Spotting the Signs and Helping a Suicidal PersonFrom HelpGuide.org
If you're thinking about committing suicide, please read If You're Feeling Suicidal or call 1-800-273-TALK now!
The World Health Organization estimates that approximately 1 million people die each year from suicide. What drives so many individuals to take their own lives? To those not in the grips of suicidal depression and despair, it's difficult to understand. But a suicidal person is in so much pain that he or she 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.
Because of their ambivalence about dying, suicidal individuals usually give warning signs or signals of their intentions. The best way to prevent suicide is to know and watch for these warning signs and to get involved if you spot them. If you believe that a friend or family member is suicidal, you can play a role in suicide prevention by pointing out the alternatives, showing that you care, and getting a doctor or psychologist involved.
Common Misconceptions about Suicide
FALSE: People who talk about suicide won't
really do it.
Almost everyone who commits or attempts suicide has given some clue or warning. Do not ignore suicide threats. Statements like "you'll be sorry when I'm dead," "I can't see any way out," -- no matter how casually or jokingly said may indicate serious suicidal feelings.
FALSE: Anyone who tries to kill him/herself
must be crazy.
Most suicidal people are not psychotic or insane. They must be upset, grief-stricken, depressed or despairing, but extreme distress and emotional pain are not necessarily signs of mental illness.
FALSE: If a person is determined to kill
him/herself, nothing is going to stop him/her.
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 death; they want the pain to stop. The impulse to end it all, however overpowering, does not last forever.
FALSE: People who commit suicide are people
who were unwilling to seek help .
Studies of suicide victims have shown that more then half had sought medical help within six month before 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.
Suicide prevention begins with an awareness of the warning signs of suicidal thoughts and feelings. Major warning signs for suicide include talking about killing or harming oneself, talking or writing a lot about death or dying, and seeking out things that could be used in a suicide attempt, such as weapons and drugs.
Take any suicidal talk or behavior seriously. It's not just a warning sign that the person is thinking about suicide — it's a cry for help.
A more subtle but equally dangerous warning sign of suicide is hopelessness. 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 that they have nothing to look forward to.
Other warning signs that point to a suicidal mind frame include dramatic mood swings or sudden personality changes, such as going from outgoing to withdrawn or well-behaved to rebellious. A suicidal person may also lose interest in day-to-day activities, neglect his or her appearance, and show big changes in eating or sleeping habits.
|Suicide Warning Signs|
Talking about suicide
Any talk about suicide, dying, or self-harm. Includes statements such as "I wish I hadn't been born," "If I see you again...," "I want out," and "I'd be better off dead."
Seeking out lethal means
Looking for ways to commit suicide. Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt.
Preoccupation with death
Unusual focus on death, dying, or violence. Writing poems or stories about death.
No hope for the future
Feelings of helplessness, hopelessness, and being trapped ("There's no way out"). Belief that things will never get better or change.
Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden ("Everyone would be better off without me").
Getting affairs in order
Making out a will. Giving away prized possessions. Making arrangements for family members.
Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won't be seen again.
Withdrawing from others
Withdrawing from friends and family. Increasing social isolation. Desire to be left alone.
Increased alcohol or drug use, reckless driving, unsafe sex. Taking unnecessary risks as if they have a "death wish".
Sudden sense of calm
A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to commit suicide.
Suicide prevention tip #1: Speak up if you’re worried
If you spot the warning signs of suicide in someone you care about, you may wonder if it’s a good idea to say anything. What if you’re wrong? What if the person gets angry? Even worse, what if you plant the idea in your friend or family member’s head? 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 person about suicide
If you're unsure whether someone is suicidal, the best way to find out is to ask. You can't make a person suicidal by showing that you care. In fact, giving the individual the opportunity to express his or her feelings may prevent a suicide attempt. The person may even be relieved that you brought up the issue.
Here are some questions you can ask:
- Have you ever thought that you'd be better off dead or that if you died, it wouldn't matter?
