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'These Are Tenacious Illnesses': Psychiatrist On Depression And Suicide Prevention

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A man walks through the afternoon shadows in New York in 2017. (Timothy A. Clary/AFP/Getty Images)
A man walks through the afternoon shadows in New York in 2017. (Timothy A. Clary/AFP/Getty Images)

The news of chef and television host Anthony Bourdain's death by suicide came just days after the news of Kate Spade's. Their deaths have renewed a conversation about how to tell if someone might be experiencing suicidal thoughts, and what can be done about it.

Here & Now's Jeremy Hobson speaks with Dr. Drew Ramsey (@DrewRamseyMD), assistant clinical professor of psychiatry at Columbia University, about suicide prevention.

"We don't know what's going on inside of someone," Ramsey says. "And it's our job to be curious to those we know and we love, and get a conversation going about this."

Interview Highlights

On people dying by suicide who appear to be happy or successful

"That's a massive misperception, as we know, and I think it's very surprising to us when we see individuals who we think have great mental health, dream jobs, kids, fame. And that's not what's going on for the inside, on the inside of them. And so then we shouldn't have any misperceptions about depression or about suicide. These are tenacious illnesses, and they influence everyone from every socioeconomic class. It is not a disease that discriminates at all."

On warning signs that people can look out for

"One concern I have as a clinician is that when we see suicides like this, we think there's nothing we can do. And that is not the case. We know that there are significant risk factors that are very clear for suicide. Risk factors are having a prior suicide attempt, having a mood disorder like depression, having a substance abuse or alcohol abuse disorder. Those are the top risk factors."

"It is not a disease that discriminates at all."

Dr. Drew Ramsey

On suicide prevention

" ... Another tip that is very important is to use the word 'suicide' to talk about what we feel are very difficult questions, and they are, although I ask them every day in my practice. But it sounds hard to say, 'Are you having thoughts about wanting to kill yourself? Any thoughts at all?' And to really pursue it as a almost neutral topic. 'What are those thoughts? When did they start? Are you making some plans?' Those frank, honest conversations about how someone is feeling is not what happens. Oftentimes we hear someone is depressed, or feeling sad or suicidal, and we say, 'Oh you shouldn't feel that way.' That's not helpful, because people are feeling that way, and it's our job to be with the people we love in their feeling state, and try and understand it with them.

"I think the other part to really emphasize is there's everything from the national suicide hotline, 800-273-TALK. There are suicide text lines. In every state in America, there are a bevy of wonderful mental health clinicians, psychiatrists, psychologists, social workers. clergy who are ready, willing and able and trained to talk about this. And so we want to talk about it, but we also want to be very vigilant right now.

"If you are an individual who loved Anthony Bourdain or Kate Spade, and you're really struggling with clinical depression and you've been suicidal, there is that temptation almost, or that door opening of someone that you look up to has died by suicide. And that is like having chest pain — go right to the emergency room, because it is a medical emergency when an individual is feeling significantly suicidal. We don't treat our mental health with the same diligence in the same sense of emergency that we do our physical health. And we have to change that."


If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting 741741.

This article was originally published on June 08, 2018.

This segment aired on June 8, 2018.

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