It is no secret that Eating Disorders have the highest mortality rate of any mental illness. According to the National Eating Disorder Information Centre (NEDIC) website, a 2002 study showed that 10 per cent of individuals with Anorexia Nervosa will die within 10 years of the onset of the disorder.

Most people assume that this death rate has to do with all the physical ramifications of being extremely malnourished. However, suicide is actually the second cause of death among people with Eating Disorders, after cardiac arrest.

Sara L. was diagnosed with Anorexia when she was 14 years old and says that she has suffered with suicidal thoughts for as long as she has had her Eating Disorder. She says she first thought about suicide when she was feeling abandoned and alone in the hospital. As she got older, she found that her suicidal ideations became much more prevalent in response to an intense feeling of hopelessness about her Eating Disorder. “I was feeling like a huge burden and really stuck; like this was never going to get better,” she says. “And if it was never going to get better, I didn’t want to live that way.”

Sara attempted to take her own life on three separate occasions. She says a lot of what lead her to act on plans to end her life had to do with that intense sense hopelessness and feeling of being a burden on those around her. She also says the fact that her brain and body were severely malnourished played a role in exacerbating her depression and made ending her life seem like the only option.

Sara acknowledges the fact that it can be extremely difficult to help someone who is having suicidal thoughts. She says that even though she expressed how constant her suicidal ideations were, it was really hard for her support system to know when those thoughts were turning into an attempt to go through with ending her life. “There was a lot of secrecy when it came to actually going forward with that,” she says. “That was just the point that I was at and I wasn’t willing to accept help from anyone.”

Common signs

Sara now has some distance from her suicide attempts and works in the mental health field. She says that while suicidality is hard to address, there are some warning signs and things that caregivers can do to help support and protect their loved ones. She says some of the most common things to watch out for are low mood, withdrawal, isolation and verbalization that they’re tired of dealing with their mental illness, are feeling hopeless or that life is pointless and meaningless.

Keep the dialogue open  

Sara says it is very important to keep the dialogue open with the person who may be suffering with suicidal ideation. “Suicidal thoughts wax and wane and as long as that conversation is ongoing, they’re going to catch people when they are more willing to open up,” she says.

What helped for her is having someone who she knew she could talk to about her suicidal thoughts, without judgement. She found comfort in the fact that, when she was willing, she could reach out to her sister for support and know that she would listen, without telling her that she shouldn’t feel the way she was feeling. “I could even just say it out loud and have her offer suggestions as to what to do in that time, knowing that she would only offer empathy and not get mad at me for having those thoughts,” she says.

Don’t assume you understand

Sara also says she always advises people not to say they understand what the sufferer is going through. “You really absolutely have no idea what it is like for that person, regardless of whether you have experienced suicidal thoughts before,” she says. “When I hear that it’s very invalidating.”

Make sure they know you want to support them

In Sara’s experience it is also important to meet the person where they are at, while also telling them that you are there to help them get to a better place. “Having people, even if it becomes a broken record, tell you that you are not a burden,” she says. “Because that’s the trick of the mind where your depression or suicidal thoughts tell you that people would be better off without you when actually that is not the case.”

If you have a plan – wait

Sara says that if she could give any advice to someone having suicidal thoughts or making a plan to end their life it would be to postpone their actions and reach out if they can. “Those thoughts wax and wane and in 12 hours you might feel differently,” she says.

Suicide is not an easy thing to address and it is often veiled in a lot of secrecy. Whether you are someone suffering with suicidal ideation or a caregiver, don’t be afraid to reach out for help. Counsellors at Crisis Services Canada are available 24 hours a day at 1-833-456-4566. Links to suicide crisis hotlines can also be found on the Open Counselling (https://www.opencounseling.com/hotlines-ca) and Teen Health and Wellness (https://teenhealthandwellness.com/static/hotlines) websites.