- Have you thought about harming yourself?
- Are you thinking about suicide?
Suicide hotlines to call for help:
These toll-free crisis hotlines offer 24-hour suicide prevention and support. Your call is free and confidential.
Suicide prevention 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's important to evaluate the immediate danger the person is in. Those at the highest risk for committing suicide in the near future have a specific suicide plan, the means to carry out the plan, a time schedule for doing it, and an intention to do it.
|Level of Suicide Risk|
Low — Some suicidal thoughts. No suicide plan. Says he or she won't commit suicide.
Moderate — Suicidal thoughts. Vague plan that isn't very lethal. Says he or she won't commit suicide.
High — Suicidal thoughts. Specific plan that is highly lethal. Says he or she won't commit suicide.
Severe — Suicidal thoughts. Specific plan that is highly lethal. Says he or she will commit suicide.
The following questions can help you assess the immediate risk for suicide:
- Do you have a suicide plan?
- Do you have what you need to carry out your plan (pills, gun, etc.)?
- Do you know when you would do it?
- Do you intend to commit suicide?
If a suicide attempt seems imminent, call a local crisis center, dial 911, or take the person to an emergency room. Do not, under any circumstances, leave a suicidal person alone.
It's also wise to remove guns, drugs, knives, and other potentially lethal objects from the vicinity. In some cases, involuntary hospitalization may be necessary to keep the person safe and prevent a suicide attempt.
Suicide prevention 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 that he or she is not alone and that you care. Don't take responsibility, however, for making your loved one well. You can offer support, but you can't get better for a suicidal person. He or she has to make a personal commitment to recovery.
As you're helping a suicidal person, don't forget to take care of yourself. Find someone that you trust—a friend, family member, clergyman, or counselor—to talk to about your feelings and get support of your own.
Helping a suicidal person:
- Listen without judgment — Let a suicidal person express his or her feelings and accept those feelings without judging or discounting them. Don't act shocked, lecture on the value of life, or say that suicide is wrong.
- Offer hope — Reassure the person that help is available and that the suicidal feelings are temporary. Don't dismiss the pain he or she feels, but talk about the alternatives to suicide and let the person know that his or her life is important to you.
- 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. If you promise to keep your discussions secret, you may have to break your word.
- Get professional help — Do everything in your power to get a suicidal person the help he or she needs. 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 a doctor's appointment.
- Make a plan for life — Help the person develop a "Plan for Life," a set of steps he or she promises to follow during a suicidal crisis. It should include contact numbers for the person's doctor or therapist, as well as friends and family members who will help in an emergency.
According to the U.S. Department of Health and Human Services, at least 90 percent of all people who commit suicide suffer from depression, alcoholism, or a combination of mental disorders. Depression in particular plays a large role in suicide. The difficulty suicidal people have imagining a solution to their suffering is due in part to the distorted thinking caused by depression.
Antidepressants and Suicide
Overall, the risk of suicide is lower in people taking antidepressants for depression. But for some, depression medication causes an increase—rather than a decrease—in depression and suicidal thoughts and feelings. Because of this risk, the FDA advises that anyone on antidepressants should be watched for increases in suicidal thoughts and behaviors. Monitoring is especially important if this is the person's first time on depression medication or if the dose has recently been changed. The risk of suicide is the greatest during the first two months of antidepressant treatment.
Common suicide risk factors include:
- Mental illness
- Alcoholism or drug abuse
- Previous suicide attempts
- Family history of suicide
- Terminal illness or chronic pain
- Recent loss or stressful life event
- Social isolation and loneliness
- History of trauma or abuse
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:
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 that is undiagnosed and untreated.
Other risk factors for suicide in the elderly include:
For more on depression and suicide in the elderly, see Depression in Older Adults .
To Learn More...
