Photo of a Medical and hospital corridor with the text "It's time we talk about chronic illness and suicide."

Every year, approximately 44,193 Americans die by suicide. While many suicide-related deaths are linked to mental illness, a new study shows that having a chronic illness can increase suicide risk as well.

According to a study published in the American Journal of Preventive Medicine, having a chronic illness increases the risk of dying by suicide, and for those living with multiple conditions, the risk is even greater.

Researchers looked at the health records of 2,674 individuals who died by suicide between 2000 and 2013. From those records, 19 chronic conditions were identified and the number of people who died by suicide having those conditions was compared to the medical records of 267,400 people. Conditions studied included diabetes, cancer, migraines, epilepsy and asthma. For 17 of the 19 conditions selected, the risk of suicide was increased. Of the 17, traumatic brain injuries, HIV and AIDS and sleep disorders carried the highest risk.

“This study really supports the idea that having one or more physical health conditions increases risk for suicide.,” the study’s lead researcher Brian K. Ahmedani, PhD, LMSW told The Mighty. “These main findings suggest that suicide may be linked to overall burden of disease or health rather than to any single condition, even though the association was particularly strong with a few conditions.”

If You Are Living With a Chronic Illness

While chronic illness can increase the risk of dying by suicide, mental health professionals note there is help out there for those living with a chronic illness who are struggling with suicidal thoughts. “Chronic illness is a daily stressor that may not go away, so it would be unusual for it not to affect mental health and well-being, at least at times,” Marisol Hanley, PhD, a psychologist in Seattle who lives with lupus, told The Mighty. “You should not beat yourself up for having emotional difficulty sometimes and not always having a positive attitude.”

There are many challenging aspects of chronic illness, especially when caring for yourself becomes as demanding as a part- or full-time job. “Usually it’s the diseases that require a lot of health care on the part of the patient that carry a higher risk [of suicide],” said Daphna Shiffeldrim, MD, MPH, a New York City psychiatrist who works primarily with patients, like herself, living with diabetes.

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Beyond increasing the risk of suicide, having a chronic illness also makes you more likely to have a mental illness. “Usually chronic illness carries higher rates of psychiatric comorbidity such as depression and anxiety,” Shiffeldrim said. “It’s not just that if you have a chronic illness you have a higher rate of suicide, but you have a higher rate of probably having depression, and therefore, leading to having suicidal thoughts.”

If you are having a hard time coping with your disease or symptoms of your condition — like fatigue or brain fog — make you feel less like yourself, it can be hard to distinguish a mental illness such as depression from any physical symptoms you may be experiencing. Depression can appear in ways beyond feeling sad, especially if you live with an illness. For those with diabetes, Shiffeldrim said, depression can present itself as uncontrolled blood sugar.

“A lot of [people] aren’t aware of what depression really looks like,” said Nicole Reynolds, PsyD, a psychologist treating those with chronic illness in New York City. “They think it’s only feeling sad, but there are a lot of other symptoms that encompass clinical depression.” Other signs of depression can include changes in appetite, self-esteem issues, changes in your sleep pattern and fatigue.

Oftentimes, your doctor will screen for depression during your exam, Reynolds said, but this doesn’t always happen. “If in doubt, if you’re concerned about being depressed, it’s best to at least sit down with someone to have the conversation,” she added. “Therapy can be beneficial regardless, whether it’s isolated depression or chronic illness. ”

The Value of a Strong Support System

Whether it is reaching out to family and friends, attending a support group or seeing a therapist, a strong support system can help you through difficult times.”In my perspective, I think anyone could use some support, in general during their medical appointments and during their medical crises especially,” Reynolds said.

For those who need more help, individual therapy can be a great resource. “Try to look for a therapist who has familiarity with health issues,” Hanley advised. “Going to talk to someone when you are newly diagnosed or still in the process of diagnosis can help work through the grief and adjustment period.”

There is also no shame in seeking psychiatric help. “Medication for mental health, like antidepressants, can be a useful tool for some people,” Hanley added. If you are prescribed an antidepressant or other medication, make sure you understand how it will interact with any other medications you may be taking, she advised, and don’t change or start more than one medication at a time.

If you are having suicidal thoughts, you can reach out for help by contacting a suicide hotline or crisis prevention center. “Most people don’t want to die, they just want the pain to stop,” Hanley said. For suicidal thoughts brought on by flares or periods of intense pain, Hanley recommends speaking with your doctor about pain management.

Managing a chronic illness is difficult, and it is OK to feel tired or have moments where you grieve. “Instead of fighting your feelings, you can think of strong emotions, even despair and hopelessness, as waves,” she said. “If you let the wave pass through, you come out the other side. These feelings are normal, and you are not alone.”

