At first, it may be thrilling for high performers to have so many looking up at them in awe of their ability to multitask at such high levels of responsibility. But often, these leaders can find themselves isolated and fearful because any misstep will be very public. As the situation increasingly becomes overwhelming, the safety net seems to disappear. This sort of high-wire act leaves them feeling trapped with no way down, and thoughts of suicide can enter their consciousness.
Most lay people do not have a sense of how lethal mental illnesses such as bipolar disorder can be. Many also believe that suicidal behavior is a problem of youth and less so for adults, particularly white men of working age. Because of this misconception and others, many warning signs go unnoticed until it is too late. For example, one study asked suicide-attempt survivors if they had made any effort to communicate their intent to die.1 Researchers found that despite what the survivors thought were clear and unambiguous communications to loved ones, their significant others responded to their statements with silence, avoidance and even aggression.
The American Association of Suicidology has released a list of evidence-based warning signs that can help identify someone in an acute suicidal crisis through a mnemonic: IS PATH WARM.2 I have taken these signs and suggested ways they might manifest in the workplace (see Sidebar).
When someone is thinking about suicide, they sometimes give off veiled communications that let others know. Sometimes these communications see what co-workers’ reactions might be before giving them more information.Substance Abuse:
The most common substance involved in suicide risk is alcohol, but increasingly, we are seeing prescription drug abuse plays a role in suicidal behavior. The residual effects of this abuse are sometimes evident to co-workers.Purposelessness:
When people start to feel that they have become a burden on others or when their main sense of purpose has been lost or taken away from them, a desire for suicide can result. Layoffs, demotions, or humiliating experiences at work can sometimes trigger this experience of feeling like a burden.Anxiety:
One psychological state that has been identified as a hallmark of someone approaching a suicidal crisis is agitated depression. As the person is filled with despondency and self-loathing, they also act as if they have ants crawling under their skin. Insomnia, pacing, and the expression of racing thoughts are outward cues that internally the anxiety has reached an unparalleled state.Trapped:
The feeling of being trapped can trigger a desire for suicide. In the workplace, financial pressures or public scandals can often be these triggers.Hopelessness:
Hope is often the antidote to suicide. As long as there is a glimmer of ambivalence between the reasons for living and the reasons for dying, there is the chance for keeping a suicidal person from following through with mors voluntaria
. Without hope that things can get better, the suicidal person’s mind focuses more intently on plans for dying.Withdrawal:
Often, high performers have gotten to where they are because they not only have talent, but also they have exceptional social skills. When someone who was very socially engaged starts to isolate themselves from colleagues or begin to have high levels of absenteeism, these behavior patterns could be an outward sign of inward struggle.Anger:
One of the other expressions of an agitated depression is irritability and rage. Sometimes in the workplace, this can manifest as over-reactions, perceived injustice, or even revenge. Many workplace violence-prevention protocols meet these symptoms with discipline and dismissal rather than intervention.Recklessness:
Especially during the manic and hypomanic phases of bipolar disorder, reckless and destructive decisions are common. These decisions may result in acting upon poorly developed business ideas, increased on-the-job injuries, or erratic and dangerous behavior at work.Mood Changes:
When someone who usually seems upbeat starts to appear sad or continually irritable, these shifts could indicate the emergence of a mental illness. By helping build the capacity of workplaces to learn such signs and symptoms, employers can help slow the progression of these illnesses by linking employees to appropriate treatment.
By educating workplaces about these warning signs and how suicidal behavior might manifest, it is possible to identify and intervene in an emergent crisis, preventing the deaths of people such as my brother, who suffered in silence, and ultimately died from a treatable disease.