How Spirituality and Purpose Transform Suicidal Despair
(A Psychiatrist’s Perspective)
By Tiwalola Osunfisan, M.D, FAPA, Physician Lead, Behavioral Health Integration with Primary Care (Adult-BHI), Henry Ford Health
Suicide is a serious public health concern and one of the leading causes of death globally. Although preventable, no one is immune to suicidal despair, regardless of their sex, profession, socioeconomic status, career, race, religion, or faith. Life's challenges can bring even the strongest individuals to their knees. Suicidal despair often involves an overwhelming mix of pain, emptiness, isolation, helplessness, and a profound sense of hopelessness. During these challenging times, one powerful source of resilience is often overlooked: spirituality and the pursuit of meaning and purpose in suffering and life, ultimately reducing suicide to zero.
Spirituality and suicidality
Spirituality is a broad concept that varies significantly across cultures and personal experiences. In some communities, it intertwines with organized religion and daily life, while in others, discussing faith is taboo, leading patients and clinicians to avoid spiritual topics for fear of controversy.
For many, spirituality involves a relationship with God or a higher order, while for others, it's a personal journey of mindfulness and meaning-making outside formal religions. This distinction highlights the difference between structured religion, which involves doctrines and affiliation, and individual spirituality, which can thrive in solitude or nature.
In psychiatry, spirituality is often overlooked due to concerns about bias and an emphasis on biological and psychosocial factors. This lack of discussion is influenced by a focus on evidence-based methods and quantifiable data, standard diagnostic criteria, cultural attitudes, and historical skepticism, notably from Sigmund Freud, a founding father of psychoanalysis. This makes patients hide their beliefs, and clinicians strive for professional "objectivity." However, emerging studies indicate that organizational religious activity can reduce impulsivity and hopelessness associated with suicide1 and serve as a protective factor against suicidal behavior2 while fostering a sense of belonging. The increased connection to something greater—whether through religion, personal faith, or a broader understanding of spirituality—promotes resilience and helps individuals navigate suffering to manage stressors productively and adaptively by drawing on personal resources and external support, ultimately protecting against suicidal behavior and lowering the risk of suicide.
As both a psychiatrist and an individual of faith, I have observed that patients who integrate an exploration of their Christian faith—particularly the concept of God’s love—alongside mental health treatment, including psychotropic medications and therapeutic interventions, often experience a renewed sense of hope and meaning in their suffering. This effect appears to be especially pronounced among individuals struggling with suicidal thoughts.
The integration of spirituality into psychological interventions, such as spiritually integrated cognitive-behavioral therapy (CBT), has been shown to facilitate meaningful pathways out of despair and contribute to reductions in suicide rates. Although spiritual themes are not explicitly included in diagnostic frameworks, they play a crucial role in addressing the holistic needs of patients.
Whether through prayer, meditation, reflective practices, or a sense of “something more,” spirituality can provide a foundation for hope. Hope is a significant antidote to suicidal ideation and acts as a guiding light, challenging the internal belief that one’s pain is infinite or irresolvable.
Finding meaning in your suffering and life to promote resilience
Discovering meaning often involves introspection—asking, “What truly matters to me?” “How can I push beyond my suffering?” “How can I turn my pain to purpose and help others?” “What did I learn about coping with challenges, and how did I grow in this experience?”
Resilience can be facilitated through various practices, including prayer, meditation, therapy, journaling, and discussions with trusted individuals. Identifying sources of meaning, such as engaging in acts of service or fostering meaningful relationships, can enhance emotional support and contribute to a more hopeful outlook.
Purpose gained from understanding oneself as part of a larger whole can highlight inherent worth, even amid despair, fostering resilience to improve emotional healing. Purpose is a powerful motivator and can reduce suicidal thoughts. Connecting with personal values and reflecting on positive experiences guides individuals toward a meaningful life. Embracing this connection helps remind those in crisis of their inherent worth.
People in despair may question their existence. Finding meaning requires honest self-reflection and can be explored through various methods. Identifying key sources of meaning can increase hope and fill the void.
Purpose motivates us through challenges. Research indicates that having a sense of purpose is crucial in reducing suicidal thoughts, particularly among veterans4. For some, purpose may be found through connection to a higher order or something greater; for others, career pursuits or service may point them to meaning or purpose. Encouraging connections with personal values and joyful moments provides insights into a purposeful life.
The act of purposefully investing energy and effort can bolster self-esteem, counteracting the negative beliefs often associated with suicidal thinking. Each small step forward builds momentum, fostering resilience. During times of crisis, reflecting on one's positive contributions can serve as a powerful reminder of the individual's inherent capacity to create meaningful impact on others.
A beacon of hope
Spirituality, religion, meaning, or purpose do not eliminate all pain, but they provide renewed perspectives and strong emotional support. They offer a powerful antidote to suicidal thinking. Recognizing oneself as an integral part of a larger narrative, discovering the personal meaning, and incorporating service and purpose into daily life makes it possible to stand firm in the face of despair. This integrated approach, coupled with professional intervention and community support, serves as a beacon of hope—proving that through spiritual insight, meaningful reflection, and authentic and purposeful living, even the soul's darkest nights can give way to a dawn of possibility and light—for oneself and others.
References:
- VanderWeele TJ, Li S, Tsai AC, Kawachi I. Association Between Religious Service Attendance and Lower Suicide Rates Among US Women. JAMA Psychiatry. 2016 Aug 1;73(8):845-51. doi: 10.1001/jamapsychiatry.2016.1243. PMID: 27367927; PMCID: PMC7228478.
- Poorolajal J, Goudarzi M, Gohari-Ensaf F, Darvishi N. Relationship of religion with suicidal ideation, suicide plan, suicide attempt, and suicide death: a meta-analysis. J Res Health Sci. 2022 Mar 2;22(1):e00537. doi: 10.34172/jrhs.2022.72. PMID: 36511249; PMCID: PMC9315464.
- D'Souza RF, Rodrigo A. Spiritually augmented cognitive behavioural therapy. Australas Psychiatry. 2004 Jun;12(2):148-52. doi: 10.1080/j.1039-8562.2004.02095.x. PMID: 15715760.
- Fischer IC, Nichter B, Feldman DB, Na PJ, Tsai J, Harpaz-Rotem I, Schulenberg SE, Pietrzak RH. Purpose in life protects against the development of suicidal thoughts and behaviors in U.S. veterans without a history of suicidality: A 10-year, nationally representative, longitudinal study. J Affect Disord. 2023 Nov 1;340:551-554. doi: 10.1016/j.jad.2023.08.040. Epub 2023 Aug 7. PMID: 37557988.