Six

A tornado watch means weather conditions are such that a tornado might form. A tornado warning means that there is a tornado on its way toward you. Watches and warnings from National Weather Service always follow this pattern. Watch = favorable conditions exist or are expected in the next 24 to 48 hours. Warning = get your butt inside and somewhere safe because nasty shit is occurring and will be arriving within minutes (tornados) or within the next 12 to 18 hours.

I think a warning in life generally follows the same concept: whatever is being warned of is happening or will happen soon/if you do the thing you're being warned against.

The same is true for some of the most widely known medical warning signs: those for stroke and heart attack, which are signs that a person is having or just had a stroke or heart attach.

With suicide, not so much. In fact, there doesn't seem to be a standard definition of what a warning sign is when it comes to suicide. Is it a sign that someone might try to take their own life in the next year? The next month? The next 12 hours? Are we talking about warning signs for people who are actively thinking about or planning for it? Are we also including people who are thinking about it but haven't made any plans but are, for some reason, more likely to attempt in the next weeks/days/hours that others who are also thinking about it but haven't made a plan?

It is understandably difficult to come up with a more targeted list of warning signs if you can't define what you are trying to warn about and who is covered.

Limits of Research

All research has its limits, and for most of the history of research into suicide and mental health the biggest limitation has been the need to rely on a person's explanation of what is or was going on in their minds. We barely know how the brain works, let alone the mind (there is, apparently a difference). There are all sorts of conscious and unconscious factors that skew our perceptions, or at least our answers. The stigma associated with mental illness and with suicide, the shame and guilt may people and family members feel, does not lend itself to clear thinking or a lot of honesty (with themselves and others). On top of all of that, language itself has limits in its ability to acurately describe what we are feeling.

This doesn't make all the research totally invalid, just harder.

More common to all research, is confirmation bias. Basically, if you set out looking to prove something, you're more likely to find proof of it. When dealing with other areas of science it is much easier to avoid that. It's harder to do so when you are dealing with emotional topics and when you have to get most of your data from people.

Once a certain set of ideas take hold, it can be very difficult to get out of that mindset and look for something new rather than for more support or refinement of the existing. This is one of those areas, too, where I think the concept that we can find a logical answer is a big problem. Or perhaps it is the search for a specific logical answer.

This doesn't make all the research totally invalid, just harder.

More Research

The last 40 to 50 years has produced a lot of research into who is at risk, methods used, trends, reasons for the trends, success of educating the public on warning signs, success of educating professionals on warning signs. For as much as we have learned, we sure don't know much.

Now, I'm sure there's a ton of research out there that I don't have access to, but there does not seem to be a lot of research into perhaps the most important question: what causes one to go from thinking about ending their life to actually planning and from planning to trying, or to go straight from thinking about to doing?

Why do some people seriously consider killing themselves but never try? I just started reading a paper that talks about the need for this type of research, and the author makes a good point. Each person's reason may differ. The thing that pushes someone over the edge might be different for every single person, but it's probably possible to group those things into bigger categories.

I also started reading some research done by the Military Suicide Research Consortium that has started looking at possible warning signs that someone is at imminent risk with imminent being the next 24 to 48 hours. You can read about it here if you'd like to know more before I get back to it.

The Final Straw

You may not be surprised to learn that it's not always something big that finally pushes someone past contemplating suicide and on to attempting it. Would it surprise you, though, that it's not always something big that pushes someone from their current state of mind into contemplating suicide?

I think the last time I ended up doubled over crying in a closet I had been folding laundry and had just dropped something for the third time. Proof that I couldn't do even the simplest damn thing right. Definitely not logical.

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