Suicide Prevention: How You Can Help?
Do you know what the warning signs of suicide are and what to do if you recognize them in someone you know? The first step is learning the myths and realities of suicide.
Myths About Suicide
Myths about suicide can lead well-intentioned people to handle a suicide crisis improperly. Here are some of the most common ones:
- Myth: Asking suicidal people if they are thinking about committing suicide will put ideas in their heads.
- "If you suspect depression and/or suicidal thinking, the best thing to do is to ask the person directly," says Sandra Simz, LCSW, clinical consultant at Yolo County Suicide Prevention in California. "Suicide is dealt with most effectively when it is discussed openly and with emotional support."
- Myth: People who talk about suicide don't do it.
- All suicidal threats need to be taken seriously, even if you believe the other person is only saying it for a dramatic effect for example, a teenager breaking up with his girlfriend, or a young girl who is teased about her weight by kids at school. It's much better to err in favor of seriousness than to disregard the threat and later have to live with the consequences.
- Myth: Nobody can stop people who say they are going to kill themselves.
- A person who says he is going to kill himself is ambivalent. One part of him wants to live, while the other part wants to be free of his emotional pain and sees death as the only option. Your task is to tip the scales in favor of life.
- Myth: There is no treatment for suicidal thoughts or behaviors.
- Suicidal thoughts and/or behaviors are symptoms of depression, an illness that can be successfully treated with certain medications, talk therapy, or a combination of both. Many medications have been shown to be helpful in treating depression and reducing the risk of suicide. For example, the medication lithium has consistently been proven to reduce the risk of suicide.
If you find yourself talking with a person who has announced his intent to kill himself, look for some of these warning signs of suicidal potential. These can vary between men and women. While women attempt suicide more often than men, suicide attempts by men are more likely to result in death. When considering risk factors, it is important to keep in mind that the presence of any particular factor or factors does not necessarily signal suicidal potential.
- Death or terminal illness of a relative or friend
- Divorce, separation, broken relationship, stress on the family
- Loss of health (real or imaginary)
- Loss of job, home, money, status, self-esteem, personal security
There are also certain behaviors associated with suicide. Again, these behaviors individually do not necessarily indicate suicidal potential.
- Requesting euthanasia information
- Writing stories or essays on morbid themes
- Inappropriately saying goodbye
- Having no support system
- Having self-inflicted injuries, such as cuts, burns, or head banging
- Making out a will or giving away favorite possessions
- Experiencing difficult times, such as a holiday or anniversary marking a significant loss
- Abusing drugs or alcohol
- Losing interest in things they usually care about
- Having depression
- Making statements about worthlessness, hopelessness, shame, guilt, self-hatred, or saying "no one cares"
- Neglecting their personal welfare or physical appearance
- Declining performance in schoolwork or other activities
The Importance of Listening
Listening is very important in helping to prevent suicide. Give the person every opportunity to express her feelings about the incidents that have lead her to consider suicide. You may not see the problem as worth killing oneself over, but remember that everyone reacts to crisis differently.
Don't judge her reasons for wanting to commit suicide. This sends the message that you aren't receptive to talking about her pain and don't take it seriously. You need to focus on how badly the other person is feeling and do your best to understand her perspective of the problem.
"It's amazing seeing somebody feeling isolated, hopeless, and afraid becoming a little less so after a conversation in which their feelings were heard, validated, and respected," Simz says. "The more people feel they have a strong support system, the less likely they are to be suicidal."
As you continue to assess the extent of suicidal risk, you need to ask the person these questions:
- Have you thought about how you are going to kill yourself?
- When do you believe you are going to do this?
- Do you have the means available to kill yourself?
- Have you made a prior suicide attempt?
Preventing a Suicide Attempt
If the person shows several warning signs of suicidal risk and also has a concrete plan for killing himself, you need to get him to the emergency room as soon as possible. If you feel you need assistance, call 911.
On the other hand, if the person has a low or moderate number of warning signs and does not have a suicide plan, he should be seen by a therapist as soon as possible. If he refuses this, suggest that he call a suicide prevention hotline where trained counselors are available by phone 24 hours a day, 7 days a week (see Resources below). People often feel more comfortable calling a hotline than seeing a therapist in person.
Get Help for Yourself
Helping a person who is considering suicide is an emotional and sometimes frightening experience. If at any time you feel you need to talk with someone, you can also call a local suicide hotline to discuss your experience with a trained counselor.
American Foundation for Suicide Prevention
Suicide Crisis Center
Centre for Suicide Prevention
Canadian Association for Suicide Prevention
Angst J, Angst F, Gerber-Werder R, et al. (2005). “Suicide in 406 mood-disorder patients with and without long-term medication: a 4- to 44 years’ follow-up.” Arch suicide Res. 9: 279-300.
Guzzetta F, Tondo L, Centorrino F, Baldessarini RJ. (2007). “Lithium treatment reduces suicide risk in recurrent major depressive disorder.” J Clin Psychiatry. 68: 380-383.
Mann JJ, Waternaux C, Haas GL, Malone KM. (1999). Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry .156:181–189
Oquendo, MA, Bongiovi-Garcia, ME, et al. (2007). “Sex differences in clinical predictors of suicidal acts after major depression: a prospective study.” Am J Psychiatry.164(1): 134-141.
Last reviewed January 2008 by ]]>Ryan Estévez, MD, PhD, MPH]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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