide should be aware that some of us made a conscious decision NOT to tell anyone that we were planning suicide, especially if we have already made a previous suicide attempt. That said, I think it's great that nowadays I almost never hear the old "if they talk about suicide, they won't really do it" myth anymore. Some people talk about their suicide plans ahead of time; some people don't. Second, please don't forget that many people who try suicide are ALREADY being aggressively treated for major depression, bipolar disorder, etc. (I have made two serious suicide attempts in recent years, and I have been taking meds and seeing a psychiatrist regularly for years.) When an interviewer asks something like "What should a friend or family member do to help when someone feels suicidal?" the interviewee seems to invariably answer with something about encouraging the suicidal person to go get treatment.  I wish they would also discuss how to help the suicidal person who is already in treatment.

    Husband - Penny - Apr 10th 2011

    On January 7, 2011 my husband Randy suddenly without warning left me for another woman.  We were together for 15 years and I loved him unconditionally. He told me to trust him and I did completely.  I am left utterly devistated by his selfish actions.  I feel that a part of me has been ripped away and I will never be the same.  I am traumatized and wish I could wake up from this nightmare.  I cry constantly and relive the event over and over.  I can't get my mind off of him no matter what I do.  I can't live like this any more.  The pain is just to great.  I have been asking God to take my life and end this suffering.  I do not want to live. 

    Suicide - Lisa - Apr 10th 2011

    My husband took his life on January 7, 2011. He loved life! he was older than me and he made me feel like a schoolgirl. He ended his life over a stupid argument we had.  I heard the gun, I looked up and he fell. I will never get over this. God has comforted me, but I feel like  a part of me went with him.

    fleeting thoughts - Starr - Feb 8th 2011

    Such BS- I have lived my entire life with fleeting thoughts of 'better off dead' I still do...My story sucks.

    How about everyone tries to make someone smile, everyday? Imagine everyone is willing to do just that one little thing...

    Share your knowledge, share your connections, mostly share your love!!!

    on the brink - kelechi - Nov 22nd 2010

    Today, i came very close to throwing myself underneath a moving car. It is surprising, as the build up to that point was sudden and that just a day before, i was awash with a feeling i might describe as joie de vivre. I shall state my case here, not because i am out of the brink, but because i do not want to die, but realize that my not wanting to die is not a strong enough reason to stop me from the act.
    I am nigerian and twenty five, i realized somewhat late in life that my sole abiding interest is literature. However,this realization came up because of my profound lack of interest in my engineering course. However, i wanted to finish it for some reasons; intense pressure and abuse from my father, a desire to escape from the jinx of an uncle and brother who had matriculated here but failed to graduate and a simple understanding that i would be better off with the degree. However, i have not succeeded so far. I stopped work on my novel for years in order to face school, so that i feel that much of my youth has essentially been a waste.

    Happiness - Realist - Sep 28th 2010

    Hello All,

    I sincerely hope that not one poster has taken their thoughts to heart and acted on them. I think that the most important element to suicide ideation is the "happiness" meter. It's like we are all running around judging ourselves against this happiness barometer that does not, in truth, exist. Happiness does exist, but it's not a perfect feeling of peace and belonging. It's making it through the day to day slogging of life. Feeding your children is an accomplishment, a place of joy. Sitting, quietly, in your own space is an accomplishment. Love is not a movie. It is a day to day acceptance of another human being. Life does not have to be dramatic to be real. The happiness that you feel eludes you is already part of you. It just takes acknowledging it as so. Pain is there too, but there would be no pain without your connections. Nothing could cause you pain if you did not actually care. AND, what's wrong with caring? It's solid proof of being human. Please hear me, all of the articles, books, news specials, and Oprah guests that tell of this extreme happiness are selling gold to the miners. They feel the same joy that you do, the same pain, they just choose to package it differently. We are all in the same boat. You could never be alone in a world like the one we live in. We all know that it would be much easier to just sleep life away. There is nothing wrong with you that you feel pain. It is not the sign of a mental disorder, but a sign of good health. (Sociopaths feel no pain.) You can, however, choose to interpret the pain in your own fashion. I choose it as proof of life. I hope that you will try as well.

