In a 2-hour, wide-ranging , Meghan Markle, the Duchess of Sussex, revealed some very frank reasons as to why she and Prince Harry have stepped away from their royal duties. After joining the royal family, she said, she did not get the support she needed from her new in-laws, even as the British tabloids printed "racist propaganda" about her.
In addition, while pregnant, she was told that her son would not receive the title "prince" (and thus would not have the security afforded to other royal children) and that a senior royal had "concerns and conversations" about how dark her son Archie's skin would be.
These stresses led to one of the interview's biggest bombshells, that in November 2019, while pregnant with Archie, Markle had considered suicide: "I just didn't want to be alive anymore," she told Winfrey. "And that was a very clear, and real, and frightening ... constant thought. I just didn't see a solution."
The duchess said she initially felt ashamed by this and was reluctant to tell Harry, "because I know how much loss he's suffered. But I knew that if I didn't say it, that I would do it." However, when she did tell him, "[Harry] just cradled me."
Markle went on to explain how she attempted to get help, consulting one of the most senior palace officials. "I said that I needed to go somewhere to get help. And I said that I'd never felt this way before. I need to go somewhere. And I was told that I couldn't because it wouldn't be good for the institution."
Markle then went to Human Resources, but was told, she said: "My heart goes out to you because I see how bad it is. But there's nothing we can do to protect you because you're not a paid employee."
Oprah asked her why she didn't go to a hospital and Markle answered: "You couldn't call an Uber to the palace. You couldn't just go. You have to understand ― when I joined this family, that was the last time until we came here [that] I saw my passport, my driver's license, my keys. All that gets turned over."
The duchess is currently pregnant with her second child, and she and Harry revealed that it is a girl.
Suicide: A Major Health Concern
Definitions:
- Suicide is defined as death caused by self-directed injurious behavior with intent to die as a result of the behavior
- A suicide attempt is a non-fatal, self-directed, potentially injurious behavior with intent to die as a result of the behavior; a suicide attempt may not result in injury
- Suicidal ideation refers to thinking about, considering, or planning suicide
By the Numbers
According to the :
- Suicide is the 10th leading cause of death in the U.S., responsible for more than 47,500 deaths in 2019
- In 2019, 12 million American adults seriously thought about suicide, 3.5 million made a plan, and 1.4 million attempted suicide
- Suicide rates in the U.S. have increased about 33% from 1999 to 2019
- Suicide affects all ages; it is the second leading cause of death for people ages 10-34, the fourth leading cause among people 34-54, and the fifth leading cause among people 45-54
Risk Factors
Many factors can increase the risk for suicide or protect against it. Suicide is connected to other forms of injury and violence. For example, people who have experienced violence, including child abuse, bullying, or sexual violence, have a higher suicide risk.
Some groups have higher suicide rates than others. Suicide rates vary by race/ethnicity, age, and other factors. The highest rates are among American Indian/Alaska Native and non-Hispanic white populations.
Other American groups with higher than average rates of suicide are veterans, people who live in rural areas, and workers in certain industries and occupations like mining and construction. Young people who are lesbian, gay, or bisexual also have a higher rate of suicidal ideation and behavior compared with their peers who identify as straight.
Far-reaching Impact
Suicide and suicide attempts cause serious emotional, physical, and economic impacts. People who attempt suicide and survive may experience serious injuries that can have long-term effects on their health. They may also have depression and other mental health concerns.
The good news is that more than 90% of people who attempt suicide and survive never go on to die by suicide.
Suicide and suicide attempts affect the health and well-being of friends, loved ones, co-workers, and the community. When people die by suicide, their surviving family and friends may experience shock, anger, guilt, symptoms of depression or anxiety, and may even have thoughts of suicide themselves.
The financial toll of suicide on society is also substantial: Suicides and suicide attempts cost the nation over $70 billion per year in lifetime medical and work-loss costs alone.
Signs and Symptoms
These behaviors may be signs that someone is thinking about suicide:
- Talking about wanting to die or wanting to kill themselves
- Talking about feeling empty, hopeless, or having no reason to live
- Making a plan or looking for a way to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun
- Talking about great guilt or shame
- Talking about feeling trapped or feeling that there are no solutions
- Feeling unbearable pain (emotional pain or physical pain)
- Talking about being a burden to others
- Using alcohol or drugs more often
- Acting anxious or agitated
- Withdrawing from family and friends
- Changing eating and/or sleeping habits
- Showing rage or talking about seeking revenge
- Taking great risks that could lead to death, such as driving extremely fast
- Talking or thinking about death often
- Displaying extreme mood swings, suddenly changing from being very sad to very calm or happy
- Giving away important possessions
- Saying goodbye to friends and family
- Putting affairs in order, making a will
Suicide Prevention
Suicide is preventable, and everyone has a role to play to save lives and create healthy and strong individuals, families, and communities. Knowing the above warning signs for suicide and how to get help can save lives.
The National Institute of Mental Health has published a graphic to inform the public of five steps to take to #BeThe1 to help someone in emotional pain:
The CDC has developed a comprehensive -- "Preventing Suicide: A Technical Package of Policy, Programs, and Practices" -- which provides information on the best available evidence for suicide prevention.
Suicide and Pregnancy
Postpartum depression and suicidality are well known. But what is the risk of suicide during pregnancy? In the past, suicide during pregnancy had been considered relatively uncommon, but more recent studies show a disturbing trend upward and have identified important risk factors. For example, a 2016 U.K. study found that were more likely to occur in those with a previous depression diagnosis. In addition, they were more likely to be under no active treatment at the time of death.
A November 2020 report in looked at trends in suicidality 1 year before and after birth in the U.S. between 2006 and 2017 for commercially insured childbearing women. The researchers found that "the prevalence of suicidal thoughts and intentional self-harm occurring in the year preceding or following birth increased substantially over a 12-year period."
In fact, the rate has nearly tripled. The increases were especially noted in those who were non-Hispanic Black, in younger age categories, and those with the lowest household incomes.
The lead author of the study, , of the University of Michigan, said in a statement: "Suicide deaths are a leading cause of maternal mortality in the U.S. It's a public health crisis that has silently grown worse."
A by another University of Michigan researcher, , and colleagues also concluded that over the past decade "the prevalence of both PMAD [perinatal mood and anxiety disorders] and SMI [serious mental illness] among delivering women increased substantially across the U.S., and affected women had more adverse obstetric outcomes and delivery-related costs compared to other deliveries."
Zivin also shared the story of her own suicide attempt during pregnancy with 鶹ý.
Sources: ,
If you or someone you know is considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255.
Michele R. Berman, MD, and Mark S. Boguski, MD, PhD, are a wife and husband team of physicians who have trained and taught at some of the top medical schools in the country, including Harvard, Johns Hopkins, and Washington University in St. Louis. Their mission is both a journalistic and educational one: to report on common diseases affecting uncommon people and summarize the evidence-based medicine behind the headlines.