Suicide Prevention – Part 2

Tip 1: Speak Up If You’re Worried

If you spot the warning signs of suicide in someone, you may wonder if it is a good idea to say anything. What if you are wrong? What if the person gets angry? In such situations, it is 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 their suicidal thoughts and feelings can be difficult for anyone. But if you are unsure whether someone is suicidal, the best way to find out is to ask. You can’t make a person suicidal by showing 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 about suicide:
“I have been feeling concerned about you lately.”
“Recently, I have noticed some differences in you and wondering how you are doing.”
“I wanted to check in with you because you haven’t seemed yourself lately”

Questions you can ask:
“When did you begin feeling like this?”
“Did something happen to make you start feeling this way?”
“Have you thought about getting help?”

What you can say that helps:

 “How can I best support you right now?”
“You are not alone in this, I’m here for you.”
“I may not be able to understand 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.”

When Talking To A Suicidal Person

Be Yourself. Let the person know you care, and that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it.

Listen. Let the suicidal person unload their despair or vent their anger. No matter how negative the conversation seems, the fact that it is taking place is a positive sign.

Be empathetic, non-judgmental, patient, calm, and accepting. Your friend or family member is doing the right thing by talking about his/her feelings.

Offer hope. Reassure the person that help is available and that the suicidal feelings are frequently temporary. Let the person know that his or her life is important to you.

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

But don’t:
Argue with the 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.”

Act shocked, lecture on the value of life, or say that suicide is wrong.

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. If you promise to keep your discussions secret, you may have to break your word.

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

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

Tip 2: Respond Quickly In A Crisis

If a friend or family member tells you that he or she is thinking about death or suicide, it is important to evaluate the immediate danger the person is in. Those at the highest risk of committing suicide in the near future have a specific plan, the means to carry out the plan and a time set for doing it, and an intention to do it.

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

Tip 3: Offer Help And Support

If a friend or family member is suicidal, the best way to help is by offering an empathetic, listening ear. Let your loved one know he or she is not alone and that you care. Don’t take responsibility for healing your loved one. You can offer support, but you can’t make a suicidal person get better. He or she has 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 his or her own life can stir up many difficult emotions. As you are helping a suicidal person, don’t forget to take care of yourself. Find someone that you trust to talk about your feelings and get the support of your own.

To help a suicidal person:
Get professional help.  Encourage the person to see a mental health professional, help locate a treatment facility, or take them to a doctor’s appointment.

Follow-up on treatment. If the doctor prescribes medication, encourage your friend or loved one to take it as directed. Notify the physician if the person seems to be getting worse. It often takes time and persistence to find the medication or therapy that’s right for a particular person.

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 even return your calls. Drop by, call again, and invite the person out.

Encourage positive lifestyle changes, such as a healthy diet, plenty of sleep, and getting out in the sun or into nature for at least 30 minutes each day. Exercise is also extremely important as it releases endorphins, relieves stress, and promotes emotional well-being.

Make a safety plan. Help the person develop a set of steps he or she promises to follow during a suicidal crisis. It should identify any triggers that may lead to a suicidal crisis, such as an anniversary of a loss, alcohol, or stress from relationships. Also include contact numbers for the person’s doctor or therapist, as well as friends and family members who will help in an emergency.

Remove potential means of suicide, such as pills, knives, razors, or firearms. If the person is likely to take an overdose, keep medications locked away or give them out only as the person needs them.

Continue your support over the long haul. Even after the immediate suicidal crisis has passed, stay in touch with the person, periodically checking in or dropping by. Your support is vital to ensure your friend or loved one remains on the recovery track. 

Risk Factors for Suicide

At least 90 percent of all people who commit suicide have one or more mental disorders such as depression, bipolar disorder, or schizophrenia. The difficulty that suicidal people have in imagining a solution to their suffering is due in part to the distorted thinking caused by mental illness.

Common suicide risk factors include:
• Mental illness, alcoholism, or drug abuse
• Previous suicide attempts, family history of suicide, or history of trauma or abuse
• Terminal illness or chronic pain, a recent loss or stressful life event
• Social isolation and loneliness

Suicide in Teens and Older Adults

In addition to the general risk factors for suicide, both teenagers and older adults are at a higher risk of suicide.

Suicide in Teens:
Teenage suicide is a serious and growing problem. The teenage years can be emotionally turbulent and stressful. Teenagers face pressures to succeed and fit in. They may struggle with self-esteem issues, self-doubt, and feelings of alienation. For some, this leads to suicide. Depression is also a major risk factor for teen suicide.

Other risk factors for teenage suicide include:
• Childhood abuse
• Recent traumatic event
• Lack of a support network
• Hostile social or school environment
• Exposure to other teen suicides

Warning signs in teens:
Additional warning signs that a teen may be considering suicide:
1. Change in eating and sleeping habits
2. Withdrawal from friends, family, and regular activities
3. Violent or rebellious behavior, running away
4. Drug and alcohol use
5. Unusual neglect of personal appearance
6. Persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork
7. Frequent complaints about physical symptoms, often related to emotions, such as stomach aches, headaches, fatigue, etc.
8. Rejecting praise or rewards.

Suicide in the Elderly:

The highest suicide rates of any age group occur among persons aged 65 years and older. One contributing factor is depression in the elderly which is undiagnosed and untreated.

Other risk factors for suicide in the elderly include:
• The recent death of a loved one, isolation, and loneliness
• Physical illness, disability, or pain
• Major life changes, such as retirement or loss of independence
• Loss of sense of purpose

Warning signs in older adults:
Additional warning signs that an elderly person may be contemplating suicide:
1. Reading material about death and suicide
2. Disruption of sleep patterns
3. Increase in alcohol or prescription drug use
4. Failure to take care of self or follow medical orders
5. Stockpiling medications or sudden interest in firearms
6. Social withdrawal, elaborate goodbyes, rush to complete or revise a will.