    Commiserating with others here - Dee - Sep 26th 2010

    I definitely want to not be alive, have felt this way for quite some time, and beginning to get to the point where I am not afraid.  I'm actually not afraid for myself ... I'm concerned about my dog and who will take care of her and I'm concerned about causing pain to my 20 yo daughter who is pretty much on her own now.  Aside from that, there is nothing, absolutely nothing that I am interested in.  I have lost all faith in human beings, aside from my daughter.  And quite sadly, she is no longer the thread that keeps me going.  I am so sorry about this, but the pain is terrible.

    left behind - Gretta McConnell - Sep 19th 2010

    I tend to agree with allot in this article, especially that the risk of suicide can increase with age.  I just lost my husband four short weeks ago.  He was 68.  Our lives had steadily declined in the last 2 years, he stopped taking medication 6 months ago, and isolated himself 4 months ago.

    With the amount of mental health resources available, even for persons who do not have insurance, persons who suffer with mental disorders still need to be accountable for their personal lives.  If therapy and medication cannot go hand in hand with living daily life, then how does one improve their long term prognosis?

    My husband could not manage his financial situation for many years and first hid it from me, and this added to his stress level.  Many people, including his own children never knew him for just the kind caring loving man he was, and instead he added pressure he did not need, and became financially bankrupt prior to taking his life.  I am just now finding out some of the things that were not done in our financial situation.

    Thank you for your article.  I too, suffer from bi-polar and am struggling daily to get through this.

    i am not preaching but help lies beyond this planet - - Sep 8th 2010

    i am myself a victim of situations described above in one way or the other. I can only state that I got help from Rajyoga meditation taught by the Brahma Kumaris World Spiritual University having its international headquarters at Mount Abu in India.

    Why not? - A man without qualities. - Sep 7th 2010

    Some people have a romantic concept of suicide, some just don't want to get old. Life just flows too slowly in some so why not speed it up. As strange as it may seem, maybe some just want to feel alive just for an instant. We're not duracell bunnies, we will not last forever and after 30 you're going to start slowing down so why not go out with a bang. Hell we weren't meant to live this long anyway.

    Kick while they are down - you love it - Chris Williams - Aug 22nd 2010

    The world is just a hateful place no matter what you do. Everyone just loves to make it impossible to do anything in this world anymore they don't want you to have any success at anything they don't want you to live and or enjoy anything but don't kill yourself either oh no act like you enjoy it while your getting screwed every which way they can screw you and laugh at you, look at you and scrutinize you. I swear humans are such bastards. You cannot understand until you have been at the edge seeing how evil this world can be and how no one really gives a damn they just want too act like they care when they don't really give a rats ass just as long as they can take everything from you that means anything including death. So I hang in there because the last enjoyment such evil bastards can have in this world you can deny them their final pleasure with you as long as humanly possible - they try and try push you over the edge and the longer you stave off their assault on everything good in life the longer you suffer at the hands of this bastard world of hate and so hate begets hate and tormented souls live on knowing the longer the huamn tormenters don't get their way with you for a final conclusion so they can laugh at that too the longer they lose and the more they ramp up the assault. So we have the survivors - but you really did not gave a crap when it counted so don't give me your horseshit just another example that humans will make sure you never ever succeed at anything without the pitfalls of their feelings and their wishes but just torments at life and torments in death to satisfy you that someone other then you failed and you didn't. Enjoy your wealth and riches spoiled brats of success and every time you look down on someone because your so grand over them your so goddamn special every time you look down on others you selfish pigs of the Earth can at the very least shove psycotropics down the throats of humans to inrisc yoursleves as you try to fit it all in your box of bullshit and bottom line is you liars love to kick em when they are down but only blame youself because it's all your fault you got screwed in life every which way possible. Your bald your ugly, your poor, your depressed, your this and your that, you have not had sex in 10 years and they laugh at that too. This is a goddam prison planet for evil selfish rich bastards to enjoy. Never any more lucky breaks for the down trodden no matter how intelligent no matter how tallented don't let them make it - just push and push and push them over the edge

    26 years to the day - - Jul 7th 2010

    After almost 26 years to the day, I've finally found out where, not why, my uncle committed suicide. This happened in the Van Cortland park area of the Bronx in New York on 10 July 1984.

    I've just spent the day reading the police report and other items of this nature and spend the whole day wondering why? I realise I will never know the true answer to this question.

