# data[].attributes.headline
Individuals who “live with illness and pain, which may make them feel as if they are a burden to others” are at a greater risk of suicide (Goldsmith 24-25).

# data[].attributes.subject
Individuals who “live with illness and pain, which may make them feel as if they are a burden to others” are at a greater risk of suicide (Goldsmith 24-25).

# data[].attributes.body
May had developed depression around the time that April committed suicide. May had lived with the pain of depression for so long that she gave up. She felt as if her depression was a burden on others because her sisters were constantly taking care of her, however that was not the case.

# data[].attributes.headline
“Depression profoundly impairs the ability to function in everyday situations by affecting moods, thoughts, behaviors, and physical well-being” (Bellenir 107).

# data[].attributes.subject
“Depression profoundly impairs the ability to function in everyday situations by affecting moods, thoughts, behaviors, and physical well-being” (Bellenir 107).

# data[].attributes.body
In the novel, anytime May hears anything negative, she begins to sing and worry. This effects her daily life because she isn’t able to carry on normal activities when this occurs. It often ends with her needing to go to her wall to calm down.

# data[].attributes.headline
“Guilt plagues many suicide survivors. They ask themselves how they missed the warning signs. Or they believe that if they had spent more time with the victim, they could have prevented the suicide” (Goldsmith 10). 

# data[].attributes.subject
“Guilt plagues many suicide survivors. They ask themselves how they missed the warning signs. Or they believe that if they had spent more time with the victim, they could have prevented the suicide” (Goldsmith 10). 

# data[].attributes.body
https://www.medicalnewstoday.com/articles/326769

# data[].attributes.headline
“By the time she was thirteen, she was having terrible depressions, and of course the whole time, whatever she was feeling, May was feeling” (Kidd 97, Ch. 5)

# data[].attributes.subject
“By the time she was thirteen, she was having terrible depressions, and of course the whole time, whatever she was feeling, May was feeling” (Kidd 97, Ch. 5)

# data[].attributes.headline
“Studies of identical twins confirm that depression and genes are related, finding that if one twin of an identical pair suffers from depression, the other has a 70 percent chance of developing the disease” (Bellenir 110).

# data[].attributes.subject
“Studies of identical twins confirm that depression and genes are related, finding that if one twin of an identical pair suffers from depression, the other has a 70 percent chance of developing the disease” (Bellenir 110).

# data[].attributes.body
In the novel, both April and May suffer from depression that eventually leads to both committing suicide. Although the depression takes place at different times, it is not a coincidence because it is proven that if one twin has depression, the other has a high chance of also developing depression.

# data[].attributes.body
https://www.uab.edu/news/youcanuse/item/9729-suicide-how-you-can-help-yourself-and-others-in-need

# data[].attributes.headline
“‘I’m sorry,’ he said. ‘It was my fault if I’d turned in the one who threw the bottle, I wouldn’t have gotten arrested and non of this would have happened’” (Kidd 204).

# data[].attributes.subject
“‘I’m sorry,’ he said. ‘It was my fault if I’d turned in the one who threw the bottle, I wouldn’t have gotten arrested and non of this would have happened’” (Kidd 204).

# data[].attributes.headline
“Despite this avoidant behavior, many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares of frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma” (Bellenir 215).

# data[].attributes.subject
“Despite this avoidant behavior, many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares of frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma” (Bellenir 215).

# data[].attributes.body
Lily constantly is reimagining the day of her mother’s death and how it occurred. Although she was super young, she remembers the image vividly due to the amount of trauma that is caused.

# data[].attributes.body
https://www.verywellmind.com/an-overview-of-ptsd-2797638

# data[].attributes.headline
“The gun shining like a toy in her hand, how he snatched it away and waved it around. The gun on the floor. Bending to pick it up. The noise that exploded around us” (Kidd 8, Ch. 1).

# data[].attributes.subject
“The gun shining like a toy in her hand, how he snatched it away and waved it around. The gun on the floor. Bending to pick it up. The noise that exploded around us” (Kidd 8, Ch. 1).

# data[].attributes.body
At the beginning of the novel, Lily has a flashback to when her mother died. This is one of the many times she has flashbacks about her mother’s death and the traumatic experience she encountered.

# data[].attributes.headline
“Symptoms of PTSD also include emotional numbness and sleep disturbances (including insomnia), depresssion, and irritability or outbursts of anger” (Bellenir 215).

# data[].attributes.subject
“Symptoms of PTSD also include emotional numbness and sleep disturbances (including insomnia), depresssion, and irritability or outbursts of anger” (Bellenir 215).

# data[].attributes.headline
“I picked up one of the honey jars and hurled it as hard as I could. It missed black Mary’s head by inches and smashed against the back wall” (Kidd 259, Ch. 13). 

# data[].attributes.subject
“I picked up one of the honey jars and hurled it as hard as I could. It missed black Mary’s head by inches and smashed against the back wall” (Kidd 259, Ch. 13). 