General information about suicide prevention
Understanding Suicidal Thinking — Learn what to do when someone is suicidal. Features advice on preventing suicide attempts and offering help and support. (Depression and Bipolar Support Alliance)
Frequently Asked Questions About Suicide — Find answers to common questions about suicide, including who is at the highest risk and how to help. (National Institute of Mental Health)
Suicide and Mental Illness — Article on the link between suicide and mental illnesses such as depression, substance abuse, schizophrenia, and bipolar disorder. (StopaSuicide.org)
Helping a suicidal person
What Can I Do To Help Someone Who Might be Suicidal? — Discusses possible warning signs of suicidal thoughts and ways to prevent suicide attempts. (Metanoia)
Suicide: Learn More, Learn to Help — Suicide prevention fact sheet that includes questions to ask to find out if someone is suicidal. (The National Alliance for the Mentally Ill).
When You Fear Someone May Take Their Own Life — Overview of what to do when someone is suicidal, including preventing suicide in an acute crisis. (American Foundation for Suicide Prevention)
Handling a Call From a Suicidal Person — Advice on how to handle a phone call from a friend or family member who is suicidal. Features tips on what to say and how to help. (Metanoia)
Suicide hotlines and crisis support
National Suicide Prevention Lifeline - Suicide prevention telephone hotline funded by the U.S. government. Provides free, 24-hour assistance. 1-800-273-TALK (8255).
National Hopeline Network - Toll-free telephone number offering 24-hour suicide crisis support. 1-800-SUICIDE (784-2433)
State Prevention Programs — Browse through a database of suicide prevention programs, organized by state. (National Strategy for Suicide Prevention)
Crisis Centers in Canada — Locate suicide crisis centers in Canada by province. (Centre For Suicide Prevention)
Befrienders Worldwide — International suicide prevention organization connects people to crisis hotlines in their country.
Facts for Families: Teen Suicide — Learn about teen suicide, including risk factors, warning signs, and how to prevent it. (American Academy of Child Adolescent Psychiatry)
Suicide Prevention Resource Center: Teens — Guide to suicide in teenagers. Includes advice for helping yourself or a friend. (Suicide Prevention Resource Center)
Suicide in the elderly
Older Adults: Depression and Suicide Facts — Overview of the problem of depression and suicide in the elderly, including how to get help. (National Institute of Mental Health)
Suicide and the Elderly: Warning Signs and How to Help — Article on suicide in the elderly covers the risk factors, warning signs, and how to provide help. (University of Florida)
How You Can Help To Prevent
Suicide: Take Threats Seriously
Suicide. We would rather not talk about it. We hope it will never happen to anyone we know. But suicide is a reality, and it is more common than you might think. The possibility that suicide could claim the life of someone you love cannot be ignored. By paying attention to warning signs and talking about the "unthinkable," you may be able to prevent a death.
Who is at risk?
People likely to commit suicide include those who:
- are having a serious physical or mental illness,
- are abusing alcohol or drugs,
- are experiencing a major loss, such as the death of a loved one, unemployment or divorce,
- are experiencing major changes in their life, such as teenagers and seniors,
- have made previous suicide threats.
Why do people commit suicide?
There are many circumstances which can contribute to someone's decision to end his/her life, but a person's feelings about those circumstances are more important than the circumstances themselves. All people who consider suicide feel that life is unbearable. They have an extreme sense of hopelessness, helplessness, and desperation. With some types of mental illness, people may hear voices or have delusions which prompt them to kill themselves.
People who talk about committing suicide or make an attempt do not necessarily want to die. Often, they are reaching out for help. Sometimes, a suicide attempt becomes the turning point in a person's life if there is enough support to help him/her make necessary changes.
If someone you know is feeling desperate enough to commit suicide, you may be able to help him/her find a better way to cope. If you yourself are so distressed that you cannot think of any way out except by "ending it all," remember, help for your problems is available.
What are the danger signs?
