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The Role of Physical Illness. Among the, most common motives for suicide, is despair. Experts studying 80 suicide cases in Washington State, USA, suggested physical illness, including cancer, heart disease and arthritis, contributed to half of' those suicides. Facing a chronic, painful and potentially disabling illness, CFS/M.E patients are clearly at risk for suicide. Neglected, and what might be worse, disbelieved by the medical community, the public, family and friends, patients can quickly become isolated .Further, the severe pain experienced by some patients and the chronicity of the illness play a role in putting CFS/M.E patients at risk for suicide. The secondary depression that can accompany CFS/M.E adds to that risk. Fear: If' they've been hurt by society's common (albeit inappropriate) response to their condition as being "all in their heads," CFS/M.E patients might not mention their suicidal thoughts in fear of again being labelled depressed, or crazy, compounding their despair and the risk of suicide even furtherChildren and Suicide: Warning signs of suicide may go unrecognised or may be down played in children and adolescents, Don't overlook the possibility that a child or adolescent with CFS/M.E may be suicidal.Depressed vs. Distressed : Clinical depression can co-exist with CFS/M.E ,and, when present, should be treated. However suicidal thoughts do not always indicate clinical depression or other diagnosable mental illness. Suicidal people are severely distressed and may be experiencing a reactive depression to difficult circumstances, such as a recent loss of health, physical pain that becomes unbearable, loss of enjoyment, changes in the financial situation and loss of self esteem or personal expectations, among others. Lack of clear boundaries surrounding one's status, i.e., undiagnosed illness, uncertainty about recovery or unconfirmed disability benefits, also adds to the stress of such a crisis.Withdrawal and Isolation : Suicidal persons have different thought processes. They cannot move beyond what is happening now. They lose the ability to see themselves in the future and often have difficulty envisioning a future without pain.Believing that things will never get better, suicidal people tend to speak in generalisation and fatalistically, i.e., "No one cares" or "I’m a burden," They feel unable to communicate with others about their despairing feelings. Often their depression will prompt a withdrawal from support systems. They are unable to see anything positive in their lives and they believe there exists only one way out of their situation. Suicide is Preventable: But, most people have a stronger wish to live than to die. Fortunately, this ambivalence makes suicide preventable. There are warning signs to watch for and steps you can take to help someone who is thinking about committing suicide. There are also ways to help yourself and others cope when someone has completed a suicide.Warning Signs: Take notice if a personExpresses feelings of hopelessness, worthlessness or helplessness. Has had a recent severe loss Has lost a job, home, relationship, money, self-esteem or personal securityWithdraws from family and friends Has changed sleeping or eating habits What to do if you receive a suicidal call. Listen. It is vitally important that people in an emotional crisis have someone who will listen and really hear what they are saying. Be sensitive to the relative seriousness of the thoughts being expressed. Determine the intensity and severity of the emotional disturbance. Take any mention of suicide seriously. Evaluate resources available. Don’t handle it alone. Get professional help. Keep talking. Focus on what there is to live for. Remember this. You can offer support, compassion and hope to a suicidal caller or friend. What happens if it happens? Unfortunately, some persons with ME/CFS see suicide as their only option to end their pain. We have heard all the tragic stories of those who could not bear to go on living. But for each who ends his or her life, there are others left behind-family members. It’s okay to grieve . The death of a loved one is a reluctant and drastic amputation without any anaesthesia. The pain cannot be described and no scale can measure the loss.It’s okay to cry . Tears release the flood of sorrow, of missing and of love. Tears relieve the brute force of hurting
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