Last spring, Craig Miller descended into a depression that was even deeper and darker than the one that led to a carefully planned suicide attempt at age 20. Now 46, the married father of two young girls says a lifetime of grappling with serious depression has taught him to interpret a suicidal thought as “a red flag that something needs to change.”
Miller responded this time by cleaning out and reorganizing every drawer in the master bedroom of his home in central Massachusetts – a symbolic way, he says, of sorting through his thoughts and emotions. “It meant I’m putting things in order,” says the author of 2012’s This Is How It Feels: A Memoir – Attempting Suicide and Finding Life.
Then Miller got a text from a concerned friend who suggested he jot down a list of 10 things that make him grateful to be alive. Miller rolled his eyes.
“I’ve been through this since I first considered suicide when I was 8 years old,” about 2 years after a neighborhood man, he says, began molesting him in the crawlspace beneath his family’s house. “I wrote that list a million times.”
But then Miller was struck by a new thought, “one that got my gears going.” Instead of acknowledging the people and moments that made his life worth living, he wondered about the lists his wife and daughters would write. Instinctively, he knew his name would be at the top. “That’s what made me slow down,” he says. “They would be destroyed by me leaving. That’s the thought I plugged into. That’s the one that worked for me.”
Miller is one of millions of Americans who have what the suicide prevention community calls “lived experience” – a suicide attempt that did not end in death. (The term “suicide survivors” is reserved for family and friends left behind by someone who takes their own life.)
The Semicolon as a Symbol of Solidarity
In 2020, more than 45,000 people in the U.S. died by suicide, the 12th leading cause of death, according to the CDC. But that’s just a tiny fraction of the estimated 1.2 million who attempted to take their own lives. Many now sport a tattoo of a semicolon – ; – signifying a pause in life, not a period at the end of it. The punctuation mark has become a sign of solidarity among those who have attempted or contemplated suicide and sympathetic supporters calling attention to mental health issues.
For some, waking up alive after a suicide attempt is not a happy ending. Nathan Lipetz of Vancouver, Canada, thinks the media too often takes a light-at-the-end-of-the-tunnel approach to lived experiences, glossing over the lingering root causes of depression and mental illness that led to the attempt.
“You see articles that say it gets better for everyone, but I don’t really think it does,” says Lipetz, 21, who estimates he has tried to end his life at least 8-10 times. Since 2013, he has been hospitalized for months at a stretch and prescribed 19 antidepressants and mood stabilizers.
Nothing worked until earlier this year, when Lipetz visited a West Palm Beach, FL, rehab center that administered ketamine, the psychedelic drug that has recently been shown to reduce symptoms of depression. A study published in The Journal of Clinical Psychiatry in September found that 72% of patients who received 10 IV infusions of ketamine saw their mood improve; 38% said they were symptom-free.
“It’s been lifesaving,” says Lipetz, whose most recent infusion was in mid-September. “After a few weeks of ketamine, any thoughts of attempting suicide would just disappear. They’d pop into my head and would be gone just as fast. I’m not actively thinking of killing myself anymore.”
That glimmer of hope is encouraging at a time when mental health and suicidal thoughts have been made worse by the endless reach of social media, where rosy depictions of daily life are rivaled only by the nasty barbs of anonymous trolls.
Suicide Risk and Social Media
A recent 10-year study by Brigham Young University found that teenagers who used social media at least 2 hours a day were at a higher risk for suicide than emerging adults.
“Social media can be a great place to connect, get information, and socialize,” says Amelia Lehto, chief of staff of the American Association of Suicidology (AAS), a science-based organization that helps develop strategies to reduce suicidal behavior. “But it can also be a tool for distress, disconnection, and harm.”
“When people post on social media, we only see their outsides, and we compare that to what’s going on in our insides,” says April Smith, 49, whose depression and anxiety after a “really treacherous divorce” and her father’s death led her to jump off a Florida bridge 8 years ago. “I woke up to a flurry of activity … and was in disbelief. How did I survive?”
Smith was hospitalized with broken ribs and three broken bones in her legs. “I was significantly beaten up and in a lot of pain, but nothing that didn’t heal well in a reasonable amount of time.”
With the support of her mother, teenage children, and therapist, Smith spent 5 months in a group-based treatment facility. “I was terribly ashamed that I had chosen to voluntarily leave my children on this earth without me, but nobody important wrote me off,” she says. “Reentering the world after a major attempt is not easy, but there was a very, very small circle of people that I slowly started confiding in and trusting. They understood what I had been through – and that was super key to me. I started to feel so much less alone.”
Smith now lives in Virginia, where she runs a Facebook group for others who have survived attempts. The focus, she says, is to talk about the best ways to get the help needed to move forward, instead of dwelling on the specific aspects of their suicide tries. “I don’t allow people to share details of their attempts,” says Smith. “I teach them how to share their story in a way that doesn’t trigger or negatively affect the others.”
