Suicidal Behavior is a Cry for Help
MYTH: If someone is going to commit suicide, nothing can stop them.
The fact that a person who is suicidal is still alive is a sign that part of them really wants to live. The suicidal person is "teetering on the fence" -- part of them wants to live while another part of them wants not really to die but to easily find an escape from their pain. The part of them that wants to live will tell another person “I am having thoughts of suicide or of just ending it all.”
If a suicidal person turns to you it means they believe you to be a caring person who is more informed than they in coping skills. They are hoping you are willing to nurture and protect them in a confidential manner. No matter how negatively the suicidal person is speaking and acting, they ARE doing something POSITIVE by trusting and reaching out to you.
Give or Get Help as Soon as Possible
Suicide prevention is not a last minute activity. All textbooks on depression say it should be addressed as soon as possible. You need to do everything you can to reduce pain, rather than increase or prolong it. Constructively involving yourself on the side of life as early as possible will reduce the risk of suicide.
If the Person is Acutely Suicidal, do NOT Leave Him Alone
If at all possible, detoxify the home or the current environment. Get rid of anything that may present a problem, either physically or emotionally.
Urge Professional Help
Persistence and patience may be needed to seek, engage and continue with as many options as possible. After giving an option a good, honest try -- if this is just not working, move on to another helpful resource. Do NOT give up!
After the Crisis is Past
Most people have suicidal thoughts or feelings at some point in their lives, yet less than 2% of all deaths are suicides. Nearly all suicidal people suffer from conditions that will pass with time or with the assistance of a recovery program. There are hundreds of modest steps we can take to improve our response to the suicidal and to make it easier for them to seek help. Taking these modest steps can save many lives and reduce a great deal of human suffering.
Know the Warning Signs: Conditions Associated with Increased Risk of Suicide
Death or terminal illness of a relative or friend
Divorce, separation, broken relationship, stresses on the family
Loss of health (real or imaginary)
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. Recent studies have associated anxiety disorders with increased risk for attempted suicide.
Emotional and Behavioral Changes Associated with Suicide
Hopelessness: The feeling that the pain will continue or get worse or that things will never get better.
Powerlessness: The feeling that one's resources for reducing pain are exhausted.
Feelings of worthlessness, shame, guilt, self-hatred or “no one cares”. Fear of losing control, harming self or others.
Personality becomes sad, withdrawn, tired, apathetic, anxious, irritable or prone to angry outbursts.
Declining performance in school, work, or other activities. (Occasionally the reverse: someone who volunteers for extra duties because they need 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 activities previously enjoyed.
Neglect of personal welfare, deteriorating physical appearance.
Alterations in either direction related to sleeping or eating habits.
Particularly in the elderly: Self-starvation, dietary mismanagement or purposely disobeying medical instructions.
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. The precipitating factors may be new pain or the loss of pain coping resources.
Difficult times: Holidays, anniversaries, the first week after being discharged from a hospital, just before and after diagnosis of a major illness, just before and during disciplinary proceedings. Undocumented status adds to the stress of a crisis.
Ways to Help a Depressed Person (*)
Convince the depressed person to get treatment or, in the case of a depressed child or adolescent, help the youngster get treatment.
Tell the depressed person that he or she is loved, deserves to feel better, and will feel better with appropriate treatment.
Recommend helping resources
If the depressed person is not functioning, accompany him or her to treatment until normal function returns.
If the depressed person is too young or ill to provide needed information to the therapist, act as a go-between as long as needed.
If the depressed person is suicidal or having hallucinations or delusions, arrange for hospitalization.
If the depressed person is functional and refuses treatment, seek the assistance of others -- friends, doctor, clergy, relatives -- who might convince him or her that treatment is needed and will help.
Don't give up too soon -- the depressed person may have to hear more than once and from several people that he or she deserves to feel better and can, with proper treatment.
If all efforts to encourage the depressed person to seek treatment have failed, and the depressed person is having a demoralizing impact on those around, further action is needed:
A supervisor might threaten personnel action unless the depressed employee gets treatment.
A spouse, with the assistance of a mental health specialist, can explore separation from the depressed husband or wife who refuses treatment.
Parents of a depressed adult can clarify, with the help of a mental health specialist, how much assistance to give their depressed offspring.
Children, other relatives, friends, or doctors of a depressed older person can assist him or her to get help from a mental health specialist who has geriatric experience and who may be willing to reach out to the older person by telephone and home visits.
(*) Information source: The National Institute of Mental Health (NIMH)
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