By Kathryn L. Casterline

There is an unhealthy stigma against depression and mental illness in this country. One that I’ll admit I used to subscribe to. My mother is bipolar and manic depressive. She has, over the years, attempted to take her own life more times than I can count with both hands.

Some of my most vivid childhood memories involve finding suicide notes she wrote but never acted on, or coming home from summer vacation to learn that she had been institutionalized, or coming home from school to find out that my father had come home and found her in the garage with the car running.

I used to tell these stories with something close to shame. When I talk about this now, though, it’s with deep respect. I struggled with depression in the past and I still struggle with crippling social anxiety disorder. It’s hard for me to get out of bed in the morning sometimes. It’s even harder for me to leave the house. That being said, I have never found life so unbearable that I thought about ending it. My mother has, and she still does. After years of unimaginable agony, she’s still here. She chooses to wake up each morning, even though she doesn’t want to. She gets out of bed, takes her medication, and sees a therapist. She is trying.

That’s all any of us can really do. Life is hard. It’s messy and it can end without warning. I have been working at two different coroners offices for about two years now. I have seen many deaths that could not have been foreseen. I’ve also seen a lot of suicides. According to the American Foundation For Suicide Prevention, suicide is the tenth leading cause of death in this country. But we don’t really deal with cause of death at the coroner’s office. That’s something for the pathologist to discern. A coroner is concerned with the manner of death, of which there are four—natural, accidental, homicide, and suicide. Murder is not as common as Hollywood would like you to believe. The majority of deaths are natural or accidental. Of the other two, suicide is far more common than homicide.

Last month, two individuals who were only 20 years old decided to take their own lives by jumping off the Capitol Boulevard bridge. Their deaths marked the first cases of suicide since the Washington State Department of Transportation put up the fence that lines the bridge back in 2011. I spoke to the mother of one these young men and she said that she had failed to see the signs, and that she wants to do all she can to help others who are feeling desperate.

So what are the signs to watch out for? While everyone is different, The American Foundation for Suicide Prevention has a list of common warning signs listed on their website. They include talking about feeling trapped, talking about committing suicide, stating that you feel as if there is no reason to live. Sometimes it’s when a person stops talking that you should become concerned. Not everyone who commits suicide tells others that they’re thinking of it. Often, when someone tells you they’re thinking of taking their own life, it’s a cry for help.

It’s not uncommon for family members to be taken by surprise when a loved one chooses to take their own life. They say things like, “We never saw it coming. They were always so happy and full of life. They had so much to live for.” It’s not hard to see why people hide their thoughts. The stigma against depression, mental health issues, and suicide in our culture can be intimidating—so intimidating that one would rather suffer alone in silence than seek help. If you believe that a friend or family member is contemplating suicide but can’t get them to open up, watch for these behavioral changes: sudden withdrawal and self-isolation, an increase of reckless behavior or increased use of drugs and alcohol, a sudden change in sleep habits, goodbyes, and attempting to give away personal possessions.

If you or someone you know is struggling, know that there is help out there. You can reach the National Suicide Prevention Hotline at 1-800-273-TALK or the local Crisis Clinic at 360-586-2800. Both lines are open 24/7 and are kept strictly confidential.