By Grace Scolyer

“If more people talked about what leads to suicide, if people didn’t talk about it as if it was shameful, if people understood how easily and quickly depression can take over, then there might be fewer deaths.”

-The wife of Dr Andrew Bryant, Brisbane gastroenterologist who committed suicide three weeks ago

I have only ever admitted to three people in the world the deepest extent of the depression. All three of them forced it out of me, asked me at points where I was too weak to lie, to scared not to admit it, terrified of how they would react but even more terrified of what I could do to myself if I kept it in any longer.

“Bad night” has become our favourite euphemistic phrase – they know to tiptoe a little, keep an ear out if it’s been a “bad night.” Sometimes they will ask. They have heard about the physical symptoms – I tell them about the insomnia, palpitations, fatigue. Do I tell them that etched onto the wall of my brain like a revision poster I can’t ever forget is a list of my paracetamol stashes? Do I tell them I have had to promise not to do it, that I have promised to throw them out?

I don’t know how to be friends with people who aren’t suicidal. I am constantly shifting between guilt at the extent to which they support me; anger when they can’t, or they forget to, or they assume I’m okay when they shouldn’t; and guilt at that anger – when did they sign on to such a heavy task?

One in five medical students have had thoughts of suicide in the last twelve months.

Four junior doctors in NSW have committed suicide over the past five months.

Whatever we are doing, it is not enough. It is a tragedy, it is an emergency, it is worthy of all of our efforts. A death by suicide is a death that could have been prevented, and when it happens to providers of healthcare, it is difficult to understand.

The truth is, very simply, that the concept of suicide terrifies us — and we aren’t sure how to react. Instead, we react with fear, imposing shame and isolation on our colleagues or ourselves. We shy away from asking the dark questions, in fear of receiving darker answers. We’d rather be ignorant, we’d rather make jokes.

In fact too often it manifests in popular culture, in casual conversation, in niche meme pages. For the past few months I have been constantly faced with jokes about self-harm and suicide – perhaps I have become more aware, or perhaps the number of these jokes has increased, I can’t be sure. Each of these casual comments or jokes on my newsfeed genuinely feels like a punch in the gut. For someone who spends every minute of every day experiencing things through the filter of mental illness and most nights fighting thoughts that should be more terrifying than they actually feel, being reminded of these thoughts, in casual ways that belittle my experience, feels awful beyond words. It’s comments like “I’d rather slit my wrists” or “I’m going to go and research how to tie a noose.”

I didn’t know how to say this. I’m a huge fan of taking the joke too far, and I would never interrupt a banter-filled conversation with Social Justice and Real Talk, but I am no longer down for not being honest about what is going on in my head – I just don’t see the point; it doesn’t help me, or anyone else going through similar experiences.

So please, think about what you’re saying before making these comments. Self-harm and suicide are really, really serious, and you never know what is going through someone’s head. Why would you want to cause any more pain to someone already in agony?

In my experience, when it isn’t being brought up in tactless and offensive ways in conversations or dark memes, it isn’t being brought up at all. Of course there has to be given due credit to the brave people who do share their stories, and the extraordinary public fight of inspirational public figures – but we aren’t at a place where we can offer solace and help to people who need it most yet.

I can’t emphasise it enough: suicidal thoughts are an emergency – like hyperkalaemia, aortic dissection, tension pneumothorax. It is unacceptable for a medical emergency to be shamed – imagine someone gasping for breath with a punctured lung, refusing to seek help, tearing interscapular pain hidden with a grimace because it is embarrassing, it’ll go away.

Jokes and silence doesn’t make it easier to admit — the consequences we predict that come from seeking help are terrifying, threatening, and are very real obstacles to the suffering mind. There’s no easy way to solve this crisis, but I think honesty is a pretty good place to start. So if you’re struggling, tell someone. If you’re worried, ask. Just say the words you’re scared of saying or hear the answer you’re scared of hearing, and we will all be better because of it.

I encourage you this week to challenge the way you think about suicide, how you would approach a suicidal friend, how you would ask the difficult questions or receive the difficult answers. And to the families and friends of those who couldn’t be helped, I offer my deepest condolences.

 Lifeline: 13 11 14                                                                                                                                VIC Suicide Helpline: 1300 651 251                                                                                          Victorian Doctors’ Health Program: http://www.vdhp.org.au/website/home.html