It’s Okay not to Be Okay. Detecting Suicidal Signs in Online Communication

Feature article by Tetiana Tytko, University of Maryland, College Park

Introduction

How are you? – Good, how are you? This everyday greeting people have at work, at school, or at the checkout in the supermarket is routinized in the English language, reflecting the cultural norm that everyone is expected to be OK. Coming from Ukraine, where people ask, "How are you doing?" only when they want to hear the real answer, when I relocated for my Master’s degree, I wondered how to let people in the U.S. know how I actually feel. After experiencing American culture first-hand, I realized that the American image of always feeling fine is just a facade. Many young adults living and studying in the U.S. are constantly stressed, lonely, or suffer from depression. Sadly, as few as one third of youth with moderate to severe symptoms of depression seek help while others suffer silently (Mental Health America, 2021). This silence results in shocking statistics on suicide rates.

 

The Crisis of Suicide

 

According to the National Institute of Mental Health (2020), suicide is the second leading cause of death among individuals in the U.S. whose age ranges between 10 and 34, and the fourth leading cause of death among people 35 and above. These already disturbing statistics have escalated due to COVID-19 as many adults in the U.S. have reported “elevated levels of adverse mental health conditions, substance use, and suicidal ideation” since the beginning of the pandemic (Czeisler et al., 2020, p. 1053). Graduate students can be considered to be one of the most vulnerable groups given the stress, workload, and expectations they have to live up to in this challenging time (Woolston, 2020). So, how can we be resilient in the face of this suicide crisis? Some people choose to seek ways to investigate the issue of suicide from different fields (e.g., psychiatry, psychology, medicine, linguistics) to shed light on the reasons behind suicide and the ways it can be recognized and prevented.

 

A Brief Overview of Suicide Discourse Research

 

While research on suicide discourse was initiated in the last century, it has been infrequent. The modern field of applied linguists has begun researching suicide discourse relatively recently. Nonetheless, these initial findings have already contributed to the development of instruments effective in identifying suicide warning signs. An extensive analysis of the language of suicide notes (e.g., Osgood & Walker, 1959) and literary works (e.g., Baddeley et al., 2011) resulted in the following salient suicidal signs: the augmented use of the first personal pronoun in the suicidal state, self-reference, extensive use of words with a negative connotation, and absolute terms. Sadly, this research was focused on studying the writing left behind by people who committed suicide. However, to really help predict and prevent suicide, we need to extend previous findings and test if suicidal thoughts are detectable in modern communication, which is accessible to most people and may allow the detection of suicidal thoughts. 

 

Why Are Texts Important?

 

On average, Americans send and receive 94 text messages every day. These messages can serve as an excellent source of reflecting genuine feelings, especially when they are sent under heightened emotions (Xie & Kang, 2015). Compared to social media posts that can be deleted, texts cannot be unsent; thus, they can serve as evidence of the actual emotional state one experienced at the time of sending a text. Given how accessible text messages are and how often

people communicate online these days, studying them can yield valuable results for local and national suicide prevention programs. These insights can help create and inform campaigns similar in importance and scope to established ones like the National Alliance of Mental Illness (NAMI), Lone Survivor Foundation, Suicide Prevention Lifeline, and others.

 

Applying a Corpus Approach to Text Messages

 

Responding to this urgent need, Tytko and Augstkalns (2020) conducted research examining whether features of suicide notes can also be found in the online communication of a suicidal person. If so, this would allow people to detect early signs of depression, which is one of the main causes of suicide.

Using corpus analysis and a machine learning algorithm, my colleague and I looked at the frequency and saliency of negative and positive emotion words, first-person singular pronouns, and absolute terms in a graduate student’s writing who is a suicide survivor. We compiled two corpora that consisted of the participant’s personal correspondence with family and friends over the course of five months. Corpus 1 included the text messages sent in September, when the participant reported having no suicidal thoughts, whereas Corpus 2 contained her personal communication from January after a suicide attempt during a depressive episode. After the two corpora were equalized, the researchers used AntConc (Anthony, 2019) as the concordance software to find the frequencies of the measures in each corpus. Additionally, the Linguistic Inquiry and Word Count (LIWC) program (Pennebaker et al., 2001) classified the person’s emotional and psychological states and tracked the change of the parts of speech use.

