Interrupting the cycle of stress

Her life felt overwhelming, all while feeling completely alone. She could see no way to escape the pressure. She was exhausted, depressed and isolated. From that perspective, she took her life. She left behind two young children. Hers is one of the too many similar losses that every reader has likely felt.

The risk of suicide is all around us. When stress becomes too great, it moves from tolerable to toxic. We all have a limit. Yet, we avoid talking about this possibility for ourselves and others. We are masters at denying our vulnerability and convincing ourselves that we are immune.

An additional worrisome fact is that mental health professionals agree that assessing suicide risk is very difficult. Research has shown that 60 percent of people who ended their lives had denied suicidal thinking to a health-care professional shortly before their death. Seeking help is confounded by both denial and stigma.

Suicide affects all ages. In 2020, the Centers for Disease Control identified suicide as among the top nine leading causes of death for ages 10-64. However, younger people are at even greater risk, with suicide as the second leading cause of death for ages 10-14 and 25-34. Signs of increased suicide risk in others may include, but are not limited to, increased isolation, a decrease in enjoyable activities, giving away belongings, talking about death, substance abuse, risky behaviors, as well as extreme sadness, rage or agitation.

A common suicide contributor is stress. Neurobiological research has revealed that suicidal people may have an overabundance of cortisol (stress response hormone) and show increased inflammation. Normative stress is a daily part of life for everyone, but there is a tipping point when too much for too long becomes unbearable, resulting in hopelessness and severe depression. The desperate pursuit of relief from intolerable stress shows up in actions like substance abuse and self-harm.

The risk for tragic outcomes increases when excessive stress and depression include isolation. Although time alone can be beneficial, too much of it can be harmful. When the only voice we hear is the one in our head, negative self-talk quickly emerges.

Yet, a support system can be a powerful buffer for toxic stress by interrupting this cycle. Dr. James Patterson, chair of the LSU Health Shreveport Department of Psychiatry and Behavioral Medicine, identifies family support as a critical part of suicide prevention.

Investments in self-care can prevent the tragedy of this loss. Through addition of key components, we can reduce the risk for suicide. This is not a one-size-fits-all strategy, but there are known protections we can put in place for ourselves and encourage in others. • Increase safety. The bedrock of mental health is safety. When external threats are present, there is no relief from toxic stress. Both children and adults require safe environments but often must have the help of others to achieve this. Safety includes economic stability.

• Increase connections with others. Don’t isolate, and watch out for those who do. Look for opportunities to spend time with supportive people and offer your support to others. Connections remind us we are not alone and that other perspectives can be more hopeful than our own. The presence of caring people alleviates fears of alienation or being a burden.

• Increase mental health care. Seek support from a licensed mental health professional. We all can benefit from opportunities to learn to manage our negative emotions in healthy ways. The only dangerous emotions are the ones we suppress.

• Increase time spent doing pleasurable activities, especially outdoors. Enjoyable activities such as exercise, gardening, art, music or countless other pursuits can provide a period of peace and an opportunity to reset an overactive stress response. Leisure activities distract from problems and can build a sense of competence. And research indicates that being outdoors can enhance stress reduction even more.

Humans are fragile beings. This is something we must acknowledge. The last three years have brought universal stress to us all. More than ever, we must be aware of our collective emotional well-being by making wise investments in our self-care.

If you think someone is suicidal, ask. By asking, you give them permission to tell you how they feel. Expressing brings relief and is likely to reduce thoughts of suicide.

If you or someone you know is experiencing thoughts of suicide, please seek help immediately. You can reach help 24/365 by calling or texting 988 or by chatting at 988lifeline.org.

Laura Alderman, LPC -S, LMFT, NCC director, The Institute for Childhood Resilience, LSU Health Shreveport Department of Psychiatry and Behavioral Medicine.