# data[].attributes.headline
“If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.”

# data[].attributes.subject
“If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.”

# data[].attributes.body
Lily has many symptoms of PTSD that last for many years, and they do not go away after a couple of weeks. It is assumed that Lily suffers from PTSD after years of T. Ray’s abuse towards her.

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Overview

Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event - either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.

Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.

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Symptoms

Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. They can also interfere with your ability to go about your normal daily tasks.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.
Intrusive memories
Symptoms of intrusive memories may include:

Recurrent, unwanted distressing memories of the traumatic event

Reliving the traumatic event as if it were happening again (flashbacks)

Upsetting dreams or nightmares about the traumatic event

Severe emotional distress or physical reactions to something that reminds you of the traumatic event

Avoidance
Symptoms of avoidance may include:

Trying to avoid thinking or talking about the traumatic event

Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood
Symptoms of negative changes in thinking and mood may include:

Negative thoughts about yourself, other people or the world

Hopelessness about the future

Memory problems, including not remembering important aspects of the traumatic event

Difficulty maintaining close relationships

Feeling detached from family and friends

Lack of interest in activities you once enjoyed

Difficulty experiencing positive emotions

Feeling emotionally numb

Changes in physical and emotional reactions
Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:

Being easily startled or frightened

Always being on guard for danger

Self-destructive behavior, such as drinking too much or driving too fast

Trouble sleeping

Trouble concentrating

Irritability, angry outbursts or aggressive behavior

Overwhelming guilt or shame

For children 6 years old and younger, signs and symptoms may also include:

Re-enacting the traumatic event or aspects of the traumatic event through play

Frightening dreams that may or may not include aspects of the traumatic event

Intensity of symptoms
PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you're stressed in general, or when you come across reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.
When to see a doctor
If you have disturbing thoughts and feelings about a traumatic event for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your doctor or a mental health professional. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.
If you have suicidal thoughts
If you or someone you know has suicidal thoughts, get help right away through one or more of these resources:

Reach out to a close friend or loved one.

Contact a minister, a spiritual leader or someone in your faith community.

Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

Make an appointment with your doctor or a mental health professional.

When to get emergency help
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

If you know someone who's in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person to keep him or her safe. Call 911 or your local emergency number immediately. Or, if you can do so safely, take the person to the nearest hospital emergency room.

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Causes

You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual violation.

Doctors aren't sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of:

Stressful experiences, including the amount and severity of trauma you've gone through in your life

Inherited mental health risks, such as a family history of anxiety and depression

Inherited features of your personality - often called your temperament

The way your brain regulates the chemicals and hormones your body releases in response to stress

Risk factors

People of all ages can have post-traumatic stress disorder. However, some factors may make you more likely to develop PTSD after a traumatic event, such as:

Experiencing intense or long-lasting trauma

Having experienced other trauma earlier in life, such as childhood abuse

Having a job that increases your risk of being exposed to traumatic events, such as military personnel and first responders

Having other mental health problems, such as anxiety or depression

Having problems with substance misuse, such as excess drinking or drug use

Lacking a good support system of family and friends

Having blood relatives with mental health problems, including anxiety or depression

Kinds of traumatic events
The most common events leading to the development of PTSD include:

Combat exposure

Childhood physical abuse

Sexual violence

Physical assault

Being threatened with a weapon

An accident

Many other traumatic events also can lead to PTSD, such as fire, natural disaster, mugging, robbery, plane crash, torture, kidnapping, life-threatening medical diagnosis, terrorist attack, and other extreme or life-threatening events.

Complications

Post-traumatic stress disorder can disrupt your whole life - your job, your relationships, your health and your enjoyment of everyday activities.

Having PTSD may also increase your risk of other mental health problems, such as:

Depression and anxiety

Issues with drugs or alcohol use

Eating disorders

Suicidal thoughts and actions

Prevention

After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being unable to stop thinking about what's happened. Fear, anxiety, anger, depression, guilt - all are common reactions to trauma. However, the majority of people exposed to trauma do not develop long-term post-traumatic stress disorder.

Getting timely help and support may prevent normal stress reactions from getting worse and developing into PTSD. This may mean turning to family and friends who will listen and offer comfort. It may mean seeking out a mental health professional for a brief course of therapy. Some people may also find it helpful to turn to their faith community.

Support from others also may help prevent you from turning to unhealthy coping methods, such as misuse of alcohol or drugs.

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Post-traumatic stress disorder (PTSD) - Symptoms and causes

# data[].attributes.attachment_link.description
Post-traumatic stress disorder (PTSD) is a mental health condition triggered by a terrifying event, causing flashbacks, nightmares and severe anxiety.

