This article contains themes that might be difficult to deal with for those suffering with depression or anxiety. If you need help in South Africa, contact SADAG’s toll-free helpline on: 0800 567 567.

Kate Spade. Anthony Bourdain. Chester Bennington. Chris Cornell. Robin Williams. Avicii. Gary Speed. Robert Enke. And the millions of others whose names we’ll never know.

The list of people whose lives have been lost because of a silent killer is long. Almost endless. And yet, whenever it happens, the overwhelming response is shock.

The World Health Organisation estimates that around 300 million people around the world are affected by depression. Suicide is the leading cause of death in 15- to 29-year-olds.

And that’s just depression. It doesn’t consider anxiety conditions, addiction or other disorders such as bipolar disorder or schizophrenia.

For comparison, cancer is estimated to affect around 14 million people globally.

Why then, if the stats are so alarmingly obvious, is there still such a surprise when somebody dies because of their mental illness?

The simple answer is stigma.

While people are increasingly willing to talk about their struggles, reporting on deaths because of these struggles is often lacking in the nuance required not only to destigmatise, but also help understand the difficulty of being in such a dark place of complete helplessness.

Reports of “death by suicide” undermine the real struggle that leads to that moment. As with illnesses like cancer, where the cause of death is often something such as septicaemia, it’s not suicide that kills. It’s depression.

There have been some improvements. In Australia and New Zealand, cause of death is rarely mentioned as suicide.

“Died unexpectedly, there were no suspicious circumstances” with helpline numbers at the bottom of the article is usually an indication of what happened and follows the recommended global best practice for reporting on such.

Across the world, though, the same standards are not applied.

In the wake of both Spade and Bourdain’s deaths last week, a number of publications led with “suicide” in the headline while several shared methods. This way of reporting can be problematic.

As noted by The Poynter Institute in 2014, a study in the Lancet Psychiatry Journal found that stories about somebody who had taken their own life that featured the word suicide or headlines might have a knock-on effect.

The data used for the study was before the advent of social media, but that does not mean the study is invalid or does not carry some weight.

It also does not mean we should not report on it. We should. But the understanding needs to be more considerate, especially when so many are at risk.

And since concrete, peer-reviewed studies are few and far between, perhaps we should listen to those who are at risk.

I straddle both spheres. I’m a journalist who frequently reports on mental health. But I am also a human being, riddled with my own struggles – self-harm, addiction, anxiety and ADHD (which, while technically a neurological disorder, often manifests its symptoms on the mental health spectrum). And then there is suicide ideation.

Suicide ideation is more common than many of us like to admit. But just because you’re thinking about dying doesn’t always mean you will take such a drastic step.

For many, this nuance is too difficult to understand. When those of us in these dark places reach out for help, a strange cycle often starts.

As veteran radio host Gugulethu Mhlungu succinctly put it in a Tweet:

“Humans are so weird about suicide ideation. You tell someone you want to die and they get super weird or start making it about themselves; now you must console them.”

Despite an increased awareness and discourse around mental health and the complex orders that surround them all, most people’s understanding, unless they have experienced it, is still lacking despite their best intentions.

And so, when there are thoughts lingering in the back of your mind and headlines of how people with all the access to care in the world still succumb to their illness, these thoughts can begin to become all-consuming.

Being sensitive about the language used around mental illness is not some “political correctness gone mad” mollycoddling. It’s taking practical steps that not only assist those who are struggling, but also helps shift the dialogue for those who do not have a concrete understanding of how these issues affect others.

Bourdain was 61 when he died. Spade was 55. When somebody dies of a visible illness at this age, the response is rarely one of shock. Instead, we praise them for the fight they put up.

Mental illness requires the same, often lifelong and silent, fight. Depression and all its co-morbid conditions don’t have to be terminal. But because of the stigma it far too often is. DM