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or text “START” to 741-741. Head here for a list of crisis centers around the world.

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It’s one of those days. The days I put on leggings and a tunic – not for fashion but because they are the softest clothes I own. Plus the damn weight gain from the medication which makes my clothes fit tighter and tighter as time goes on.

The effort to get out of bed is almost more than I have in me, but I need to work. Medication doesn’t pay for itself.

The feel of the shower is too hot then too cold because my nerve endings are over-stimulated by the flow of the water on my skin.

 

Get out, get dressed. Skip the foundation for my face because the feel of it on my skin makes my face ache. I put the bare minimum on. A little eye liner and a little mascara. I can feel the weight of the mascara on my lashes causing my lids to feel heavy.

Shoes, oh god, shoes. Flats because the thought of putting socks on my feet would put me over the edge.

Walk to my car. I can do this. Drive the 20 minutes to work but pull over at the park nearby because the thought of walking up the stairs to my office overwhelms me with dread. Thank goodness I’m early enough to take a couple minutes to gather my energy to make the trek that feels like climbing Mt. Everest.

I want to cry, to sob out my despair, my frustration. Why me? I exercised, I eat relatively well. I quit smoking 20 years ago…but now I am struck down. Betrayed by my body.

No, my illness is not a death sentence. It’s not a terminal disease stripping my life from me a day at a time. No, I have a life sentence. One with no chance of parole. I have a disease that few understand, and that until recently, many didn’t even believe was real. Me included. Is that why I got this? Because I believed people were milking it and became frustrated when they made plans and cancelled over and over again? No… I know that isn’t true, but when the darkness and despair creep in on these bad days, I wonder. Why me? Why can’t I do what I used to? Why can’t I walk around the block without the fatigue and weakness and pain that always comes?

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The tears come. I probably shouldn’t have even tried to put the makeup on…it’s mostly gone now. I wipe my tears and the mascara from beneath my eyes, take a deep breath and drive the rest of the way to work.

I remind myself why I push to do this. Because I refuse to be a victim. I refuse to let this horrible life sentence defeat me. My body may betray me, but I will not give up. I will fight because to do otherwise, even when the despair and darkness try to consume me, would be to let the darkness win. I am a fighter. I will fight the despair and the depression. I will not let this disease define me or defeat me. I will not let it win.

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Thinkstock photo via RyanKing999.


Remember that classic line from Shrek? “Onions have layers, ogres have layers. You get it? We both have layers!”

In a way it makes me laugh, but at the same time, it blows my mind thinking that chronic illness can feel so similar.

That initial diagnosis sounds so simple. If you’re like me, I walked into my doctor’s office, got diagnosed with CFS (chronic fatigue syndrome), left with the rest routine and that was it. Simple, right? If only! 

 

First, there’s fatigue, causing me to sleep all the time, limiting more and more the things I did every day. Then there were the random body crashes, the migraines, the photophobia, the struggle to feel a part of society, communities, social interactions disturbance, dissociation, sensory overload, joint and body pain, temperature confusion, insomnia, mental health instability, lack of motivation, and on and on it goes.

It’s not just about the physical – it affects the social, mental, spiritual, emotional, etc. We need to think about chronic illness in a holistic way. You will find that it won’t just affect one aspect of your life, but many. How full on is that?! Like I’ve said in my other stories, we need to make ourselves aware that we are all different. We need different types of support and have different needs because we all tackle and experience our illnesses differently.

But how do we tackle it all at once? The appointments, waiting rooms, blood tests, talking to psychologists, counseling, medication tryouts, physiotherapy, rest, exercise physiotherapy and every other approach that may or may not be helpful – it’s all recommended to us. We are constantly met with ideas of what we should try and what is next to be tried in the process of each of our recovery journeys, leaving us – most of the time – even more exhausted.

There is so much we experience that you don’t see. The tears, the nights awake in bed staring at the walls, the agony of pain, the loneliness, the anxiety, the depression and the struggles with mental health. When we don’t get to see our friends and be in our social environments or groups, our lives are put on hold. All these things matter – every aspect needs to be taken into consideration to move forward.

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Feeling tired yet?

First, remember to breathe. Get people around you to support you and drive you to appointments, touch base with your friends, invite them over to help make food, have people over to sit with, go for walks, watch movies. Be patient. This is all overwhelming. For most of us who have a chronic illness to the extreme, it sucks and makes us even more tired. What is worse is when doctors look at everything separately and forget where everything stems from. You feel you’re not being heard, and around and around the process you go – which, if you are like me, has caused countless appointments to end in tears and frustration.