Some warning signs that a person may be suicidal include:
- repeated expressions of hopelessness, helplessness, or desperation,
- behavior that is out of character, such as recklessness in someone who is normally careful,
- signs of depression - sleeplessness, social withdrawal, loss of appetite, loss of interest in usual activities,
- a sudden and unexpected change to a cheerful attitude,
- giving away prized possessions to friends and family,
- making a will, taking out insurance, or other preparations for death, such as telling final wishes to someone close,
- making remarks related to death and dying, or an expressed intent to commit suicide. An expressed intent to commit suicide should always be taken very seriously.
Prevent a suicide attempt
If you are concerned that someone may be suicidal, take action. If possible, talk with the person directly. The single-most important thing you can do is listen attentively without judgement.
Talking about suicide can only decrease the likelihood that someone will act on suicidal feelings. There is almost no risk that raising the topic with someone who is not considering suicide will prompt him/her to do it.
Find a safe place to talk with the person, and allow as much time as necessary. Assure him/her of your concern and your respect for his/her privacy. Ask the person about recent events, and encourage him/her to express his/her feelings freely. Do not minimize the feelings involved.
Ask whether the person feels desperate enough to consider suicide. If the answer is yes, ask, "Do you have a plan? How and where do you intend to killyourself?"
Admit your own concern and fear if the person tells you that he/she is thinking about suicide but do not react by saying, 'You shouldn't be having these thoughts; things can't be that bad." Remember, you are being trusted with someone's deepest feelings. Although it may upset you, talking about those feeling will bring the person relief.
Ask if there is anything you can do. Talk about resources that can be drawn on (family, friends, community agencies, crisis centers) to provide support, practical assistance, counseling or treatment.
Make a plan with the person for the next few hours or days. Make contacts with him/her or on his/her behalf. If possible, go with the person to get help.
Let the person know when you can be available, and then make sure you are available at those times. Also, make sure your limits are known, and try to arrange that there is always someone that he/she can call at any time of day.
Ask who else knows about the suicidal feelings. Are there other people who should know? Is the person willing to tell them? Unfortunately, not everyone will treat this issue sensitively. Confidentiality is important, but do not keep the situation secret if a life is clearly in danger.
Stay in touch to see how he/she is doing. Praise the person for having the courage to trust you and for continuing to live and struggle.
What to do following a suicide attempt
A person may try to commit suicide without warning or despite efforts to help. If you are involved in giving first aid, make every effort to be calm and reassuring, and get medical help immediately.
The time following an attempt is critical. The person should receive intensive care during this time. Maintain regular contact, and work with the person to organize support. It is vital that he/she does not feel cut off or shunned as a result of attempting suicide.
Be aware that, if someone is intent on dying, you may not be able to stop it from happening. You cannot and should not carry the responsibility for someone else's choice.
What can you do if you are feeling suicidal?
The beginning of the way out is to let someone else in. This is very hard to do because, if you feel so desperate that suicide seems to be the only solution, you are likely very frightened and ashamed. There is no reason to be ashamed of feeling suicidal and no reason to feel ashamed for seeking help. You are not alone; many people have felt suicidal when facing difficult times and have survived, usually returning to quite normal lives.
Take the risk of telling your feelings to someone you know and trust: a relative, friend, social service worker, or a member of the clergy for your religion. There are many ways to cope and get support. The sense of desperation and the wish to die will not go away at once, but it will pass. Regaining your will to live is more important than anything else at the moment.
Some things that you can do are:
- call a crisis telephone support line,
- draw on the support of family and friends,
- talk to your family doctor; he/she can refer you to services in the community, including counseling and hospital services,
- set up frequent appointments with a mental health professional, and request telephone support between appointments, and get involved in self-help groups,
- talk every day to at least one person you trust about how you are feeling,
- think about seeking help from the emergency department of a local hospital,
- talk to someone who has 'been there" about what it was like and how he/she coped,
- avoid making major decisions which you may later regret.
Do you need more help?
If you or someone you know is feeling suicidal and you need more
information about resources in your area, contact a community
organization, such as the Canadian Mental Health Association, which can
help you find additional support.