Findings

 

Our findings show that there are some prominent features reflecting suicidal ideation in a graduate student’s text messages:

  • First personal pronoun: I, me, my, myself (e.g., I have to do all my own work myself).

  • Dichotomous thinking and extreme mood swings from negative emotion words: sad, bad, terrible, tired (e.g., It was terrible, and I was like 7 and had insanely low standards) to positive emotion words: fun, happy, glad, nice (e.g., I’m extremely happy that after all this happened to me).

  • Contrastive conjunctions: however, but, although (e.g., But sometimes I don't have anyone else to talk to).

  • Absolute terms: ever, never, definitely, everything (e.g., Nothing’s helping. Nothing in particular is happening).

 

Obviously, encountering these words in text messages cannot guarantee that an individual is considering taking their life. However, if combined with the overall negative coloring of the message along with the themes of blame, guilt, loneliness, and hopelessness, this can be a serious indication that someone is starting to develop depression and experience suicidal thoughts.

Another interesting finding of our research was that individuals who are suicidal cannot objectively evaluate their emotional states, but their language can reflect suicidal ideation. In other words, there was a significant number of suicide markers in text messages sent right before the suicide attempt as well as five months prior when no suicidal thoughts were self-reported by the participant. Therefore, the responsibility of noticing and evaluating the sender’s feelings, emotions, and thoughts lies on the part of the receiver. Once the warning signs are detected in personal communication, a receiver should take immediate action that requires dedication, perseverance, and fearlessness. While asking someone directly about their intentions to commit suicide can be difficult, this is the first step. This question may not guarantee a truthful answer, but it will be the start of an open dialogue.

 

Available Resources

 

According to the American Psychiatric Association, “predicting when someone will commit suicide has been nearly impossible” (2003, p. 3). Still, there are numerous resources available for people seeking help for themselves and others:

  • The National Suicide Prevention Lifeline is available 24 hours in two languages, English and Spanish, at 800-273-8255. Suicide crisis hotlines help millions of people by offering the option to speak with a trained specialist, either via phone or text message. More than 150 local centers offer 24/7 free and confidential emotional support to those who are in crisis. Their online chat is available at https://suicidepreventionlifeline.org/chat/

  • The Crisis Text Line is a free text messaging resource offering 24/7 support to anyone experiencing a crisis. Simply text HOME to 741741. There are trained people on the other end who will help you!

  • If you are having extreme thoughts of ending your life, calling a therapist or suicide hotline may not be an option. In this case, you should go to the nearest Emergency Room. Going there doesn’t necessarily mean you are going to be admitted to the hospital, but qualified specialists will assess you and make necessary referrals if you are safe to leave.

 

In addition to suicide hotlines, there are a great number of online forums and support groups offering help to people who need emotional support in a crisis but do not want to tell others out loud (e.g., IMAliveBetterHelp7 Cups of Tea, etc.). More resources, online support networks, and apps can be found here: https://www.healthline.com/health/mental-health/suicide-resource-guide#Online-forums-and-support

  • Resisting suicide takes bravery and requires perseverance. There are many people who have already managed to overcome this crisis. Survivors’ stories about hope and recovery can be found here: https://suicidepreventionlifeline.org/stories/

  • #BeThe1To is the National Suicide Prevention Lifeline’s message which helps spread the word about actions we can all take to prevent suicide. Their main five steps are: ask, keep them safe, be there, help them connect, and follow up. More information can be found if you follow the link https://www.bethe1to.com/

  • You can also get involved by joining the Active Minds movement. This is a non-profit student organization aiming to improve young adults’ mental health. Active Minds centers exist on 800 U.S. campuses; annually they reach around 600,000 students through events such as Send Silence Packing, campus awareness campaigns, conventions outreach, and more.

 

As recommended by many counselors and therapists, to resolve ambiguity if someone is thinking about taking their own life, the first step is to ask them directly about their intentions. The question “Are you thinking about suicide?” communicates your desire to help. It also demonstrates that you’re willing to speak about suicide in a non-judgmental and supportive manner (#BeThe1To, n.d.). Asking this direct question can be uncomfortable, but this can create a productive dialogue revealing their emotional pain and suicidal intentions.