    But what is really strange and bizzare is the fact that I spent almost three years living in the neighborhood where this park is located without knowing what had previously happened. It's an unreal feeling knowing I might have walked past the tree where my uncle hanged himself all those years ago. It's not all bad as there is a sense of relief and closure now and someday I hope to return to this park and lay some flowers there.

    philisophical reason - angel - Jun 11th 2010

    I know how I can cure the sadness and suicidal thought just by duming myself down, believing with no proof, and just not thinking which is the key to hapiness. It is when you don't want to let go of your reality that brings you pain. So the only way I can cure myself is to let go of this world live in the wilderness and figure a way to make myself stupid and less aware of this world, or try to live by the basic rules society whis is become a celebrity/athlete/politician etc and just follow the pain, and in the end there is nothing more ruthless than someone who takes their own life. So im just left with the extremes of two choices: death or basicly live like a vegetable baby.

    If you have to ask, you don't get it...... - Dave - Jun 1st 2010

    Why do people commit suicide?  Well, if you've never felt that way, you definitely can't understand.  People, like myself, who are at the end of their rope, are just tired of life, tired of the lies that people tell every single day, tired of rejection, tired of the struggle, tired of clawing and scraping along this miserable existence, just to have our footing pulled out from under us every single time we feel like things might just be going our way for once.  Tired of the people we felt like we could trust the most betraying us, tired of friends and family turning their backs on us, tired of going on and hearing "Just keep your head up."  The only reason I will keep my head up is so it will be easier to cut the carotid artery in my neck.  Oh, and I'm 24 years old.  If this is life so far.....I don't want to keep living it.  I'm doing myself a favor by removing myself from the equation.  The rest of the world can burn for all I care.

    looking for bravery - empty - May 30th 2010

    I want to die - I think about it constantly, especially the past 2 years or so when I finally had to reconcile myself to the fact that I will never accomplish anything in life nor find the happiness I've always longed for.

    My husband puts up barriers to my working, then derides me for it. He has become cruel and intolerant. He has always refused to allow me to go for counseling, citing the cost and telling me I wasn't trying hard enough on my own. He doesn't believe I am depressed, only lazy and selfish.

    I took anti-depressants for years - they helped, but never provided complete relief. Then about 5 months ago, my husband unconditionally demanded that I stop taking them. He said he was concerned that I was "addicted" to them and besides, they cost too much. Now things are so much worse. My body weighs 100 x more than it used to; the desolation of the future stretches ahead without wavering; I want to be loved, but am not.

    I have a brother, but he has severe health problems of his own and, like my husband, doesn't believe I try hard enough, either. My closest friend died 5 years ago and the one other friend I have is currently very sick, battling cancer. I struggle to be positive when I talk to her. My husband alternates between telling me how much he loves me so that if I think about divorce, he'll throw me out without any money and then will flare up other times, demanding that I leave NOW. I don't have a firm footing. I feel like I'm falling through space all the time, no matter how carefully I try not to provoke him. He also drinks too much.

    I've been Hedda Nussbaum-ed, but without the black eyes.

    * So, I have abundant hopelessness.

    * My husband tells me frequently what a burden I am.

    * I am trapped in a dangerous marriage with no way to seek relief.

     The only component I'm missing is the bravery, the fearlessness, to actually kill myself. I desperately need to know how to get it.

    I understand - Susan - Apr 2nd 2010

    I am a psychotherapist who has lived a long time with depression. My advice is to get involved, and create a community for yourself. If your family is unkind...(and mine are world-class unkind), create your "family of choice". Sort through people collecting the "gems" along the way. Be a "gem" yourself". Don't throw pearls before swine and expect the swine to be appreciative. Find people who can appreciate  a good friend like yourself. Make sure the "new friends" are not just takers but are also givers. When people are not treating you right, move along...don't get stuck expecting them to change. Let people be responsible for their own behavior. Don't blame yourself for the way other people act.

    Be determined that you can make your corner in this world a better place. As you help make life a better place for others, you create a better place for yourself. Love others...love yourself. Life on Earth did not occur due to random chance. Your here, make your mark, recognize the power you have to bring joy, rest, laughter, peace and warmth to your fellow human beings. Remind people that we are all simply part of the human family, and we need to treat each other right. 

