The fallout from suicide is catastrophic. For every life that falls to the hopelessness and darkness of depression, there are the lives of those who love them that are changed forever.

Depression isn’t a choice between living and letting go. It’s what happens when someone feels there are no choices left. It’s impossible to understand for those who have never lived under the black cloud of depression. Similarly, for those contemplating suicide, it’s impossible to understand the devastation they will leave behind, should they go.

As much as we might understand that on an intellectual level, when you’re the one grieving the loss of a life lost to suicide, the depth and unpredictability of emotion that embeds itself into the inner walls of you is likely to be unspeakable – grief, confusion, guilt, anger, fear – sometimes insane, unfathomable anger – and the desperate longing to go back to that point and make one thing different. Catastrophic.

According to the World Health Organisation, more than 800,000 people commit suicide every year. 20 times that number attempt to end their life. Suicide is the second leading cause of death in 15-29 year olds. In the UK it is the leading cause of death for men under age 35.

Recently a large-scale international study, the BRIDGE-II-MIX, set out to identify whether or not there were patterns of behaviour that were often seen in people who were about to attempt suicide. There were. Let’s talk about them.

• 40% of all depressed people who attempted suicide had a ‘mixed’ depression rather than just depression. This is where someone shows symptoms of depression such as fatigue, despair, hopelessness, indifference, apathy but at the same time shows some of the polar symptoms of mania or excitation, such as increased energy or a decreased need for sleep, elevated mood, faster speech, less inhibited, racing thoughts. The lesson is not to be fooled if someone you care about has depression and suddenly seems to be happier, or to have more energy than usual. Keep a closer eye on them, stay with them or seek professional support.
• If a depressed person shows any of the following, their risk of suicide is at least 50% higher:

  >>  risky behaviour (such as driving recklessly, promiscuous behaviour);

  >>  psychomotor agitation (such as pacing around a room, wringing their hands together, taking off clothing and putting it back on) 

  >>  acting impulsively (acting on a whim, behaving without a lot of thought for the consequences).

If you or someone you know is struggling with depression, there is help available. Nobody has to do this alone. Depression is a chemical imbalance and although a depressed mind can run a pretty convincing argument that the hopelessness somebody feels is a hopelessly permanent state, it’s not. Know that there is help available.

If you or someone you love is struggling, here are some important numbers. There will be people on the other end of the phone, or sometimes the internet, who will understand exactly how you’re feeling, and who can help you to find a way through:

If you live in Australia:

• Lifeline Australia (24 hour phone support for anyone who needs it)
• Beyondblue (Depression, Anxiety, Suicide with phone or web chat)

If you live in the US:

• National Suicide Prevention Lifeline (For immediate support)
• Crisis Chat (For immediate support)

If you live in the UK:

• Samaritans (For immediate support)
• Depression UK (Support and helplines for various mental health issues)

International suicide hotline:

• Befrienders (Enter your country to find an emotional support helpline)