 

Concluding Remarks

 

The bottom line is that research on suicide highly benefits from applied linguistics instruments. But most importantly, my goal was to emphasize that you don’t have to be an applied linguist to recognize depression and suicide signs. Nowadays it is crucial to be vigilant to each other’s emotional shifts reflected in the text messages which currently are one of the main methods of communication and staying connected with each other. I’m hopeful that this article showcased that while we all are physically separated from each other, online communication can be a valuable source for people to check in on each other’s thoughts and feelings. When you talk to your family, friends, or classmates, spend some time to actually let them know how you feel and be the first one to open up so that your loved ones know you really care. You can never be sure of what other people think, so trust your gut feeling and ask directly if they have suicidal thoughts. And if you are the person who is depressed or hopeless and feel like you may hurt yourself, seek help fearlessly! It’s never too late to ask for help. And always remember, it’s okay to let people know you are not feeling fine or raise a concern about others’ emotional state. Remember, if you or other people you know are in crisis, there’s always help!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Anthony, L. (2019). AntConc (Version 3.5.8) [Computer Software]. http://www.laurenceanthony.net/software.html

American Psychiatric Association. (2003). Practice guideline for the assessment and treatment of patients with suicidal behaviors. American Journal of Psychiatry, 160(Suppl), 1-60. 

Baddeley, J. L., Daniel, R., & Pennebaker, J. W. (2011). How Henry Hellyer’s use of language foretold his suicide. Crisis, 32, 288-292. https://doi.org/10.1027/0227-5910/a000092.

Czeisler, M. É., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., ... & Rajaratnam, S. M. (2020). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic – United States, June 24-30, 2020. Morbidity and Mortality Weekly Report, 69(32), 1049-1108. http://dx.doi.org/10.15585/mmwr.mm6932a1

Hedegaard H., Curtin S.C., & Warner M. (2020). Increase in suicide mortality in the United States, 1999-2018. NCHS Data Brief, 362.

#BeThe1To. (n.d.). How and why the 5 steps can help. https://www.bethe1to.com/bethe1to-steps-evidence/

Mental Health America. (2021). The state of mental health in America. https://www.mhanational.org/issues/state-mental-health-america 

National Institute of Mental Health. (2020). Suicide. https://www.nimh.nih.gov/health/statistics/suicide.shtml 

Osgood, C. E. & Walker, E. G. (1959). Motivation and language behavior: A content analysis of suicide notes. The Journal of Abnormal and Social Psychology, 59(1), 58-67. https://doi.org/10.1037/h0047078

Pennebaker, J. W., Francis, M. E., & Booth, R. J. (2001). Linguistic Inquiry and Word Count (Version LIWC2015) [Computer Software]. http://liwc.wpengine.com/

Tytko, T., & Augstkalns, M. C. (2020). How well do we know ourselves? Identifying suicide markers in online communication: A case study of a graduate student’s writing. Studies in the Linguistic Sciences: Illinois Working Papers, 43, 45-62.

Woolston, C. (2020). Signs of depression and anxiety soar among US graduate students during pandemic. Nature, 585, 147-148. https://doi.org/10.1038/d41586-020-02439-6

Xie, W., & Kang, C. (2015). See you, see me: Teenagers’ self-disclosure and regret of posting on social network site. Computers in Human Behavior, 52, 398-407. https://doi.org/10.1016/j.chb.2015.05.059

 

 

 

Headshot2 - Tetiana Тytko.jpg

Tetiana Tytko is a Ph.D. student in SLA and a Graduate Assistant in the School of Languages, Literatures, and Cultures at the University of Maryland, College Park. She holds an M.A. in Linguistics from Ohio University and an M.A. in English Language and Literature from Chernivtsi National University. Her research interests include instructed second language acquisition (ISLA), computer-assisted language learning (CALL), and their intersection. Given nearly eight years of EFL/ESL teaching in experience, Tetiana strives to showcase the results of her research in the language classroom. Additionally, she is interested in Corpus Linguistics, L2 Writing, and the way technology can aid social issues. Tetiana can be found online at https://www.tetianatytko.com/.