Suicide: Know the Facts: A Life Depends On It

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Anxiety, Depression, Despair, Hopelessness, Isolation, Suicide

“It is true that most people who die by suicide have a mental or emotional disorder.  The most common underlying disorder is depression, 30-70% of suicide victims suffer from Major Depression or Bipolar (Manic-Depressive) Disorder.”

SUICIDE.

It’s one of those words that we all struggle with.  Not only that, but it’s one of those words that usually has a bad connotation behind it.  It invokes bad feelings.  So how can we understand it better and learn how to help a loved one who might be struggling? To those not in the grips of suicidal depression and despair, it’s difficult to understand what drives so many individuals to take their own lives.

So let’s for a moment step into a person’s shoes who is contemplating suicide to understand what they might be feeling:

A suicidal person is in so much pain that they can see no other option.  Suicide is a desperate attempt to escape suffering that has become unbearable.  Blinded by feelings of self loathing, hopelessness, and isolation, a suicidal person can’t see any way of finding relief except through death.  But despite their desire for the pain to stop, most suicidal people are deeply conflicted about ending their own lives.  They wish there was an alternative to committing suicide, but they just can’t see one.

So let’s first clear up some common misconceptions about suicide:

FALSE: People who talk about suicide really won’t do it.  Almost everyone who commits suicide or attempts it has given some clue or warning beforehand.  Statements like “you’ll be sorry when I’m dead” or “I can’t see any way out” no matter how casually said, may indicate serious suicidal feelings.

FALSE: Anyone who tries to kill themselves must be crazy.  Most suicidal people are not psychotic or insane.  They usually are upset, grief stricken, depressed, or despairing.  Extreme distress and emotional pain are not necessarily signs of mental illness.

FALSE: If a person is determined to kill themselves nothing is going to stop them.  Even the most severely depressed person has mixed feelings about death, wavering until the very last moment between wanting to live and wanting to die.  Most suicidal people do not want to die, they just want the pain to stop.  The intense impulse to end it all does not last forever.

FALSE: People who commit suicide are people who are unwilling to seek help. Studies of suicide victims have shown that more than half had sought medical help in the six months prior to their deaths.

FALSE: Talking about suicide may give someone the idea.  You don’t give a suicidal person morbid ideas by talking about suicide.  The opposite is true.  Bringing up the subject of suicide and discussing it openly is one of the most helpful things you can do.

So, what do we look out for?

Most people thinking about committing suicide give warning signs of their intentions. The best way to prevent suicide is to recognize these warning signs and know how to respond to them.

Major Warning Signs to Look Out For:

• Talking about killing or harming oneself.
• Talking or writing a lot about death and dying.
• Seeking out things that could be used in a suicide attempt, such as weapons or drugs.
• Hopelessness.  This is a subtle sign, but a very dangerous one.  Studies have found that hopelessness is a strong predictor of suicide.  People who feel hopeless may talk about “unbearable” feelings, predict a bleak future, and state they have nothing to look forward to.
• Dramatic mood swings or sudden personality changes (going from outgoing to withdrawn or from well behaved to rebellious).  A suicidal person may lose interest in the day to day activities, neglect their appearance, and show big changes in eating and sleeping habits.
• Giving verbal threats such as “You’d be better off without me” or “Maybe I won’t be around.”
• Previous suicidal attempts.
• Daring or risk taking behavior.
• Depression.
• Giving away prized possessions.
• Lack of interest in future plans.

**Did you know that teens and the elderly are at a higher risk for suicide?

Major Warning Signs to Look Out For In Teens:

• Change in eating and sleeping habits.
• Withdrawal from friends, family, and regular activities.
• Violent or rebellious behavior, running away.
• Drug and alcohol use.
• Unusual neglect of personal appearance.
• Persistent boredom, difficulty concentrating, or a decline in the quality of school work.
• Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
• Not tolerating praise or rewards.

Major Warning Signs to Look Out For In The Elderly:

• Reading material about death and suicide.
• Disruption of sleep patterns.
• Increased alcohol or prescription drug use.
• Failure to take care of self or follow medical orders.
• Stockpiling medications.
• Sudden interest in firearms.
• Social withdrawal or elaborate good-byes.
• Rush to revise a will.

What Can We Do To Help?

1) Speak up if you are worried.  You may wonder if you should say anything.  What if you’re wrong? What if the person gets angry? In such situations, it’s natural to feel uncomfortable or afraid.  But anyone who talks about suicide or shows other warning signs needs immediate help, the sooner the better!  Talking to a friend or family member about suicide can be extremely difficult for anyone.  But if you’re unsure whether someone is suicidal, the way to find out is to ask.  You can’t make a person suicidal by showing that you care.  In fact, giving a suicidal person the opportunity to express his or her feelings can provide relief from loneliness and pent up negative feelings and may prevent a suicide attempt.

Ways to start a conversation:

“I have been feeling concerned about you lately”

“Recently, I have noticed some differences in you and wondered how you are doing”

“I wanted to check in with you because you haven’t seemed like yourself lately”

Questions to ask:

“When did you begin feeling like this?”

“Did something happen that made you start feeling this way?”

“How can I best support you right now?”

“Have you thought about getting help?”

What you can say that helps:

“You are not alone in this.  I am here for you.”

“You may not believe it now, but the way you are feeling will change.”

“I may not be able to understand exactly how you feel, but I care about you and want to help.”

“When you want to give up, tell yourself you will hold off for just one more day, hour, minute, whatever you can manage.”

DO’S and DON’TS:

DO: Be yourself.  Let the person know that you care and that they are not alone.  The right words are often unimportant.  If you are concerned about the person they will notice it.