    Depression makes it difficult to reach out for help. DO IT anyway! Keep doing it until you get the results you need.

    Done - Done - Mar 25th 2010

    My life is work. 7 days a week, 365 days a year.  I get 6 hours of sleep a night. In the last 9 months, I have had exactly 2 days off. For the forseeable future, I see no days off... No time off work or ... when not in work... no time not being primary caregiver for someone else. I have no life. I am tired. I am trying not to show it so that no one will try talk me out of it. I have been thinking about this for a long time.  If I could make it NOT look like suicide, I would do it today. I want my wife to get my life insurance, and I want my kids to NOT blame themselves for it. I am thinking about making it look like I just fell a asleep with the car running in the garage. 

    It's my fault - Angie - Mar 22nd 2010

    When I was 10 years old my father died and my grandmother blamed it on me, though he died of a heart attack and stroke. I was young and believed her, and it stuck to me. I went to counseling at school and people tried to tell me that life would go on but it doesn't matter anymore.

    My counselor told me that if I went on pills my depression would improve, but my mother objected and I never got the help I needed. I haven't attempted suicide, just self-mutilation, but people say that that leads up to suicide.

    I know that I am of no use to my family, so I've been thinking, "why do I bother?"

    No One Would Care - A Note - Mar 21st 2010

    I have suffered from clinical depression for over 10 years. My condition has been exacerbated by a series of life circumstances, too complex, convoluted and personal to post in a public forum.  It is enough to say that I am Asian, have had to meet exceedingly high professional, academic and social expectations set by parents and family my entire life, and well, of late, I am finding that I have become too tired and exhausted - mentally, emotionally and physically - to carry on living. 

    By objective standards, I am a high-achieving professional.  I am proud of what I have done in my life and, importantly, of who I am.  I certainly do not suffer from low self-esteem;  I am well aware of my capabilities. 

    I am, however, profoundly disillusioned by the people in my life.  In recent years, family members, so-called friends and colleagues have gone out of their way to hurt me in the worst possible ways.

    So it has come to this:  I will leave this world one day, at a time, in a place and using a method of my choosing.  I will leave not because I think I am worthless or a burden to others.  Rather quite the opposite.  I will leave because at the age of 41 I have lived enough of life to know that my future will be the same as my past; a continual downhill gradient to increasing pain and unhappiness because of the people in it - unless I do something about it.  I want to find that special quality of happiness and peace that has eluded me my entire life - and I will find it, not right now, but eventually, may be soon.  It is discomfiting to admit this, but oblivion is a far happier prospect than the pain I've had to experience.

    And what about those left behind?  Well, in my case, there will be no one left behind.  No one has walked with me - beside me, held my hand, worried about me, as a thinking, feeling human being - for years now.  So that means that no one will miss me, care about me or suffer after I've gone.  Even if they do, believe me, it will be momentary - sort of like a slightly irritating mosquito bite that has to be scratched now and again, but will eventually fade away.  In any case, given all the pain they have caused me, it would hardly be a lie to say that: I simply don't care. 

    I also have a major trump card : no one suspects, in the slightest, that I am depressed.  I've kept it very well hidden over the years. 

    Well, these few minutes have been quite cathartic.  Not to worry -  I am giving myself a little bit more time, but it's best if i don't tarry too long. 

    Trying to Understand - Teresa From California - Feb 2nd 2010

    I never thought I would be raising my son alone, but my husband committed suicide on Thanksgiving of 09.  You would never believe he was suicidal, because he always smiled with everyone.  We had been together for 12 years with a few problems in between.  He was a working alcoholic and abused prescription drugs while we were married.  After 12 years of marriage I found out he had molested my 2 girls when they were only 8 and 10.  I was devestated and didn't understand how someone could hide this act or even do it.  He was a Christian and studied the bible and went to church with us.  A little while after that, he lost his job after 31 years and everything went downhill.  I decided to leave him and take my 10 year old son, until he got help.  1 week before I was to move he shot himself in the head in our house.  He was depressed, but didn't want to go for help, he just wanted to die.  I didn't think it was selfish, because it was his choice and that is what he left in a letter.  He left 4 beautiful kids not understanding what happened.  There is help out there, but if you don't ask, you won't get it.  He totally turned his back on God.  God says I will never leave you or forsake you.  If you are thinking of giving up....Please Don't....There are people who care.  My husband had 500 people show up at the memorial.....but he felt he was all alone.  He thought about this for a long time, it wasn't over night.  Don't let the negative voices deceive you......