The process of trying to cover all bases of care may be overwhelming, but don’t give up on getting the proper care you need. Get the helpful hints, the rest and everything else you need to begin or continue on the road to recovery. There are so many layers, and not one of them should be ignored.

You’re amazing; remember this through all the pain and tears. You are remarkable and so much stronger than you think.

Take hold of the small wins and celebrate every joy and victory in your day. Hold on, you’ve got this. You’re not alone.

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Thinkstock photo via Ingram Publishing.


Lately, I’ve become more aware of something troubling. It’s not new or immediately dangerous, but it is insidious. Many people, healthy and ill, are sitting in judgment of others’ health management. Within the chronic illness community, this issue creates tension and extreme caution. Should I share this big development? Will someone relate to this, or will they try to tear me down? While going through appointments, treatments and hospitalizations, the weight of the decision to be open about health ups and downs increases. Personally, I’m choosing to stand up (well, sit) and talk about it instead of retreating.

 

As I’ve said, unsolicited judgment of fellow patients is nothing new. Several years ago I was involved in a chronic illness support group for teens. For the most part, it was a positive experience. However, it only took a few inflammatory participants to cause discord. Since I was already tired and ill, I decided that the risk of super negative or weirdly competitive interactions wasn’t worth the emotional cost. In a way, the decision to be less involved in chronic illness groups until quite recently was part of my health management. The risk of emotional danger appears to be especially high for teens, some of whom are newly diagnosed. Knowing that stress makes many of my conditions worse, I chose to go about my life and reduce my online presence while I came to terms with my medical conditions.

Maybe I forgot how intense it could be, or perhaps I hoped it had changed, but the undercurrent of judgment is still around. Amongst “spoonies” of all ages, that skeptical tone creeps into the conversation. Instead of trying to persuade another person to say no to opioids or medical marijuana, we need to be sympathetic to their very real pain. Rather than chastising someone for posting tough updates or unpleasing pictures, we must remember that sharing their struggle can help lessen their individual burden. Those are the moments when love must rush in, not negativity.

My own blog and Instagram posts are mostly bright, intentionally positive images. Right now, that’s my comfortable tone. Does that mean my words about the toughest parts of my conditions are untrue? Nope. Do I necessarily feel better than the person who chooses to document their struggle in strikingly raw images? Yeah, no. Just because two…or 20…or 200 patients have the same illness doesn’t mean their approaches to management and sharing will be identical. That’s part of being human; we’re not robots. Our bodies are similarly flawed and glitchy, but we are individuals leading amazingly varied lives. Let’s celebrate the spectrum of constructive techniques, and be thankful for the support of our online and offline communities.

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Despite my past experiences and current concerns, I believe that patient-to-patient support is invaluable. There’s truly nothing like chatting with someone who gets your jokes and relates to your experiences. In fact, I love seeing the way that two people still reach out to support each other when they’re both dealing with major health setbacks. Connecting with each other, motivating each other and sharing our toughest days are parts of what make chronic illness communities strong. I’ll stick around, and I’ll keep choosing encouragement over judgment.

Follow this journey on Maria Gracefully.

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Thinkstock photo via Martinan.


It’s no secret among the chronic illness community that movies and TV shows are not typically reliable sources of information on diseases and medical procedures. In fact, it’s pretty rare to find a show that gets every detail right – and there always seem to be the same stereotypes and inaccuracies portrayed over and over again (looking at you, doctor who just diagnosed a patient in under five minutes…).

Since entertainment media often give such misleading information about illnesses (thus affecting how viewers empathize and interact with chronically ill people in their own lives), we wanted to bust the myths and explain what really happens. So we asked our Mighty community to help us list the things that tend to happen to patients on TV shows that don’t usually happen in real life. These are the things that make people want to yell at the TV, “That’s not how this works!” Let us know in the comments if there are any other inaccuracies you’ve noticed on TV or in film that you want to clear up.

