Right now, you can’t go to any social media or news site and not be bombarded with images of Robin Williams. He was an incredibly talented comedian, a humble humanitarian, and will be missed by all. His death makes me stop and think about all of the patients I have cared for who came to the ED in crisis. Perhaps they had suicidal ideations. Perhaps they acted on a plan to end their life, and were not successful. Each one suffering from mental illness, sucked into a black hole of despair that I would wish on no one. Did I hold their hand long enough? Did I listen to their concerns and provide reassurance and not judgment? Did I provide comfort? Did I help coordinate the care they so desperately needed in a way they found useful? Did I do enough to make a difference?
What about their family members and friends? How do you comfort the family of someone who just tried to end their life? Is empathy enough? Did I say something stupid like “he’s in a better place?” Did I hold their hands long enough? Did I answer all of their questions? Did I hug them when they asked questions I couldn’t answer? At the absolute worst moment of their lives, did I do enough to make a difference?
It’s easy to think major depression and suicide will never happen to you, your family, or your work family. It absolutely amazes me the number of emergency nurses who are walking around with a brave face and can-do attitude who are struggling with this disease. They are coming to work every day. Some might be sharing what’s going on. Others let us know in their words, actions, and change in behaviors. And we don’t see it. We rationalize behavior changes and attribute then to other causes. How do we not see what is right in front of us? It’s our job to recognize patients who are at risk for suicide, yet we can be blind to it when it’s our coworker, family member, or friend.
We are too proud to share our struggles. We are in the business of caring for others, and we forget we need to care for each other. Someone you know is struggling with depression, contemplating suicide, or dealing with any number of mental illnesses. They may be too embarrassed to ask for help. They may have reached out to you, and you were too busy to notice. We need to do more to rid ED’s of the stigma of mental illness. Depression is real. The dark spiral, crazy roller coaster of emotion, feeling of helplessness, worthlessness, and paralyzing fatigue is real. We need to do more for our patients, their families, our families, and our friends. If we don’t, then one day they won’t be here anymore. And that is a thought I just can’t bear.
If you or someone you know needs help, visit http://www.suicidepreventionlifeline.org or call 1-800-273-8255.