In Nebraska, one person dies by suicide every 32 hours. September is National Suicide Prevention Month, an opportunity to learn more about the risks of suicide and how to cope with suicide loss.

It can be hard to recognize the signs of suicide – for many already dealing with chronic depression or other mental illnesses, the signs may vary. Some individuals considering suicide may begin withdrawing from social events or will seem less engaged in the moment.

"Others, paradoxically, may appear to be in a better mood – like a weight has been lifted," says Steve Salzbrenner, MD, Department of Psychiatry. "These changes in behavior, combined with other actions – like out-of-the-blue sentimental phone calls, new life insurance policies or risky behaviors at work, might be a sign to check in closer with that person."

For those experiencing suicidal thoughts, it can be difficult to access help – they may feel isolated and hopeless, like they're the only person in the world at all. If you are reaching that point, tell someone – anyone. That person will be able to think more rationally and get you the help you need.

"If someone tells you they're considering suicide, don't try to save them yourself," says Dr. Salzbrenner. "They're giving you ownership of the decision to help them. Call the authorities, even if they tell you not to. You don't want that to be on your conscience. You're the conduit to get them help."

Dr. Salzbrenner's relationship with suicide goes beyond his work with patients. His ex-wife, Jen, lost her father to suicide five years ago. She found the wide range of emotions and trauma were difficult.

"There's a genetic component to depression, and I'd struggled with underlying depression for most of my adult life," says Jen Salzbrenner. "I experienced the normal grief and trauma response, but I also was so fearful – if this disease could take my father from me, who's to say I couldn't fall prey to it as well? It scared me and made me more vigilant of my own self-care."

For Jen, searching for others who had similar experiences was challenging, but important. She also sought counseling, and worked with her doctors to find a holistic approach to her mental health.

"I found a family physician who focused on treating my whole person – my medical needs as well as psychiatric, and that made a big difference," says Jen.

Overall, Jen wants to share with others dealing with suicide loss that it's important to never stop reaching out. "If you don't find the right resource, don't get discouraged. Keep trying to find places and people to lift you up and help you grow. The grief will never go away, but it will change."

Dr. Salzbrenner agrees finding support is critical after dealing with suicide loss.

"Don't isolate yourself," he says. "You're not an outcast – you deserve resources and love as much as anyone else. Suicide is a sickness, just like cancer. It's okay to grieve and honor your loved one just as you would anyone else."

Suicide is a growing concern in our state and country – it's the second leading cause of death in the 10 to 34 age group both nationally and in Nebraska, and the suicide rate has increased 37% in the last 20 years.

You can also text the Crisis Text Line at 741-741 for a suicide or mental health crisis, as well as the American Foundation for Suicide Prevention and the Kim Foundation.