PreventingTPrehe Suicide: The Power of True Support
PREVENTING SUICIDE: THE POWER OF TRUE SUPPORT
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I’ve been excited about many of my guests on Living Chronic, but I’m especially looking forward to my conversation with Dr. Robert C. Smith, MD. His work on mental health and suicide prevention deeply resonates with me, not just as someone who has seen friends and former colleagues in the Army take their own lives, but as someone who has grappled with my own struggles.
For years, I’ve wondered: Why is the burden placed on those who are struggling to “reach out” if they’re suicidal? Why aren’t we turning to the people around them, their family, friends, co-workers, and asking, “Why didn’t you do something?”
Dr. Smith has asked the same question and, more importantly, has provided a practical method for helping those in crisis. In a 2020 Psychology Today article, he introduced the NURS method for responding to emotional distress:
Naming it – “…so you’re pretty angry [worried, depressed, upset, stressed]…”
Understanding it – “…makes sense to me, I understand…”
Respecting it – “…thanks for telling me, you’ve had a tough time…”
Supporting it – “…let me know how I can help…”
Dr. Smith points out our minds naturally want to add an “E” to NURS, completing the word “nurse.” That “E” stands for Empathy, and can you think of anyone more empathetic than a nurse? Especially after what we’ve seen during the COVID-19 pandemic, it’s a powerful reminder that compassionate, active support can save lives.
I want to focus on the “S” in NURS, Support, because, in my experience, this is where we so often fail each other.
We like to say we support people in distress. We tell them, “Let me know what you need.” But how often do we actually follow through? How often do we show up, unprompted, with a meal, a ride to the doctor, or a simple, “Hey, I’m thinking about you”?
My own experiences have made me think of this often. Last year, my health spiraled out of control.
I had just undergone sinus surgery and was hopeful it would help me regain some stability. Instead, everything went wrong. My bladder stopped working, my tremors worsened, I had trouble breathing, my muscles and joints ached, and my heart raced uncontrollably. Each day brought new symptoms, new pain, new uncertainty. And the worst symptom? Severe migraines.
They were so unbearable that I was blacking out from the pain. I was nauseous, throwing up, and seeing spots, when I could see at all. The pain was all-consuming. My neurologist at the VA was impossible to reach. My primary care doctor prescribed medication that wasn’t helping. I suffered in silence until I couldn’t anymore.
I went to the ER, because what else could I do? But that’s not a treatment plan, that’s desperation.
When I finally got my neurologist on the phone, he mentioned an MRI and better medication. Then he forgot about both. So, I went back to calling. No response. I fought to get someone, anyone, to listen. Finally, an MRI was scheduled.
But that led to another fight.
I need three Xanax to get through an MRI. Not two. Three. My records are very clear about this. Yet, when my doctor prescribed two, I explained, again, why that wouldn’t work. She refused to listen.
That was it. I lost it.
I have been through so much since the day I was diagnosed with Crohn’s. Since the reaction to Humira that went undiagnosed for 19 months despite the relative commonality of the side effect. Since the years of fighting for someone, anyone, to diagnose the neurological damage that Humira reaction caused. And now, after everything, I had to fight over one pill to get an MRI that should have been ordered months earlier.
How did the VA respond to my meltdown?
Did they fix the problem? Get me proper neurological care? Offer real support?
No.
Instead, they sent police to my house. They had random veterans from the crisis line call me 10+ times a day, a relentless barrage of well-meaning but unhelpful outreach that did nothing to actually address the root cause of my distress.
This could have all been avoided if someone had simply done their job. If someone had truly supported me, rather than leaving me to fight alone.
I always talk about how isolating and lonely chronic illness is.
I’ve never had much in the way of support, not when I had to find a new career that would accommodate my illness, not from medical professionals who were more interested in medicating me than helping me live, and certainly not in the day-to-day burden of carrying this reality.
And I think about the "S" in NURS every time I lose a friend or colleague to suicide.
We knew they were struggling. We knew they were carrying something heavy. What did we actually do?
Maybe we sent a quick text: “Thinking of you.”Maybe we said “Let me know what I can do”, without actually meaning it.
And then, when they were gone, we asked:"Why didn’t they reach out?"
Why didn’t you?
Why is the onus always on those who are suffering? Why aren’t we asking, "What did I do?"—of substance?
Thoughts and prayers are meaningless, just ask anyone drowning in pain.
I’m grateful that Dr. Smith has given us a tangible way to support those in crisis. But knowing the method isn’t enough, we have to put in the effort.
The burden of survival should not fall on the people who are suffering.
It should be on all of us, friends, family, coworkers, society, to truly reach out and help each other.
So, I challenge you:
What have you done today to truly support someone in need?
Because “Let me know if you need anything” is not enough.
Not anymore.
If we truly want to prevent suicide, we have to stop making support conditional on someone asking for it.
We have to:
✔️ Check in—without waiting to be asked. Call, text, drop by.
✔️ Offer something specific. “I’m bringing you dinner tonight.” “I’ll drive you to your appointment.” “I’m free to talk—how about Tuesday?”
✔️ Listen and validate their emotions. Don’t minimize. Don’t try to “fix” them. Just be there.
✔️ Follow through. Don’t make an empty promise. If you say you’ll be there, BE THERE.
Dr. Smith’s NURS method is a powerful tool. But if we don’t take the “S” for Support seriously, if we let it be just another platitude instead of an action, then we’re leaving too many people behind.
If you know someone who’s struggling, don’t wait for them to reach out. Be the one who steps in. You never know whose life you might save.
Here is a link to Dr. Robert C. Smith’s article, You Can Prevent Suicide in Someone Close to You and be sure to check out my upcoming episode with Dr. Smith on Living Chronic.
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