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GriefSPEAK: Suicide. Not wanting to die – just not wanting to live anymore – Mari Nardolillo Dias
By: Mari Dias, EdD, contributing writer
Only me can save myself, but it is too late
Now I cannot think, think why I should even try
Yesterday seems as though it never existed
Death greets me warm, now I will just say goodbye (Fade to Black, Metallica)
My clients come in waves. Waves in regard to cause of death. September was crowded with young widows whose husbands died suddenly of a massive heart attack. (Despite the fact that most massive heart attacks occur on December 24 at 10 pm). This month is filled with moms, suicide survivors of twenty something year old sons.
Suicide is a leading cause of death worldwide. The World Health Organization (WHO, 2023) estimates that more than 700,000 people die by suicide each year globally. In the United States, suicide remains a leading cause of premature death. According to the Centers for Disease Control and Prevention (CDC, 2024), there were 49,476 recorded suicides in 2022, yielding an age-adjusted rate of 14.2 deaths per 100,000 population.
Males accounted for approximately 79% of all suicide deaths, underscoring the difference in gender in suicide outcomes. The National Institute of Mental Health (NIMH, 2024) reports that males are almost four times more likely to die by suicide than females, though females attempt suicide more often. Firearms are the most common method among males, representing over 60% of male suicide deaths, followed by suffocation (including hanging) and poisoning.
Among various demographic groups, males aged 16 to 30 represent a population at heightened risk, with suicide rates higher than those of their female peers. Understanding the different types of suicide, their causes, and the current epidemiological patterns is essential for effective prevention and intervention. Young males (ages 16–30) face unique developmental, social, and psychological challenges that contribute to elevated suicide risk. These include identity formation, social pressure, economic instability, and cultural expectations around masculinity and emotional expression (Canetto & Cleary, 2012).
According to the CDC’s National Vital Statistics System (2024):
– among males aged 15–24, the suicide rate was approximately 21.1 per 100,000 in 2022.
– among males aged 25–44 (a group encompassing those aged 25–30), the rate increased to 29.6 per 100,000.
This pattern shows a clear upward trajectory in suicide risk from late adolescence through young adulthood. Regarding suicidal ideation and attempts, data from the Substance Abuse and Mental Health Services Administration (SAMHSA, 2024) indicate that approximately 12.6% of adults aged 18–25 reported serious suicidal thoughts in the past year, with about 1.9% reporting a suicide attempt. These rates are significantly higher than those in older age groups. For males aged 16–30, firearms remain the predominant method of suicide.
– Untreated mental health disorders (especially depression and substance use disorders)
– Social isolation or relationship loss
– Economic strain or unemployment
– Exposure to violence or trauma
– Access to lethal means (particularly firearms)
Suicide among males aged 16–30 remains a serious and preventable cause of death. The disproportionate impact on young men underscores the importance of early detection, de-stigmatizing help-seeking behaviors, and reducing access to lethal means. Effective suicide prevention must be multi-layered—combining public health strategies, education, and individualized interventions that address the unique social and psychological pressures faced by young men.
Most notably, only 16% of males in the United States received mental health treatment compared to 27% of women, which indicates a higher degree of receptivity and societal acceptance of women (2002,US Census).
What can we do?
So often I hear survivors’ state: “We never saw it coming! He/she seemed happy and content without any life issues. This is a shock.”
Many of those struggling with suicidal ideation (SI) do all they can to hide it from their loved ones. The above quote is evidence of how successful many of them are; however, the most unsuccessful suicide attempt individuals I have worked with often state:
“The overwhelming feeling is noticeably short lived. Just a few minutes. Yet during those minutes, all else does not just fade – it disappears. There is no worrying about our loved ones, as we think we are doing them and the world a favor as we (I am a burden). There is no rational thought – just the need to relieve the pain of living with (my depression, my anxiety, etc.). I do not want to die; I just don’t want to live like this anymore.”
It’s difficult when the individual struggling with SI tries so desperately to hide it from us.
Be observant. Have they been acting differently? Happier? More content? Or isolating themselves from others. Any behavior that is not the norm for the individual deserves some attention.
If you call 911 because you believe the person is in danger of hurting themselves, there are three basic questions the professionals will ask:
“Are you thinking of killing yourself?
Do you have the means?
Do you have the method?
If the answer to all three is in the affirmative, they will be admitted. If not, (and many will not tell the truth as they do not want anyone to thwart their plans) they are released.
If you find someone in an active suicide state, you can attempt to ground them by asking a series of questions:
- Name five things you see.
- Name four things you can hear.
- Name three things you can taste.
- Name two things you can smell.
- Name one thing you can feel.
Sometimes it only takes this grounding exercise to get them out from under the emotional weight and focus on the here and now. Other quick methods include having them hold a handful of ice cubes. This immediately tells the brain to focus on the cold and shifts the immediacy of the thought. Eating something distasteful (like a tablespoon of salt, lemon, vinegar) is often used. It is up to the professionals to stop the SI long term, as chances are the individual is not open to your protestations.
Unfortunately, most who die by suicide do not leave notes. (Medpage Today). If they are successful, we spend the remainder of our lives trying to identify the reason. “Why?”
It is unlikely to be one issue. It is the perfect storm. It can be a culmination of childhood issues of trauma and neglect, combined with substance abuse, mental health issues, physical problems, legal issues, and social environment. As a psychological autopsy specialist, we often investigate deaths to determine an unintentional/intentional suicide. We look at their social media accounts, their phones for texts and emails, and interview key figures in their life, including friends, family, spouses, and children.
We also spend a great deal of time reviewing their mom’s pregnancy with them, their birth, childhood, and social life, to assess any unresolved issues. Were they bullied in school? Have their experienced a major life stressor (divorce, loss of job, a death, etc.)? Is there any evidence of genetic clues or history of suicide in the family? Research indicates that familial transmission of suicide is a key factor, along with a familial transmission of mental illness (Psychiatric Times).
There is no one reason one suicides. It can sometimes be planned, sometimes impulsive. And very often we cannot see it. We blame ourselves, feel guilty or ashamed. If someone is intent on suicide, they will. There are cases of individuals hospitalized for a suicide attempt who successfully complete the suicide while hospitalized.
Many ask me if self-harm (cutting, etc.) is a precursor to SI. There is no one answer to that as it depends on many other factors. Just like the ice cubes and the salt, cutting oneself forces the brain to focus on the physical pain rather than the psychological pain. The more cutting, the less psychological pain.
There a still a major stigma around suicide. Some believe that individuals that suicide are selfish. Some believe that attempts are “just wanting attention.” Yes. It is a cry for help. See me. Hear me. I am here and in pain, but I cannot tell you any of this.”
Still others have suicidal ideations without ever acting upon them. People tell me that there is comfort in knowing that if everything goes wrong, there is a way out.
Dear readers, there is always a way out without dying. Please get help.
___
Access all of Dr. Dias’ columns at: GRIEFSPEAK
Dr. Mari Nardolillo Dias is a nationally board-certified counselor, holds a Fellow in Thanatology and is certified in both grief counseling and complicated grief. Dias is a Certified death doula, and has a Certificate in Psychological Autopsy.
Dias was an Adjunct Professor and was Professor of Clinical Mental Health, Master of Science program, at Johnson & Wales University. Dias is the director of GracePointe Grief Center, in North Kingstown, RI. For more information, go to: http://gracepointegrief.com/