Excerpts from Trauma: Healing the Hidden Epidemic, by Peter M. Bernstein, PhD

On Monday, August, 11th, Robin Williams took his own life. Robin was a brilliant, gifted actor and comic who struggled with addictions to alcohol and cocaine. He admitted to experiencing episodes of depression and displayed manic tendencies in his work. Personal experiences of trauma, I believe, left their mark on his life in recognizable patterns. His death is a tragic loss for his family and fans.

After the suicide of a friend or loved one, people often ask themselves if there were signs that they missed of the individual’s intent to suicide. In some cases, the troubled individual does exhibit warning signs, which can be subtle or obvious. In the following excerpt from my book, I provide guidance and suggestions for finding and recognizing signs of potential suicide.

“First, be observant when dealing with a traumatized individual. Loved ones of suicide victims often recognize too late that there were warning signs. Understand the possible warning signs of suicidal behavior. If you suspect a person may be contemplating suicide, trust your judgment.

“Suicidal behavior results from many different traumatic experiences, from sexual abuse to a disabling accident to the death of a loved one. It can also be caused by seemingly less serious life situations that are uncontrollable, such as a successful professional’s job loss or an exemplary student’s experience of poor grades. As this book illustrates, almost anything can lead to trauma if the event is unexpected and the person has a negative reaction to the experience, particularly if she has suffered developmental trauma in childhood.

“Look for specific, telltale behaviors in your loved one, such as the following:

  • Crying and withdrawal
  • Recklessness
  • Quitting activities and lack of interest in former activities
  • Loss of appetite
  • Lack of interest in appearance
  • Diminished physical energy
  • Frequent minor illness
  • Sadness, hopelessness, guilt, loneliness
  • Scattered thoughts
  • Drug or alcohol abuse

“Pay special attention to any individual with a previous history of suicidal behavior or suicide attempts. And certainly, take action if someone close to you begins talking about suicide or shares plans of suicide. At this stage, professional help is absolutely necessary and should be sought as soon as possible. If you feel your loved one is at a very high risk of suicide, don’t leave him alone; call help to the scene.

“Drastically elevated moods after a long period of deep depression can also be a warning sign that a suicide attempt is imminent. Once a person has resolved to commit suicide, he or she may exhibit behaviors that seem almost euphoric. The shift is usually sudden and without any change in life circumstances. The change can distract loved ones and friends from the victim’s condition, giving them hope that things are turning around. In fact, such a dramatic change in behavior is a smokescreen for the increasingly dark feelings and can be a sign that a suicide attempt is just days or even hours away.

“Many family members of suicide victims wish their loved one had shared their despair and plans with them. If so, they feel they could have stopped it. But most people contemplating suicide keep their plans to themselves. Therefore, it’s up to those around them to stay in tune with their behaviors. If you are suspicious, ask the other people in your circle what they have noticed.

“Even if you aren’t convinced that your loved one is contemplating suicide, reach out to her and show you care. Be open to hearing what she has to say, but also tell her what you have noticed in her behavior, referencing specific actions and incidents. Then, ask direct questions about her current state. Don’t be afraid to say the word suicide. Talk to her about her plans, previous attempts, and thoughts about suicide, if applicable. Listen, talk openly, and let her talk. Try to be understanding and open-minded about her thought process and feelings. This is the time to determine her risk for suicide.

“Most important, try not to become upset or over-emotional during these conversations. Becoming upset might discourage at-risk people from talking to you again about their situation, and you want to keep an open dialogue so you can continue to monitor them. By mitigating your reaction in this way, you pause your own feelings and emotions about the situation in the moment. Remember, you must deal with these emotions at some point, allowing yourself to experience your feelings when it’s more appropriate. Ignoring your feelings indefinitely or overriding them for an extended period will only do you harm, and you will likely become a secondary trauma victim.

“Finally, offer hope and solutions to those at risk. Discuss the option of seeking professional help to deal with their pain. If they are resistant, help them imagine what life could be like without pain and despair. Let them know that such a life is possible for them with the right help and support, including that of friends and family, and counselors and therapists. Resolve to find help for your at-risk loved ones even if they are resistant. Be firm and diligent about your intentions to get help for them, even if they refuse to get it for themselves. When the danger signals are present, don’t wait for confirmation of their plans to seek professional help; move forward on your own if at all possible. (See chapter 6, “Seeking Treatment.”) They might ask you to keep your conversation secret. Don’t. Secrets can be deadly.

“There is hope, and there is a solution. We have learned a lot about the effects of trauma in recent decades, and even more about the process of healing from it.”

From Chapter 8, “Danger Signals and Trauma First Aid”