DO: Listen.  Let the suicidal person unload despair, ventilate anger.  No matter how negative the conversation seems, the fact that it exists is a positive sign.

DO: Be sympathetic, non judgmental, patient, calm, accepting.  Your friend or family member is doing the right thing by talking about their feelings.

DO: Offer hope.  Reassure the person that help is available and that suicidal feelings are temporary.  Let the person know that their life is important to you.

DO: If the person says things like “I’m so depressed, I can’t go on” ask the question: “Are you having thoughts about suicide?”  You are NOT putting ideas in their head, you are showing that you are concerned and take them seriously and it’s OK for them to share their pain with you.

DON’T: Argue with a suicidal person.  Avoid saying things like “You have so much to live for”, “Your suicide will hurt your family”, or “Look on the bright side.”

DON’T: Act shocked, lecture on the value of life, or say that suicide is wrong.

DON’T: Promise confidentiality.  Refuse to be sworn to secrecy.  A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe.

DON’T: Offer ways to fix their problems or give advice, or make them feel like they have to justify their suicidal feelings. It’s not about how bad the problem is but how badly it’s hurting your loved one.

DON’T: Blame yourself.  You can’t fix someone’s depression.  Your loved one’s happiness or lack thereof, is not your responsibility.

2) Respond quickly in a crisis.  If a loved one tells you they are thinking about death or suicide, it’s important to evaluate the immediate danger the person is in.  Those at the highest risk for committing suicide have a PLAN, the MEANS to carry it out, a TIME SET for doing it, and an INTENTION to do it.  Ask them the following questions to determine if the danger they are in is immediate:

• Do they have a suicide plan? (PLAN)
• Do they have what they need to carry out their plan (pills, gun,etc.) (MEANS)
• Do they know when they would do it? (TIME SET)
• Do they intend to commit suicide? (INTENTION)

If a suicide attempt seems imminent, call a local crisis center, dial 911, or take the person to the emergency room.  Remove guns, drugs, knives, and other potentially lethal objects from the vicinity but do not, under any circumstances leave a suicidal person alone.

3) Offer help and support.  If a loved one is suicidal, the best way to help is by offering an empathetic, listening ear.  Let your loved one know that they are not alone and that you care.  Don’t take responsibility for making your loved one well.  You can offer support but you can’t get a suicidal person better.  They have to make a personal commitment to recovery.  It takes a lot of courage to help someone who is suicidal.  Witnessing a loved one dealing with thoughts about ending their own life can stir up many difficult emotions.  As you’re helping your loved one, don’t forget to take care of yourself and talk to someone about your feelings.

4) Do everything in your power to get a suicidal person the help they need.  Call a crisis line for advice and referrals.  Encourage the person to see a mental health professional, help locate a treatment facility, or take them to the doctor’s.

5) Don’t forget to follow up if needed.  If the doctor prescribes medication, be aware of the side effects, and make sure your loved one takes it as directed.  Notify the doctor if the person gets worse.

6) Be proactive.  Those contemplating suicide often don’t believe they can be helped so you may have to be more proactive at offering assistance.  Saying “call me if you need anything” is too vague.  Don’t wait for the person to call you or return your calls.  Drop by, call again, and invite them out.

7) Encourage positive lifestyle changes.  Examples of this would be a healthy diet, plenty of sleep, and getting out in the sun or nature for at least 30 minutes each day.  Exercise is important too since it releases endorphins, relieves stress, and promotes emotional well being.

8) Make a safety plan.  Help the person develop a set of steps that they promise to follow during a crisis.  It should identify any triggers (i.e. anniversary, loss, stressful situation) that may lead to a suicidal crisis.  Also include people to contact who will help in an emergency.

9) Remove potential means of suicide.  Get rid of pills, knives, razors, or firearms.

10) Continue your support over the long haul.  Once the crisis has passed, stay in touch with the person, periodically checking in or dropping by.  Your support is vital to ensure your loved one stays on track.

DID YOU KNOW:

Studies dating back to the late 1800’s found that suicides peak in the spring and are lowest in the winter.  The reason for this seasonality is unknown, but some researchers think weather or the ebb and flow of sociality drives the trend; others blame inflammatory processes that increase in spring.  One theory held that the heat of spring and summer leads to excess energy which expressed itself in violence.  Others suggest that people are vulnerable and face more challenges when the weather warms and social interaction increases and people who are struggling may feel left out.  Depression and suicidal thoughts and behaviors have long been linked to inflammation, a bodily response that occurs during times of stress, and a theory suggests that bodily inflammation might affect the mind.  Studies have linked inflammation that occurs in the body from increased tree pollen and air pollution levels that are found in the spring to an increase in suicidal rates that occur.

IF YOU KNOW SOMEONE WHO IS CONTEMPLATING SUICIDE PLEASE CALL:

National Suicide Hotline: 1-800-SUICIDE or 1-800-784-2433

National Suicide Prevention 1-800-273-TALK (8255)

The Hopeline 1-800-394-HOPE

Deaf Hotline 1-800-799-4TTY

Sources:

Melinda Smith, Jeanne Segal, Lawrence Robinson. (2015). Suicide Prevention. Retrieved from http://www.helpguide.org/articles/suicide-prevention/suicide-prevention-helping-someone-who-is-suicidal.htm.

Mentalhealthamerica.net. (2015). Suicide. Retrieved from Mentalhealthamerica.net/suicide.

Pappas, Stephanie. (2014, March 24). Springtime Suicide Peak Still Puzzles Scientists. Retrieved 2015, from Livescience.com/44290-suicides-peak-spring.html.