    TOO MUCH! - Kate - Jan 10th 2010

    You did indeed find the tip of the iceberg.  Psychological pain, years of flashbacks and nightmares about childhood abuse, a lack of coping skills, inability to deal with extreme emotions that seem to come up from nowhere... wondering if it will ever get better or only worse as the years go by.  Is there something to live for and look forward to?  Will there ever be a time of LIVING life instead of just existing or surviving?  Will there ever be a medication that works for more than 18 months for me?  Have I passed this awful cursed mental disease on to my children ~ not knowing I even had it until after they were born?!?!

    No, I don't fear death ~ I welcome it.  What I fear is messing up a suicide attempt (again) and being a mutilated vegetable in more pain than I already have.  My sister feels the same.  At least my immediate family wouldn't fuss about the bills to care for me or the burden I'd be, though sadly hers would.

    To: Hopelessness - Hopeful - Jan 9th 2010

    People do care, it is just the ignorant ones that don't. You should not kill yourself, although I know sometimes it feels like the only way out. A friend of mine died last year, we didn't keep in touch that much over the last few years but he always came across my mind. Now he is gone, and literally not a day has gone by that I haven't thought about him. I doubt he would have thought I would have been so affected by his actions, but I am. There are people who care. You just don't know it, cause you can't see threw the hurt. I care and you don't know me...

    hopelessness - - Dec 21st 2009

    As I walk in the street, I notice that people turn away from me. We're supposed to be a community but that's only for political gatherings; in reality, we are afraid of each other. We live in fear but the powers that be deny this. They always speak of community which is only an idealistic imagination. For the depressed person, walking in the street in a constant reminder that he is not wanted. People avoid him or her. This adds to the feeling of worthlessness that he already feels. 

    Suicide is ending this pain. The daily pain of living as a non entity. In the US, a culture that worships celebrity, an average person is a non entity. While people are young they try so desperately to make it but there's only so much room at the top. Most people cannot make it and when the forties arrive, it is too late. Unless you happen to be wealthy or possess something to trade, you are cast aside and become a non entity. Most adults are depressed and the only thing that keeps them alive is the entertainment indusrty. They don't have a life anymore so they live vicariously through the lives of celebrities. When entertainment does not work anymore then the thoughts of ending it all appear. Most people don't kill themselves because they do not want to hurt family members, that's the only reason.

    When the pain is too much they say" sorry, guys, this is as much as I'm willing to take. " Some people say: don't commit suicide, you will hurt the community but is not the community cruel with everybody. Look at yourself, don't your eyes look away from people? Being friendly is dangerous because they might want something from you. If you open up, people will want something from you, so we close up. This is the reality that no one wants to admit. We are friendly to each other in the measure in which we profit from each other.

     Ultimately, there's no such thing as suicide because nothing gets to really die. There's only transformation in the Universe. Sure if you kill yourself, someone will think about you here and there and feel a little sad, but if their lives are working out for them, they won't give you another thought. This weekend people are rushing to see AVATAR, the new movie by James Cameron, and at the same time soldiers are dying abroad, does anybody care? Of course not. Of course, when we get together at some gathering, we put on a show that we care but truly, deeply, we don't. We only care when it touches us directly. So don't feel bad about ending your life because everyday, in the street, in your family, they show you that they don't care.

    take a second - - Jun 7th 2009

    to suicide may 9th and any others of you contemplating suicide please dont. i understand that situations can be very painful and life can be rather meaningless and tedious and for some of you unbearable but unless you are quite literally the only person in the whole world who will be affected by your death do not even think about ending your life. you still have a responsibility to those left behind if not to yourself. for those of you who come from broken families or who have been isolated by friends, don't see this as an excuse for suicide because when someone dies someone knows and you don't know how it will affect the police officer, coroner, doctor or the little girl watching the special on your death. so please before you commit to something that can never be taken back and take the hope away from someone who still sees something in life, live for the rest of the world if not just for yourself.

