How you can spot the signs of suicide

The news of Anthony Bourdain’s and Kate Spade’s deaths has been a sobering reminder that depression and suicide cut across all demographics.

“Depression and mental illness do not discriminate …. it’s like cancer,” said Karen Ranus, executive director of the National Alliance on Mental Illness Austin.

What is shocking about this news, she said, is that Bourdain and Spade were so highly successful on the surface. “They let you see what they wanted you to see,” Ranus said, but people don’t get to a place of suicide without something going on.

With celebrities, “often times there’s more at stake,” said Dr. Kim Kjome, an assistant professor at Dell Medical School at the University of Texas and a psychiatrist at Ascension Shoal Creek Hospital. People might still feel there is a stigma to receiving treatment for mental health and that might feel greater with celebrities, Kjome said.

The concern with celebrity suicides is that suicides among noncelebrities seem to rise immediately afterward, she said.

In general, suicide rates have increased in recent years, statistics show. On Thursday, the federal Centers for Disease Control announced that from 1999 to 2016, the national suicide rate increased 25.4 percent. In Texas it was 18.9 percent.

It’s now the 10th leading cause of death in the United States, and the only one of three in the top 10 that is on the rise, the CDC reported.

It cuts across all demographics, Kjome said. “We don’t know why it’s happening,” she said.

The CDC report found these causes (some people had more than one factor, according to the report):

• 42 percent had relationship problems.

• 29 percent had a crisis in the past or upcoming two weeks.

• 28 percent involved substance abuse.

• 22 percent had a physical health problem.

• 16 percent had financial or job problems.

• 9 percent had criminal legal problems.

• 4 percent had a loss of housing.

Ranus said 90 percent of people who die by suicide have an underlying mental illness that “might be undiagnosed, underdiagnosed or undertreated.”

They or the people in their lives might think that this depression is a phase that they can get over, Kjome said.

It’s important to know the signs of suicidal thoughts. the National Alliance on Mental Illness Austin has conversation cards on its website,, and at its office that you can print out or pick up. The cards give warning signs as well as suggestions for talking to someone you suspect might be thinking about suicide.

The common warning signs:

• Excessive worrying or fear.

• Feeling very sad for more than two weeks.

• Confused thinking or problems concentrating and learning.

• Extreme mood changes.

• Prolonged or strong feelings of irritability or anger.

• Isolation: avoiding friends and social activities.

• Changes in sleeping or eating habits or sex drive.

• Difficulty perceiving reality: hearing, seeing or believing things that are not real.

• Repeated abuse of alcohol or drugs.

• An intense fear of weight gain or concern with appearance.

• Thoughts or acts of self-harm, including plans to kill oneself.

• Inability to carry out daily activities or handle daily problems and stress.

Ranus said a red flag is a person expressing that he is a burden or that his family will be better off without him, that he has no worth or that he is making note of not being around much longer.

Sometimes a person will exhibit signs of depression, but then seem to be doing better. That can be a sign that he’s made a plan. Or a person might go through a struggle with suicidal thoughts and be better for a time and then something will trigger those thoughts again, Ranus said.

You — as a friend or family member — can have a conversation with him in a nonconfrontational way by making observations about behaviors you are seeing and asking questions about how he is feeling and how you can help.

If you feel he is in imminent danger, you can take him to the emergency room. Dell Seton Medical Center has a psychiatric emergency department, or you can go to Integral Care’s Psychiatric Emergency Services, 1165 Airport Blvd., second floor. Integral Care is open from 8 a.m. to 10 p.m. Monday-Friday, and 10 a.m. to 8 p.m. Saturday, Sunday and holidays.

You can call 911 if you cannot get to an emergency room. Let the 911 operator know it’s a potential suicide so an officer trained in mental health care is sent to respond.

Integral Care has a 24-hour, seven-day-a-week crisis hotline, 512-472-4357, and now a crisis text line: Text TX to 741741. Integral Care has a Mobile Crisis Outreach Team that will come to you, create a care and safety plan, connect people with services and follow up for 90 days.

Suicide prevention could mean multiple levels of treatment and therapies for a long time.

“This is a condition that can affect anyone,” Kjome said. “There is help for it.”

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