1. Patients can always stay in the hospital until they get a diagnosis.

“Patients in ‘House’ just stay in the hospital until they find out what’s wrong with them. Yeah, that’s not how it’s worked for anyone I’ve ever met. Hospitals don’t let you just chill while they devote a team of top doctors to your case and only your case and don’t rest until they diagnose you.” — Shannon

“In the movies, doctors keep you in the hospital until they find out what’s wrong, and then they keep you there until they find a treatment that works. In reality it takes several visits over years.” — Bethany

2. Sick patients are always well enough to go on a series of “bucket list” adventures.

“I’m way too sick for that — to the point where a trip to the nearby store is a giant and exciting feat that leaves me drained for the rest of the day and I usually have to leave before I complete my list. There’s no way I could go to a theme park or foreign country!” — Katie

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“Seriously ‘Fault In Our Stars.’ No way Hazel would have felt well enough to go on that trip! She couldn’t even handle going to school anymore.” — Jeanell

3. Medications seem to work instantly.

“In ‘Crossing Lines’ the lead character would open a new morphine patch and the second it touched his skin he would get instant relief. Yeah, no. Not how it works. At all.” — Laura

4. Patients can afford treatment, and insurance doesn’t need to be discussed.

“Every single one of them can magically afford treatment or has family that helps out.” — Stacy

“On TV shows/movies they rarely deal with insurance. Dealing with insurance is a full-time job.” — Nikki

5. Insulin is the only treatment option for diabetes.

“I hate when the media portrays insulin as the only ‘medicine’ to help a person with diabetes who’s experiencing a low blood sugar or hypoglycemic diabetic coma… People with diabetes can and do eat sugar, and often that sugar is their lifesaving ‘medicine!’ I have type 1 diabetes, and I can’t tell you how many times people have shamed me for shoving Skittles down my throat or sucking down a juice box at warp speed because my blood sugar was dangerously low… just trying not to die, that’s all!” — Kaitlin

“My dad keeps candy on hand and usually soda too in case of a sugar drop. He uses an insulin pump and actually went into a diabetic coma because of too much insulin, and unfortunately by the time we found him his sugar was so low the paramedics machine didn’t even register it. I didn’t even realize that could happen with an insulin pump, but you really can have too much insulin, and if your sugar drops before you realize it then you [may] become confused and it can be really life-threatening.” — Alicia

6. Recovery from surgery takes no time at all.

“After having surgery (even brain surgery) the person is up and moving around right away as if nothing has even happened to them. From a lot of experience, that is very unrealistic.” —Heather

7. Patients with narcolepsy always fall asleep instantly, wherever they are.

“Pretty much anytime narcolepsy is shown in TV/movies, they get it wrong. It’s rare to fall asleep so suddenly without any kind of warning that you’d fall into your food. Also, the falling to the ground asleep is actually a bad portrayal of cataplexy where the person loses muscle tone due to emotional triggers, and the person actually remains awake, they’re just unable to move.” — Sloane

In the movie ‘Rat Race,’ narcolepsy is incorrectly portrayed (as usual). The character standing there asleep for hours on end? No way. His legs would’ve collapsed.” — Lisa

8. Doctors provide every type of care to their patients.

“In most TV shows the doctors stay with the patient seemingly for every test and when giving treatment, and clearly that doesn’t happen in real life. Most patients when in hospital see their doc once a day for rounds and then maybe an intern or a resident after that, but not like they portray on TV.” — Amanda

“Seeing doctors doing things like ambulating patients, getting them a pillow or caring for the patient’s comfort… please. That’s what nurses and physios do. You’d be hard-pressed to find a doctor that does any sort of daily cares.” — Caitlin

9. According to commercials, you become perfectly healthy after taking [insert medication].

“I take Lyrica, and according to the commercials I should be happy, riding carnivals rides, and camping with the family, when in reality for me it’s hard to walk to the kitchen and make a cup of coffee.” — Bobbie

“I absolutely detest commercials that depict people with severe diseases like myasthenia gravis, multiple sclerosis, lupus, diabetes, who: A. Lead a life apparently free from pain if you take their pill. B. Show in very small letters ‘actor portrayal.’ [and] C. The medication has more serious side effects than the disease itself.” — Suzanne

10. Migraines can always be “cured” by fixing the “underlying cause.”

“There are really years of tests that come out normal because they aren’t to show migraine exists; they’re to rule out any other possible cause, trial and error treatments because everyone is different in what works/helps. Oh, and it’s a primary disorder, which means there is no other cause. Migraine disease is the cause, and it’s neurological and genetic and there is no cure.” — Selena

11. Shocking a flat-lined (asystole) heart will get it started again.

“It happens in so many movies and TV shows. Shocking can ‘reprogram’ an arrhythmia back into a sinus rhythm… but it can’t reintroduce electrical activity into a heart that has none!” — Caitlin

12. All seizures are tonic clonic (formerly called grand mal), and the person always wakes up immediately afterwards.

“Like there aren’t about 10 other ways to have a seizure. My daughter is epileptic and has partial and complex partial seizures. Had I not previously nannied an epileptic child, I would not have not recognized what was happening as seizures and got her the help she needed.” — Jeanell