    Cheers.

    rose.

    suicide - - May 9th 2009

    I am suicidal. Have had these type of thoughts my whole life but they always stayed inside, subconscious in a way. now they are out. I am terribly lonely, depressed ( it comes and goes my whole life) and now for the first time I am telling people that I want to die. I am no longer afraid of the consequences of my death. I used to think I would go to hell but thats just a bunch of crap. there is no God, no hope, no truth and definately no punishment for suicide. Its all just a bunch of crap we feed ourselves to stay "positive" and keep hope alive. what is hope, its deluding yourself that life can and will improve. it wont. those are the statistics.some people by luck or whatever have a better life but some of us dont and after a while the pain just gets too much. I am 37 years old so i feel i have given it a good run. I have tried everything - psychologists, a healthy lifestyle, a good career, an over all positive life but bottom line I come home alone everyday. And i cant understand why, why am I so jinxed in love. why have i been doomed to spend my life on my own. It really sucks you know being alone, pulling into the driveway after a productive day and knowing I am going to eat alone again tonight and wake up alone again tomorrow. So i don't feel like a burden but I definately do feel hopeless, fearless, and terribly depressed. I am sorry as my sister will be devastated if I die and I will be devastated to leave her, she is everything to me, but this pain is too much. and she must please understand that I am the one living with this pain, she cant take it away, she lives on the other side of the world. no one can truly understand what it feels like to be alone day after day year after year and finally realising its never going to change. I am destined to a live alone and I am sorry whoever decided this to be my fate I am sorry but I just cant cope. I have needs to be loved to and to love in a romantic relationship dont ask me to live without it. please forgive me and offer me the way out. I am actively looking for it now, the poison that will take put me out forever. amen

    Motivational Aspects Collide - Frank from Australia - Apr 1st 2009

    Great interview with Dr Joiner. When the three motivational aspects collide you are in trouble.

    I suffer from major depression, diagnosed late in life after forty years of torture. Suicide was always an option. It lead to many situations where you place youself at risk without fear of the consequences, knowing that if you didn't come through the other side it was no great loss. In fact most times you hoped for it. 

    Early diagnosis of mental illness may have helped me. Self medicating didn't. I would like to see some more studies on the relationship between self abuse and suicidal behaviour.

    For those in my shoes, stay close to those you love and who love you.

    I know - Scott - Mar 28th 2009

    About two and a half years ago I experienced that pain in such a way that I wanted to end my life. I felt like I was a burden to my wife, children, parents, inlaws, sisters family, and myself. In the same day I lost my job, my wife kicked me out of our home, I was living in my car, and was depressed. Within a month someone stole my clothes, my computer, my cell phone and some of my possesions. I had been married for 20 years and had three great children. My counciler suggested to my wife to ask me to move out. I was 150 pounds overweight and I had sleep apena. I was getting maybe 2 hours of sleep each night and now in my car less. I was crying alot and I was falling asleep while driving in town. My parents let me stay at there home but I was so depressed all I could do was sleep, and not move because of fear of failing. I had adhd which I found out later in life. I also had mild addiction to porn on the computer. I never cheated on my wife with someone else but I did look at pictures of porn. I had lost around 15 plus jobs in my life and I left about 15 because of my uncared for mental health. I felt over medicated. I was taking lexipro, wellbutrin xl, straterra for add, and many other meds for blood. My wife while we were seperated started dating other men and inviting these men to our home. Some of these men spent the night but my wife said she never had any sex. My kids have told me otherwise. This just sent me into a downward spin. My wife went to a lawyer and I signed seperation papers because she said if I changed she would ripp them up. I think hindsite she was stringing me along just to have me sign them. I told my parents that I felt better if I was just out of everyone hair. I had stomach pain all day. I was angry that my wife would do this to me. I was codependant and I did not know this. She really did so much for our family that I took it for granted. What kept me from killing myself? I had God in my heart! I just could not let my kids experience the loss of there dad. I also relized Gods grace. How I had been always trying to earn everything in life. Love, approval, boss approval, family approval, wife approval, family approval, God approval. I found out that I cannot earn Gods love and grace. It is and was always free! I could not earn it. I found this out by going to Grace life ministries and seeing a counciler. I found some men in my church that affirmed me and me them and I could have a safe relationship with them. I put my hope and trust is God and Jesus. I started letting the Holy Spirit lead my life. I just did not let any thought go through my mind. If it was a bad thought I know where it was coming from and stopped it. I am getting better at that each day. When it was a great thought I new where that was coming from as well and I meditated on those thoughts more. I got into Gods word the bible and I wanted to read it more and more because I liked to and not because I had to. It was like I was no longer under the law. Jesus released me from that and His grace took alot of that pressure off. I was believing a lie that I was no good, and a burden, and I was alone, when all along I was in the family of Jesus Christ. No one could ever take me out of this family ever. Once I found out who I was in Jesus I was saved forever. Yes I have bad days and I have great days too! I now understand in my mind God and sin. I am not alone. I also can see the pain I experienced in others now. I guess God in me now loves to love on the hurting people like I was. How special is this gift I have been given. If you read this and know what I have felt then you too have hope too! You are very special too! Let someone show you how special you really are! I have lost over 100 pounds, have been able to go off many of my medications and now I let God live through me. He exchanged His life for mine. What a great gift it has been. Totally free! 

