The Invisible Backpack: Suicide Awareness + PTSD Awareness Month

There is so much to discuss when it comes to suicide prevention, suicide intervention, and PTSD awareness; we are going to attempt to shine a light on these topics in this blog post. The ultimate goal is recognizing the signs and symptoms of someone in danger of harming themselves, approaching them with compassion, empathy, and a listening ear, while getting the individual connected with the help they need.

Let us take a moment and reflect upon our “invisible backpack”. Our backpacks are different sizes, each carrying different weights in the forms of stress, trauma, and/or burden. This weight can even feel as heavy as the weight of the world on one’s shoulders.

Whether it is depression, anxiety, trauma, grief and loss, or other types of life stress and/ or conflicts; we never know what someone else is going through – we cannot simply see it. Sadly, what makes us all human is that we all struggle at different levels, and, no matter what, we each carry an “invisible backpack”. Please take a moment to remind yourself of the invisible struggle that everyone carries – the “invisible backpack”.

In the literature, this term refers to the impact of childhood trauma, and the pain that the child carries throughout their lives; this experience applies to anyone whether they are an adult or child. When we picture children, teens, young adults, and college students (of all ages) heading to class, they each carry their visible and invisible backpacks. This applies to anyone heading into class, work, or during any other moment of life: we all carry psychological and emotional burden and stress that the world cannot visibly see.

With the recent, shocking deaths of Kate Spade and Anthony Bourdain this month, in addition to the numerous Americans who have heartbreakingly and tragically died by suicide, it is important to recognize the invisible struggles that people experience. “On average of 122 Americans die by suicide each year”, and “suicide is the second leading cause of death for 15-24 year olds in the United States” ( We never know what the person next to us at work, class, or the commute is going through, but it is important to understand these struggles and know how to approach with compassion. If we recognize the signs and behaviors of distress and struggle, and approach with compassion and understanding, some people unable to seek help for themselves may be able to receive help earlier with the encouragement of others. The individual silently suffering may not “like” being approached about the struggles and emotional pain they are experiencing, but it could possibly save their life.

If someone you know is showing one or more of the following behaviors, he or she may be thinking about suicide. Don’t ignore these warning signs. Get help immediately.

  • Talking about wanting to die or to kill oneself
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no reason to live
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious or agitated; behaving recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

Furthermore, June is PTSD awareness month. For someone suffering from Post-Traumatic Stress Disorder (PTSD), their “invisible backpack” is filled with stressors that can lead to “flight or fight” panic responses, triggering memories of a traumatic event. The impact of a traumatic event permeates throughout every aspect of an individual’s life.

What is Post-Traumatic Stress Disorder?:

It is a stress response elicited/ enacted/ experienced after a perceived threat to their own life, or witnessing the loss of someone else’s life. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

  • Directly experiencing the event(s)
  • Witnessing, in person, the event(s) as it occurred to others
  • Learning that the traumatic event(s) occurred to a loved one
  • Experiencing repeated or extreme exposure to aversive details of the traumatic event(s).

Someone with a PTSD diagnosis experiences the following symptoms, carries this weight in their “invisible backpack”:

  • Heightened anxiety, arousal/ keyed up/ constantly feeling threatened
  • Intrusive, involuntary, and recurrent distressing memories of the traumatic event
  • Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
  • Dissociative reactions (flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.
  • Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble as aspect of the traumatic event(s).
  • Marked physiological reactions to internal or external cues that symbolize or resemble as aspect of the traumatic event(s).
  • Avoidance of certain places because they trigger such negative psychological and physiological responses (triggers).
  • Negative feelings and beliefs about themselves and the world; negative alterations in cognitions and mood associated with the traumatic event(s).

Associated feelings with a PTSD diagnosis following trauma (in addition to above symptoms):

  • Shame
  • Guilt
  • Depression
    • Suicidal thoughts
  • Persistent panic
  • Dissociative symptoms may arise (depersonalization or derealization).

How you can support someone you know that is struggling:

  • Compassion
  • Empathy
  • Listening
  • Recognizing the signs of concerning behavior and struggle as mentioned above.
  • Asking them if they do feel hopeless and suicidal
  • Encourage them to reach out to a professional
  • Having to call 911 if they are in immediate danger/ are expressing suicidal thoughts, a means, and a plan.

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Trained crisis workers are available to talk 24 hours a day, 7 days a week.

If you think someone is in immediate danger (is exhibiting the above mentioned concerning signs and behaviors) do not leave him or her alone—stay with them and dial 911.

If you or someone you know is struggling, please do not hesitate to reach out to a professional therapist. Therapists are available to support and provide guidance no matter where any individual is in their journey. If the individual is not actively suicidal and is not in immediate danger, but is experiencing depression, anxiety, or other overwhelming thoughts or feelings, then outpatient counseling would be appropriate for them. Feel free to visit our clinician page to reach out to a therapist who would be a best fit for you or your loved one.


Emily Pagone, MS, LPC


630-590-9522 x7





DSM-5.  American Psychiatric Association.