“You [may be] unconscious for a little while after the seizure stops, then go into a ‘postictal‘ state, where you’re unresponsive, but you’re performing different simple motor functions, like attempting to stand or even stacking objects randomly. Then you become aware of your surroundings but have some long-term memory loss, so you have no idea what year it is, what your birthday is, different things like that until they slowly start coming back to you.” — Jenni

13. It doesn’t take long to get a diagnosis.

“[It’s unrealistic] how fast they find out what’s wrong with them from just a couple tests and magically get the right and single medication which makes their lives back to what it used to be before being sick, and nowhere along the way anyone ever questions how sick they are.” — Ashley

“Some of us wait years for a diagnosis, and once we get one, there isn’t really a cure, only a treatment that will manage the symptoms and allow us to be semi-functional.” — Patricia

Photo courtesy of Grey’s Anatomy Facebook page


I don’t often write about the ins and outs of living with a stoma but today I’m making an exception.

The life of an ostomate is, in general, a mystery to the general population. Let’s face it, you don’t generally think about having a stoma or research what it might be like to have one unless that particular path is a possibility or if someone close to you has one.

 

I certainly didn’t give much thought to what it might be like to have a stoma when I had a functioning bowel. Any thought I might have had was one of “Yuk, I wouldn’t want one.” My reaction was, of course, based on my own ignorance and lack of understanding.

One of the concerns I had when facing the prospect of life with a stoma was whether it would smell. Whether I would smell. It was my biggest fear. Again, it was a fear based on a lack of knowledge.

Stoma bags have an in-built filter, so when an ostomate passes gas, the smell is filtered and contained. In essence there is no smell, unlike someone without a stoma who accidentally passes gas in public.

images 11


Stoma bags are amazing, really. There are all kinds to choose from. I have a colostomy which means my output is pretty normal as I still have most of my large intestine. My stoma is on the left side of my abdomen and is a cute red little button. Who knew our intestines were a lovely red color and so clean?!
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images 10

So, back to my bag. I have a one-piece bag that literally just sticks onto my skin around my stoma. So easy to put on and dispose of and change. The stoma bag is the same color as my skin and is so comfortable. I’m at the stage where I often forget I even have a stoma. To get to that point takes a while, but I’m nearly four years post my colostomy surgery.

Today, however, I was very aware I had a stoma.

I had to go for blood tests, but I was not feeling wonderful and my stoma was being quite active. I didn’t have a full bag, but it was full enough that I knew I didn’t want to be out for too long, so I was hoping to be seen very quickly.

My husband and I entered the pathology rooms and I was hit by a smell. “Oh no,” I thought, “I’ve had a leak!” Leaks can happen, but I quickly put my hand on my abdomen and could tell I hadn’t. You learn the signs, and everything felt in place and OK. My next fear was the bag had a hole or tear in it. That has happened before, only twice, but once was enough. I wouldn’t be able to tell until I got home or found a toilet.

I use two crutches for mobility and my legs were playing up so I didn’t have the strength to try and find a toilet. No one else was in the waiting room apart from the phlebotomist, so we just took a seat.

The smell dissipated and I relaxed a little.

We were soon called into the collection room. As my hubby and I entered with the phlebotomist, the smell hit again and flooded the small room. My heart sank. It was the smell of a baby’s diaper in desperate need of a change. I just wanted to go home or at least have the floor swallow me up.

I looked at my husband, trying to speak to him with my eyes to check if he could smell anything. I probably looked strange, so not the best idea under the already awkward circumstances.

The smell quickly dissipated again, which was slightly odd, as usually if a bag leaks the smell is there until you sort the issue out.

My blood was quickly taken and I thanked the lady, grabbed my crutches and walked as fast as possible out into the street.

I asked my husband immediately: Did I smell? He said no but confirmed my fear that he definitely could smell something when we were in the rooms. We got into the car and I checked my bag (thank goodness for tinted windows). My bag was perfect. No smell, no leak!

We looked at each other and burst out laughing.

It wasn’t me!

It was the lady in the rooms. We realized the smell in the collection room was worse when she bent over to get something out of the cupboard.

Hmm…perhaps it was something she had for lunch.

While I felt slightly bad for laughing, I can’t tell you how relieved I was it wasn’t me.

Just goes to show that even though I am comfortable with my stoma, even I was pointing the finger at me first.

So, moral of the story…if you are in a room with someone who you know has a stoma and you smell something odd, please don’t assume it’s them. In all likelihood, their stoma bag is protecting any smells. In all likelihood, it is someone else.

I’m just glad it wasn’t me!

You can read more about Sam’s Colostomy story at My Stoma Story.

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Thinkstock photo via PapaBear.

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