Why the death of Stephen ‘tWitch’ Boss is hard to process

Content Warning: This article is about depression and suicide.

A few days ago, I came across a post about Stephen ‘tWitch’ Boss on social media. I didn’t stop to read it; It was early in the morning, I was getting ready for work, and I was seeing my first patient in less than ten minutes. So I kept scrolling, through training reels and challenges, and filtering vacation selfies. But as I continued to scroll, I saw it there again. This time, on a mental health page, and that’s when reality began to sink in. I still haven’t stopped to read the full caption; He didn’t have to (or maybe he just didn’t want to). So I turned my phone off, finished what was left of my protein shake from the morning, and tried to get on with my day.

But I couldn’t stop thinking about it.

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I just saw him dancing with his wife on Instagram. He has a beautiful family. He is always smiling. She is only 40 years old, more or less the same age as me.

As news of her death spread, and in particular about how tWitch died, I watched as other psychiatrists and mental health experts went out of their way to talk about what no one wants to talk about: suicide. But the question that most people were thinking was: How could this have happened to someone who seemed so happy? Or as her former boss, Ellen DeGeneris, put it, someone who was “pure love and light.” And that’s exactly why it’s so important for all of us to create an environment where talking about mental health is not just normal but expected.

Psychiatrists like me are trained to identify risk factors for suicide. These include having been diagnosed with a mental illness like depression or bipolar disorder, dealing with addiction, being in a toxic relationship, or having a serious medical illness like cancer. The truth is, you don’t have to fall into any of these categories to be at risk for suicide, and just being born a man automatically puts men in that category as well. Men die by suicide three to four times more often than women, and suicide attempts are increasing, particularly among black men.

As a black man who knows both sides of depression, has struggled with it, and dealt with it, I personally understand how difficult it can be for black men to get help. Perhaps one of the biggest barriers is that some men are hesitant to seek help from a mental health professional who is unlike them. It makes sense; guys want to talk to someone who really understands them. But only about 4 percent of psychologists and 2 percent of psychiatrists in the United States are black, so it can be challenging.

One of the most important lessons I’ve learned is that the person you’re talking to doesn’t have to look like you in order to help you. Therapists are trained to be curious, ask questions, and listen without judgment, regardless of how you or they look.

However, there is a larger role for all of us when it comes to fostering productive conversations about mental health, especially when someone we thought had it all dies by suicide. It is important that we have these conversations in a compassionate and intelligent way.

Here’s how to talk about suicide to improve mental health:

stop the spread

When we hear about a suicide, whether it’s the death of a friend or a celebrity like tWitch, we need to be careful how we talk about it. That’s because the contagion effect is real. This means that some people may be inclined to imitate suicidal behavior that they become aware of through word of mouth or in the media. One thing you can do to stop the spread is to ask those close to you how they feel about tWitch. Start a conversation, and if someone tells you that they are having very dark thoughts, encourage them to meet with a professional, such as a therapist or psychiatrist. Now may be a good time to see people you know who may be dealing with depression or another mental illness; a text or phone call goes a long way.

Focus on prevention

When you talk about suicide, skip the part about how they died. It is not helpful and does not promote mental health. Instead, reflect on the life of the person with fond memories, stories, or moments of joy. But it’s important to do this in a way that always encourages suicide prevention. If you share a post on social media, try adding a link to the suicide prevention hotline or tagging 988 (the new mental health crisis hotline number). If you are telling a story about someone you know who committed suicide, end it by normalizing and encouraging therapy. This can offer a much-needed lifeline for people you never knew are struggling with their mental health.

learn the signs

Suicide can be hard to predict, that includes psychiatrists like me. Often even close friends and family don’t see it coming. Some people who are depressed are very good at hiding it. They go to work, they smile, they seem happy. But there are usually subtle signs worth paying attention to. If someone you know frequently talks about death, or spends more time alone, giving away her valuable possessions, or stops talking about the future, check them out. Invite them to lunch or ask how they are doing. (Here it is a bit more about what you should know if you or someone else is having suicidal thoughts). Detecting subtle signals can ultimately save a person’s life.

Learning about a suicide is hard, talking about it is too. But if we all do our part, we can turn tragedy into an opportunity to prevent future suicides.

If you are having suicidal thoughts, please call 988 to speak to a trained professional. Help is available 24 hours a day, 7 days a week.

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