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Depression is a potentially life-threatening illness.

Today we learned that one of our most beloved entertainers, Robin Williams, has died from suicide. This is a difficult subject to talk about, but flushing the demon of suicide out of the darkness into the light takes away some of it’s power. So we need to have a conversation — I’ll start.

Depression is the mental equivalent of having a condition like diabetes, but instead of haywire blood sugar levels it makes mayhem with neurotransmitters. And when these brain chemicals fluctuate, people feel differently… and they think differently.

People who struggle with Depression are vulnerable to “cognitive distortions” that hijack their minds and tell them all sorts of lies: About how terrible they are, how terrible the world is, and how futile it is to resist.

The really insidious part about Depression is that it feels to the sufferer like all the lies are true. And when the voice of Depression becomes louder and stronger than the voice of love or reason it becomes a very dangerous illness.

In the grips of profound Depression, suicide can feel like a reasonable option and a decisive way to end unbearable pain that cognitive distortions cause. People can become even more vulnerable in the days and weeks after a public figure dies of suicide, because what was formerly unthinkable becomes more acceptable when someone we “know” and admire chooses this path.

Chronic Depression ebbs and flows, but when it gets more intense the pain may roar into a crescendo that becomes a life-threatening psychiatric emergency. At these times, people cannot help themselves, but rather need to be kept safe until the crisis passes. But how do you know when to intervene?

Warning Signs of Impending Suicide

Here are things to watch for, or to ask about if you get the feeling someone is spiraling down:

1) Are they depressed? (i.e., Feeling sad, hopeless, and helpless?)

2) Do they have a history of suicide attempts?

3) Have they suffered a recent loss?

4) Do they describe their problems as permanent conditions and / or have difficulty seeing any hope or meaning in their lives? Loss of hope is a particularly important indicator that someone may be in danger.

5) Do they have the means to kill themselves? Is there a gun or potentially lethal medications in the home?

6) Do they tend to be impulsive?

If a number of these factors are present, the person you care about may be more vulnerable to suicide.

What to Do If You’re Concerned

1) ASK. It is okay to literally say, “Do you feel like killing yourself?” Because the person you love is probably not going to start that conversation, particularly if the idea is seeming attractive to them. They don’t want to shock you, or scare you. But if you can open the door to the conversation, you’ll be able to find out if they need more support.

2) If someone tells you that they are thinking of killing themselves don’t leave them alone. They need to have a net of support around them until this passes. This means social support, and it also means professional support. Call their therapist and help them make an appointment. Call their psychiatrist and get them seen stat. And if they are not currently in mental health treatment, assist them in connecting with a professional. Your local community mental health center, or a referral from your general medical practitioner are good places to start.

3) If you feel that they are in imminent danger, GET HELP. If someone is in a crisis, and saying they want to kill themselves ESPECIALLY IF THEY HAVE MEANS they need to be protected until this transient psychiatric emergency passes. This may require temporary hospitalization. In every local hospital emergency room there are professionals trained to assess and cope with these situations. It sounds dramatic, but don’t be afraid to go to the hospital for help. It can make the difference between life and death.

3) If you are afraid for the life of someone you know and you are not able to contact them, they won’t answer the door, or they will not go with you to the hospital you can call the police and ask them to do a “Welfare Check.” Most law enforcement agencies have specially trained officers who can go to the home and do a suicide assessment.

4) For more support, or to help yourself if YOU have been struggling with thoughts of suicide, please call one of the many suicide hotlines available:

In Denver, call the Metro Crisis Services Hotline:888.885.1222
Nationally, call the Suicide Prevention Hotline: 1-800-273-8255

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