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No Laughing Matter

San Francisco and the world lost Robin Williams, one of its most beloved figures, to suicide Monday. Today we are all asking the same questions that families ask after a suicide: How could this have happened? Why didn't we see it coming? Why couldn't we have helped?
In the United States each year, there are 39,000 suicide deaths. That compares with 16,000 homicides and 33,000 highway vehicle deaths. How can we lose so many people to suicide and not know about it? What makes this happen and what can we do to stop it?
Suicide is the result of pain. Suicide happens when people are in so much pain that they kill their bodies to kill the pain. That pain may be emotional - it usually is in the United States - or it may be economic, physical or social pain (shame). The common denominator is that even though it is unbearable, it is largely invisible. Does this mean that there is nothing we can do?
At a moment when we have all lost someone we love to suicide, it is important to learn and understand that each of us is capable of saving someone else's life. Each of us who has felt invisible pain of any kind is an especially important force for saving the life of another person, who may save the life of yet another person in the future.
This is the moment when we can realize that at any given time 1 out of 5 of us is in pain. We can look for this pain, even though our culture trains us to ignore it. We are taught that it is a sign of weakness, of being unfit. We know now that it can exist anywhere for anyone - even for a man who has consistently given us joy.
We were captivated by the high energy characters Williams played, and by his perceptive and agile performances. Yet behind the laughs, information from Williams' publicist hints he possibly battled both severe depression and drug and alcohol addictions.
What do we look for? We look for people who talk about wanting to die by suicide. We are taught by our culture not to listen to them because they are trying to "attract attention. " But when one is drowning, one should be trying to attract attention. So we ask about the pain and we listen. We tell them we are here for them and we don't tell them that they shouldn't be feeling all this pain.
We don't even give them advice.
We also look for people who understand that suicide is a big decision and, who, rather than make it themselves, leave the decision up to the universe. They may, for example, hint about suicide - saying that they will be better off dead. Or they may act out their intent to die - giving away belongings or pets, making final arrangements, writing or painting about their death. We ask them about their pain and we listen. They are relieved that we notice and they can live. It is, for them, a real gift from us.
Some people are capable of using pain for laughter. Today perhaps each of us will use our grief to save a life.

When you need a friend

Local suicide crisis line centers are always a source of support for helping a friend through a crisis. Their telephone and computer services are staffed by local volunteers who can offer advice and the phone numbers of community resources. San Francisco Suicide Prevention offers resources at www.sfsuicide.org.
Crisis lines anywhere in the U.S. can be reached by calling 1-800-273-8255.
Eve R. Meyer is the executive director of San Francisco Suicide Prevention.