After a Suicide: "How Could I Not Have Known?"

Source: Sasin Tipchai / Pixabay

What's the saying? "A picture is worth a thousand words."

A YouTube video, produced by the Norwich City Football Club, with more than 1 million views, says more in two minutes than perhaps I or anyone else could say in a thousand words.

What is it about? Depression that is camouflaged by someone's energy, by their outward relationship with their world, by their apparent great lock on enjoying life.

And where subtle hints that might be noticed... aren't.

What I've termed perfectly hidden depression.

Two men, seated side by side all year long at their beloved football team's games, one very caught up in the game, at times screaming in elation over a point made, and other times agonizing after a defeat. The other is more quietly watching each success and loss, perhaps bored. Perhaps disgruntled. We can hear bits and pieces of their conversation, seeming chit-chat.

The next season, there's only one man that returns to his seat. And it's the second man that has survived, his friend having taken his own life.

Please listen to its message. In a world where there's so much to distract us, we can miss this kind of depression.

The role of seemingly unbearable pain...

In the last decade, bewildered and grieving widows and widowers, mothers and fathers, as well as best friends have contacted me as part of their search for answers after a loved one's suicide. "What did I miss? How could I not have known?"

The answers may lie in emotional pain, even trauma, that has lain dormant, secret, and rigidly protected against for years—camouflaged by an armor of the perfect-seeming life.

Until that pain can no longer be borne.

Dr. Edwin Schneidman, founder of The American Association of Suicidology, called this pain "psychache." Unbearable pain. And his research (which has been more recently studied and supported) showed that psychache was more significant than a diagnosis of depression in predicting suicide.

Dr. Sydney Blatt, author of a highly regarded treatise on the destructiveness of perfectionism, explained that when perfectionism presented along with depression, it changed how that person might be seen or diagnosed.

But, culturally, we worship success. We see the bright wrapping, the outside of what success seems to be. And there are times when we're missing the despair and loneliness that could be lying underneath.

Mental health clinicians, psychiatrists, doctors, and nurses ask this question, "Do you feel hopeless?" Or, "Do you have thoughts about hurting yourself?" And we somehow believe that everyone, if in danger, will answer, "Yes."

Some do. Some will. But certainly not all.

Just as important a question is this: "If you felt hopeless, would you tell anyone?" The answer—either a flat "No" or "Probably not"—might lead to a conversation that could save a life—a conversation that would deepen the understanding of someone else's inner struggle.

We need to invite transparency.

My deep gratitude goes to this football club for, once more, pointing out what we might be missing—the questions we may not be asking—and must ask.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.