A New Way to Get Help Right Away
Accessing vital mental health services is essential for anyone who has tried suicide or is plagued by suicidal thoughts. But a survey published earlier this year in JAMA Psychiatry reported that 40% of Americans who had recently attempted suicide said they were not receiving any mental health care. The primary reasons cited by nearly 500,000 respondents: not knowing where to go, the high cost of treatment, and a lack of transportation.
Fortunately, a new, groundbreaking way to get help right away was launched in July: the 988 Suicide & Crisis Lifeline. The three-digit emergency phone number is the mental health equivalent of 911, a simple way to connect with operators who can send trained counselors – not police and ambulances – to assist callers within minutes.
“Suicide is often a time-limited event that peaks with intense suicidal thoughts,” says the AAS’s Lehto. “It’s such a critical moment. If the field can provide the support that’s needed in that moment, more and more lives will be saved.”
Suicide rates in the U.S. soared by 35% from 2000 to 2018, but dipped slightly in 2019 and 2020, according to the CDC. That’s an encouraging sign, one that hints at an important shift in the public perception of suicide. What was once a hush-hush topic, rife with shame and stigma, is now viewed with more empathy, as demonstrated after the recent suicide deaths of country legend Naomi Judd, former Miss USA Cheslie Kryst, rockers Chester Bennington and Chris Cornell, and fashion designers Kate Spade and L’Wren Scott. This summer, UCLA football player Thomas Cole shared the story of his attempt at the beginning of the year, while Los Angeles Clippers guard John Wall and Australian tennis pro Jelena Dokic talked about their battles with depression and thoughts of suicide.
These high-profile incidents, coupled with increased public awareness of suicide’s prevalence nationwide, have prompted robust calls for better ways to stop the things that trigger attempts.
“It’s never one thing,” says Jill Harkavy-Friedman, PhD, a New York City psychologist and senior vice president of research at the American Foundation for Suicide Prevention (AFSP). “It’s always a combination of factors, mostly mental health issues, but also chronic pain, head trauma, genetics, and family history.”
‘I was intent. I wasn’t going to hesitate’
Peter Hollar was 21 and living with his mother in Olympia, WA, in the late 1970s when he found out his estranged father had killed himself in California. “It shook me to the core, of course,” says Hollar, now 65 and retired. “I can remember it like it was yesterday.”
Yet Hollar found himself contemplating the same fate in 2000, debilitated by an imploding marriage and “job stress through the roof,” he says. “There was a lot of torment, anguish, and pain.”
He developed a long-range plan to end the “overwhelming trauma” by jumping off a nearby bridge. “I was intent. I wasn’t going to hesitate.”
But as Hollar was driving to his destination that night, he suddenly felt as if he was in the grip of a higher power. “I’ve always had a spiritual part of my life, and I had been praying a lot in the 30 days before I headed to the bridge, reaching out for some kind of guidance,” he says. “I started thinking about my dad, and I said, ‘What will my loved ones think? Is this how I’m going to leave my two young sons?’”
When Hollar reached the bridge, he kept driving and crossed it. “I drove to a gas station and called my psychiatrist.”
A weeklong hospital stay was supplemented with medication, counseling, and a renewed sense of purpose. “I guess the bottom line is it wasn’t my time to go,” says Hollar, who later married “an amazing, awesome, wonderful” woman and moved to a Seattle suburb. “God did not want me to die. I had things left to do. Now things are better. I don’t have those feelings anymore.”
Navigating Emotional Turbulence
Of course, not everyone with lived experience feels that kind of closure. Their struggle to survive continues to be fought daily. “It’s not that you want to die, it’s that you’re willing to die to make your life different,” says Miller, who tells his story in Moving America’s Soul On Suicide, (masosfilm.com), an online documentary series developed in cooperation with six health care agencies, including the National Action Alliance for Suicide Prevention. “There’s no magic answer.”
The key is to somehow weather the emotionally turbulent storm instead of succumbing to the moment. Someone in crisis needs to know where to reach out for help, and friends and family members must learn to recognize signs of struggle and step up.
“If you notice a change in someone, trust your gut,” advises Harkavy-Friedman of the AFSP. “Ask how they’re feeling. Tell them, ‘I’m concerned about you.’ Have a conversation to find out what their stresses are and help them to get help. Call 988 or tell them to talk to a therapist.
“Be patient and persistent,” she says. “Don’t give up. Suicidal thoughts can be managed. I am ever the optimist.”
If you know someone in crisis, call or text the Suicide & Crisis Lifeline at 988, contact the Crisis Text Line by texting HELLO to 741741, or dial 911.