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Help Someone Who May Be Suicidal

Suicide is always a scary topic… it can be even scarier when someone you know and care about may be feeling so hopeless that he or she is considering ending his or her life.  Here are some steps you can take to help support a friend or family member who may be suicidal.

Take it seriously.
A lot of people think that people who talk about suicide don’t really mean it, and that they are just looking for sympathy or attention, but the truth is that over 75% of those who have completed suicide have indicated to others that they were in deep despair.  Anyone who expresses suicidal feelings needs to be taken seriously, and given immediate attention.

 

Another commonly believed myth is that people who are suicidal are also psychotic or have delusional beliefs about reality, when really, only about 10% of all suicidal people suffer from these types of disorders.  A lot of suicidal people are also depressed, even though they may do a surprising job of going through their days as if nothing’s wrong.  Even if someone seems fine, if you get any indication that suicide may be a risk, follow up on it.

Remember that Suicidal Behaviour is a Cry for Help.

In many instances, suicidal behaviour represents a struggle between life and death…but ultimately, the struggle represents a wish to end the pain that an individual is feeling. The fact that a suicidal person is still alive is evidence of the part of him or her that is struggling to choose life.  By trying to connect people to those things that KEEP him or her choosing life instead of death, you might be able to help pull them back from a seemingly hopeless situation.

Give and Get Help.

Suicide prevention is not a last-minute activity; it needs to be addressed sooner rather than later. Unfortunately, many suicidal people feel that asking for help might lead to more pain if others do not take their clues seriously. They might fear being told that they are stupid, sinful or manipulative; they might fear rejection or punishment; the might fear involuntary commitment to a psychiatric institution, or they might fear that their confidentiality will be breached.  But you need to do everything you can to reduce pain rather than increasing or prolonging it; don’t keep it a secret. Tell an adult that you trust – a parent, older sibling, teacher, or school counsellor – so that you can get help in order to give it.

Listen.

Allow every opportunity for the suicidal person to unburden his or her troubles and vent feelings. Be patient, empathetic, and accepting; avoid arguments or advice-giving.

Ask.

Asking people if they are suicidal will NOT plan the idea in their heads, contrary to what some people might think. If they aren’t suicidal, they’ll tell you…and if they have been thinking about it, you will show your concern and your willingness to talk about something that is very difficult to discuss and that is still “taboo” to a lot of people.  Asking the question is an invitation to let someone else share his or her thoughts and feelings about suicide with you.  Other important questions to ask are if the suicidal person has a plan and a timeframe for when he or she might go through with these feelings. Get as many details as you can; the more advanced the plan or timeframe is, the higher at risk the person likely is for going through with it.

Don’t Leave an Acutely Suicidal Person Alone.

If the means (i.e., pills), try to get rid of them or at least get them out of immediate reach of the suicidal person. 

Urge Professional Help.

Persistence and patience may be necessary. In any referral situation, let the person know you care and still want to maintain contact.

Don’t Promise to Keep Secrets.

The part of a person that is afraid of more pain is the part that says, “Please don’t tell anyone”; but it’s the part that wants to stay alive that tells you about the suicidal thoughts in the first place. Repond to that part of the person, and seek out a mature and compassionate person with whom you can talk about the situation. Don’t try to do this alone – it’s important to take care of yourself as well!

WARNING SIGNS

Conditions associated with increased risk of suicide

- Death or terminal illness of relative or friend
- Divorce, separation, broken relationship, stress on family
- Loss of health (real or perceived)
- Loss of job, home, money, status, self-esteem, or personal security
- Alcohol or drug abuse
- Depression.

In the young, depression may be masked by hyperactivity or acting-out behavior. In the elderly, it may be incorrectly attributed to the natural effects of aging. Depression that seems to quickly disappear for no apparent reason is cause for concern. The early stages of recovery from depression can be a high risk period for suicide because people can regain the strength and energy necessary to go through with a suicide attempt. Recent studies have also associated anxiety disorders with increased risk for attempted suicide.

Emotional and behavioral changes associated with suicide

- Overwhelming Pain: pain that threatens to exceed the person's pain coping capacities. Suicidal feelings are often the result of longstanding problems that have been exacerbated by recent precipitating events
- Hopelessness: the feeling that the pain will continue or get worse, and that things will never get  better
- Powerlessness: the feeling that one's resources for reducing pain have been exhausted
- Feelings of worthlessness, shame, guilt, self-hatred, or that “no one cares”
- Fears of losing control, harming self or others
- Sad, withdrawn, tired, apathetic, anxious, or irritable personality or proneness to angry outbursts
- Declining performance in school, work, or other activities (occasionally the reverse: some volunteer for extra responsibilities because to “fill up” their time)
- Social isolation or association with a group that has different moral standards than those of the family
- Declining interest in sex, friends, or other activities previously enjoyed
- Neglect of personal welfare or hygiene; deteriorating physical appearance- Alterations in sleeping or eating habits.
- Self-starvation, dietary mismanagement, disobeying medical instructions (especially among the elderly)
- Difficult times: holidays, anniversaries, and the first week after discharge from a hospital; just before and after diagnosis of a major illness; just before and during disciplinary proceedings 

Suicidal Behavior

- Previous suicide attempts
- Explicit statements of suicidal ideation or feelings
- Development of suicidal plan, acquiring the means, “rehearsal” behavior, setting a time and/or place for the attempt
- Self-inflicted injuries, such as cuts, burns, or head banging
- Reckless behavior; unexplained accidents among children and the elderly
- Making out a will or giving away favorite possessions
- Inappropriately saying goodbye
- Ambiguous or indirect verbal behavior implying suicide: “I'm going away on a real long trip”; “You won't have to worry about me anymore”; “I just want to go to sleep and never wake up”; “I'm so depressed, I just can't go on”; “Does God punish suicides?”; “Voices are telling me to do bad things”; requests for euthanasia information, inappropriate joking, stories or essays on morbid themes

 Sources:             Youth One Archives, 2002http://www.metanoia.org/suicide/whattodo.htm