Suicide Isn’t a Dirty Word — Talking Suicide and Bipolar

September is National Suicide Prevention Month, and so I want to talk suicide and bipolar. But I don’t just want to talk about suicide and bipolar disorder, I want to straight talk about it. I don’t want to get caught up in stigma or political correctness or whitewashing the pain. Because I believe we need to really talk about suicide to show that suicide is not a dirty word and to help all those who struggle with it.

Talking Bipolar and Suicide Basics

There are arguments over exactly how many people with bipolar disorder die of suicide, but a current, commonly-accepted number is 11%. So that’s more than one in 10 of our bipolar brothers and sisters dying — and we’re not talking about that reality nearly enough. After all, if anyone else was given an illness diagnosis and told they had an 11% chance of death, it would be an awfully, awfully big deal.

As most of us know, though, when it comes to bipolar and suicide, suicide deaths are hardly the only problem — suicide attempts are a pretty big issue too. Between 25-50% of people with bipolar disorder attempt suicide. That means that up to half of our brethren are in so much pain, they are prepared to end their lives. That is no small deal for the attempter or to the people around him or her. Suicide attempts can be absolutely devastating.

So the problem of suicide in bipolar disorder is a very real one, and again, we don’t talk about it nearly enough.

Suicide Is a Symptom of Bipolar Disorder

Suicide is not just a part of bipolar disorder; it is a symptom of bipolar disorder. The official wording on this diagnostic symptom is:

“Preoccupation with death or suicide; patient has a plan or has attempted suicide”

So it’s not like we don’t know it’s happening. We know it’s happening so much that it’s a diagnostic symptom. But in all the bipolar psychoeducation that is commonly offered, do we offer straight talk about this symptom? When you were diagnosed, did anyone explain those statistics to you? Did anyone explain to you that you likely would be facing suicide in some form because of bipolar disorder? Don’t you think that if it were another disease, every symptom would be discussed?

But It’s Suicide Awareness Month — We Are Talking About Suicide

Well, sort of. We are talking about suicide in the abstract. We are lamenting it. We are talking about signs and symptoms. We’re talking about suicides of celebrities. And all of that is good. All of that is important. I’m not saying we shouldn’t do that.

But bipolar disorder (or mental illness in general) and suicide is an important topic too. Because we are the ones dying.* It’s people with mental illness who die of suicide. Not random people — mentally ill people. So let’s say it. Let’s say that people with mental illness die of suicide. Let’s say that people die of the symptom of suicide in bipolar disorder. Let’s be honest about it. Let’s say that if you have bipolar disorder, you need to know about suicide and suicide attempts and you need to know that you will likely face those demons (whether you follow through with any action or not). We talk about hypersomnia; we talk about hypersexuality; we talk about bipolar symptoms. Now it’s time to talk about the bipolar symptom of suicide. The risk is real. We can’t avoid it by pretending it doesn’t exist.

Suicide is not a mental health problem; it is a mental illness problem. Mental illness needs to be in the conversation. Mental illness needs to be the conversation.

Suicides and Suicide Attempts in Bipolar Are Covered Up

Let’s face it, when people face the death of a loved one by suicide, they most often cover it up. It’s the death that no one talks about. It’s that dirty word thing. “Shh, no one say ‘suicide.'”

And it’s the same with suicide attempts. Many people with bipolar disorder don’t tell a soul about their suicide attempt — not even their doctor. For those who have survived, they just go on (often to try again). And again, that’s because everyone is scared of the dirty word.

I understand why these things happen and I’m not blaming anyone. I have been there. I just think we need to change how we view suicide. We need to change the conversation.

Why Is ‘Suicide’ a Dirty Word?

Suicide is treated like a dirty word for two reasons:

1. Suicide is considered a personal and moral failing.
2. Suicide is considered to be a choice and thus if you act on it, a sign of weakness.

Neither of these things are true, and we need to get over these ideas.

Firstly, the “moral failing” idea is historical. Mental illness was considered a moral failing (after it was considered a demon). People blamed “morality” for behavior they didn’t like or understand. And it’s pretty simple. If I’m your average person and I can live without doing these “crazy” things, then clearly if someone else does those things, it is his or her fault.

And if you don’t understand illness or medicine, this train of thought, however ignorant, makes sense.

But we are past that now, and we need to let go of our faulty, old-fashioned thoughts.

Secondly, yes, suicide is partly a very clear choice. No one kills you but you in a suicide. This is true. But the forces acting upon a person who attempts suicide or who dies of suicide are so much stronger than most people will ever experience, let alone understand. These are the forces of the illness. An illness that the person didn’t ask for and an illness that isn’t his or her fault. Yes, it’s a choice, but that choice does not exist in a vacuum. That choice exists in a place most people will never even glimpse. And when a person does act on their suicidality, it really is understandable, no matter how undesirable it might also be.

Suicide and Bipolar Are Linked, and That’s Okay — Suicide Is Not a Dirty Word

So for our part, for the part of the bipolar disorder community, let’s just say it — suicide is killing us, and we want it to stop. Let’s stop pussyfooting. Let’s stop beating around the bush. Let’s say that suicidality is something that likely will attack people with bipolar disorder and let’s talk about that openly. It’s okay to say you feel suicidal. Your saying that you are feeling suicidal is actually the first step in being able to deal with that feeling and not let it get worse. Hiding that feeling is a good way to eventually feel compelled to act on it.

So I say that bipolar disorder and suicide should hide no more. I have bipolar disorder, and it makes me feel suicidal sometimes; in fact, I’ve often suffered from chronic suicidality. I have bipolar disorder, and I have attempted suicide. There. I said it. And I know others can too. And I know families can say their loved ones have died of bipolar-related suicide. I know we can do this. And I know that by doing it, we can help each other.

So during this National Suicide Prevention Month remember: the realities of suicide are painful and scary and downright awful, but we won’t hide from them, we won’t hide from expressing them anymore.

* I recognize that some percentage of suicides are by people with no discernible mental illness. They are important too. That said, I suspect this is a very small number as many people are ill without anyone knowing at the time of their death.

Statistics and facts in this article come from the bipolar disorder section on Medscape.

Banner image by Alpha Stock Images.