A renowned psychiatrist was asked to name the biggest myth about suicide. His response is a must-read.

Suicide is one of the hardest topics to discuss.

That's why so many of us have such a difficult time recognizing signs of suicidality or responding to them.

Add to that the myths we're told about suicide —  "just talking about is dangerous," for instance; or that people who are contemplating suicide always show outward signs — and it becomes even more difficult to navigate. Even as several high-profile celebrity passings, and rising suicide rates re-affirm that the discussion is now more important than ever.


On World Suicide Prevention Day, an expert took to Reddit to make the conversation just a little bit easier.

Dr. Tyler Black is a child and adolescent psychiatrist and the Medical Director of the Child and Adolescent Psychiatric Emergency Department at BC Children's Hospital in Vancouver, where he's worked with thousands of families during his nine-year tenure.

Aside from the work and research he does at the hospital, Black is passionate about educating others about the science of suicide. And because he knows that the world's got questions, he set up an "Ask Me Anything" to give people a chance to further their understanding of suicide in order to reduce its rates.

One question makes it clear we need to rethink how we view suicide.

When one user posed the question of what one misconception Black wants others to stop believing, the doctor dropped some real knowledge that does away with the belief that only those with serious mental health issues become suicidal:

Probably the biggest would be that suicide behaviour or thinking is only for people with mental illness. Risk factors and protective factors don't work like that. Just like all humans are at risk for heart attack (some, very very very low compared to most humans, some very very very high), all of us have various risk factors that push us towards suicidal thinking and protective factors that push us away. Mental illnesses add to our suffering but so do physical illnesses, stressors, bad news, poor sleep, etc etc. There are hundreds of risk and protective factors that all work in different directions to influence suicide risk.

This misconception, Black explained, allows us to ignore risk factors until they're at crisis levels. It also allows us to not think about suicide until a person shows outward dysfunction. But for many people, suicide isn't often predated by a long period of mental illness.

That's why it's so important for us to be aware of the emotional states of our friends and loved ones, check in on them regularly, and make an effort to be there for anyone we care about.

What can you do to help others? Show up.

One of Black's most important points is this: Often, we undervalue the impact we have in others' lives. We think that psychiatrists are the only ones who can help those who may be contemplating suicide, but as Black notes — mental health professionals are just one piece of the puzzle.

Recognizing that we have the ability to help others, only if it's just by listening, is a powerful way to let those we care about know they're not alone. So if you've been thinking about calling a friend who is struggling, or just saying hi to someone you haven't seen in a while — now's a good time to reach out. Of course, no one's expecting us to single-handedly change a person's entire outlook on life, but making contact can make a huge difference.  

If you or someone you know is struggling, know that there are immediate resources available if you're in a crisis. There are many organizations to become familiar with, including the National Suicide Prevention Lifeline 800-273-8255, the Crisis Text Line (text "HOME" to 741741), and the Trevor Project 866-488-7386.

via ABC and Bee Gees / YouTube

A year ago a woman in Pearland, Texas helped save her husband's life because of her quick thinking and the sweet, four-on-the-floor disco beat of the Bee Gees.

After finishing a two-mile run with her husband Quan, Ganesa Collins watched him fall to the ground. "We sat on the bench, and he was in front of me," Collins told ABC. "I was standing behind and stretching, and he just went face forward. His head hit the dirt."

She quickly called 911 and the operator said he was having a heart attack.

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via ABC and Bee Gees / YouTube

A year ago a woman in Pearland, Texas helped save her husband's life because of her quick thinking and the sweet, four-on-the-floor disco beat of the Bee Gees.

After finishing a two-mile run with her husband Quan, Ganesa Collins watched him fall to the ground. "We sat on the bench, and he was in front of me," Collins told ABC. "I was standing behind and stretching, and he just went face forward. His head hit the dirt."

She quickly called 911 and the operator said he was having a heart attack.

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True

Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."