    Life long depression - alice - Mar 17th 2009

    I agree with Deb L.  I find my suicidal thoughts are based in  my feeling overwhelmed and hopeless. My thoughts of suicide grew as my life became overwhelming.  I lived each day, wanting to kill myself, but holding off for whatever reason I could come up with, usually due to my love for my children and not wanting to scar them for life.  After many years of torture, I was diagnosed as Bipolar ll (hypomanic, or depressed). One of my children (now grown) has 4 distinct and significant disabilities. I fought to secure assistance help for him all of his childhood and until recently (he is now 22).  He was just diagnosed with Bipolar l (manic).  I blame myself for his troubled life.  This guilt is overwhelming at times.  Sometimes I feel I would like to end both of our lives.  I know I would never do that, but just like the suicidal thoughts I have had for all of my adult life, I know I have to keep fighting.  Therapy has given my limited help, but I can not afford to go any longer, but I am consistant in taking my medication.  I do have good days, but it doesn't take much for my depression to take over.  I have heard people say that committing suicide is a selfish act of a coward, but they just don't know how much pain each day can bring. 

    What a waste of humanity - M. Justice - Mar 14th 2009

    My family is dealing with the recent death of  son-in-law, estranged husband, father... It is very complicated; but as always, the surviving family are asking themselves "How did I miss this? What could I have said, done? How can I explain this to a 9-year old when I don't even understand it myself?"

    My son-in-law meets all of your criteria. He had lot his job & his RN license because of drug abuse. He could not hold a job. He had some significant loss of mental and physical abilities due to the drug use. I'm sure he was feeling that he was a burden to his family. He had been taken to the hospital several times with suicidal behavior, but was released quickly because he had no health insurance.

    He was surely feeling lonely, alienated and isolated. He had become physically abusive to his estranged wife, my daughter, and his son. They had moved into an apartment a few blocks away. He lost their home in foreclosure and wasn't able to pay child support. When he no longer had money for drugs, many of his "friends" abandoned him.

    As for fearlessness, he was a big man, tall, weight-lifter. He was always pretty macho. The fear of dying compared to his psychological pain probably seemed small.

    Our daughter & grandson had been held prisoner by this young man for about a year. We had no idea what was going on until they came home for Christmas on a gift-ticket. If she had only talked about their lives, we might have been able to intervene. However, she was so embarrassed that he had "tricked" her into moving 1000 miles away from family, that she never talked about this situation. She only returned after Christmas to retrieve her dog and a few personal possessions. He took his own life within 2 weeks.

    His parents didn't seem to have a clue about his mental state.  

    I am not trying to excuse myself. I just didn't understand the situation until he was gone.  I wish I had tried more to understand him.

    We must all communicate better! Life is too short and too precious to have these violent deaths continue. We can't find peace until we love enough to listen and respond to the pain of our children/friends/parents.

    Psychological Pain - Deb L - Mar 13th 2009

    It is indeed psychological pain which often drives a person to suicide. Several years ago I came very close to suicide, and it wasn't in order to punish anyone, or even to be less of a burden to others, but just because the psychological pain was excruciating. I felt alone, hopeless, and in agony because of a loss I'd suffered. I can't tell you how much I just wanted to end my own pain and suffering. In the end, I reached out and obtained psychotherapy, which saved my life.

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