# data[].attributes.headline
“Obsessive Complusive behavior is an anxiety disorder in which you are frequently or constantly troubled by ideas or images that stick in your mind and that you can’t ignore (obsessions)” (Bellenir 219)

# data[].attributes.subject
“Obsessive Complusive behavior is an anxiety disorder in which you are frequently or constantly troubled by ideas or images that stick in your mind and that you can’t ignore (obsessions)” (Bellenir 219)

# data[].attributes.headline
“People with OCD often have depression or symptoms associated with depression. These include guilt, low self-esteem, anxiety, or extreme fatigue” (Bellenir 219).

# data[].attributes.subject
“People with OCD often have depression or symptoms associated with depression. These include guilt, low self-esteem, anxiety, or extreme fatigue” (Bellenir 219).

# data[].attributes.body
Throughout the novel, Lily constantly feels guilt for killing her mother. This gets in the way because she constantly longs for her mother to be with her, but feels as if it is her fault which leads Lily into a depressive state.

# data[].attributes.headline
“Compulsions are the second part of obsessive compulsive disorder. These are repetitive behaviors or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away” 

# data[].attributes.subject
“Compulsions are the second part of obsessive compulsive disorder. These are repetitive behaviors or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away” 

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What is OCD? | International OCD Foundation

# data[].attributes.attachment_link.description
Obsessive compulsive disorder (OCD) is a mental health disorder that affects people of all ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings.…

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“I started thinking maybe I should find out what I could about my mother, before T. Ray or the  police came for us. But where to start? I couldn’t just pull out the black Mary picture and show it to August without the truth wrecking everything, and she would decide—might decide, would decide, I couldn’t say—that she was obliged to call T. Ray to come get me. And if she knew that Rosaleen was a true fugitive, wouldn’t she have to call the police?” (Kidd 101). 

# data[].attributes.subject
“I started thinking maybe I should find out what I could about my mother, before T. Ray or the  police came for us. But where to start? I couldn’t just pull out the black Mary picture and show it to August without the truth wrecking everything, and she would decide—might decide, would decide, I couldn’t say—that she was obliged to call T. Ray to come get me. And if she knew that Rosaleen was a true fugitive, wouldn’t she have to call the police?” (Kidd 101). 

# data[].attributes.body
Lily has constant reoccurring thoughts about her mother or T.Ray coming to get her. She is always troubled with the idea of having to come clean with August, however the thought of her mother is always in her head. She copes with the obsession of her mother by holding on to old belongings of her mother.

# data[].attributes.headline
“Yes she’s been depressed lately. Well, actually, she was depressed on and off” (Kidd 195, Ch. 10).

# data[].attributes.subject
“Yes she’s been depressed lately. Well, actually, she was depressed on and off” (Kidd 195, Ch. 10).

# data[].attributes.headline
“I imagined how May had rolled the rock from the bank out into the river, then lay down, pulling it on top of her. She had held it tight, like a baby, and waited for he lungs to fill” (Kidd 193, Ch. 10).

# data[].attributes.subject
“I imagined how May had rolled the rock from the bank out into the river, then lay down, pulling it on top of her. She had held it tight, like a baby, and waited for he lungs to fill” (Kidd 193, Ch. 10).

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https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm

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“However, when one of these factors persists for a long period of time or reaches an unbearable level, people may begin to wrestle with thoughts of suicide” (Goldsmith 25).

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“However, when one of these factors persists for a long period of time or reaches an unbearable level, people may begin to wrestle with thoughts of suicide” (Goldsmith 25).

# data[].attributes.body
May’s depression has occurred for so long and it left her feeling hopeless. When she couldn’t take it anymore she decided to commit suicide. It was described in her letter that she would be happier with April and the rest of her family.

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“And then, when April was fifteen, she took our father’s shotgun and killed herself” (Kidd 97, Ch. 5). 

# data[].attributes.subject
“And then, when April was fifteen, she took our father’s shotgun and killed herself” (Kidd 97, Ch. 5). 

# data[].attributes.headline
“Shock usually immediately follows the suicide. Shock is a psychological and physical response to an extremely traumatic event” (Goldsmith 9).

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“Shock usually immediately follows the suicide. Shock is a psychological and physical response to an extremely traumatic event” (Goldsmith 9).

# data[].attributes.body
When the Boatwright sisters found May they couldn’t believe that she was actually gone. They sat their quiet just taking in everything. They didn’t believe that she had actually committed suicide.

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“ ‘We sit with her so we can tell her good-bye. It’s called a vigil. Sometimes people have a hard time letting death sink in, they can’t say good-bye. A vigil helps us do that ’ ”(Kidd 200).

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“ ‘We sit with her so we can tell her good-bye. It’s called a vigil. Sometimes people have a hard time letting death sink in, they can’t say good-bye. A vigil helps us do that ’ ”(Kidd 200).

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Kevin Briggs: The bridge between suicide and life

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For many years Sergeant Kevin Briggs had a dark, unusual, at times strangely rewarding job: He patrolled the southern end of San Francisco's Golden Gate Bridge, a popular site for suicide attempts. In a sobering, deeply personal talk Briggs shares stories from those he's spoken - and listened - to standing on the edge of life.