Suicide Prevention: How To Help

Suicide Hotline: 1-800-273-TALK (8255)

Nothing is quite so tragic and heartbreaking as the feeling that your life no longer holds any worth, that you aren't worth fighting for. That the pain is so unbearable, death feels like the only way out.

When someone confides in you that they're feeling suicidal, or have had thoughts of suicide, it naturally can be unsettling and scary. You may not know how to act, or what to say, or wonder if you should say anything at all. You should. Taking action is always the best choice. It doesn't have to be so scary. This post takes on the subject of suicide; understanding, common misconceptions, warning signs, prevention, and risk factors. I really hope it helps bring understanding on a subject that has been taboo for far too long. It's time to bring light and knowledge to the subject. The problem is real and the pain is real. And it needs to be talked about right now.

● Understanding

If you've never been in the deep sorrow of suicidal depression and despair, suicide is difficult to understand. The suicidal person is in so much pain they see no other option or way out than by ending their life. Suicide becomes a desperate attempt to escape the pain and suffering that has become unbearable to them. When the feelings of self-loathing, isolation, and hopelessness become too great, it's hard to see any way of finding relief except through death. However, even if all they want is the pain to end, most suicidal people are deeply conflicted about ending their own lives. They wish there was an alternative, but are unable to see one.

● Common Misconceptions About Suicidal People

Unfortunately suicide and people wanting to commit suicide are so misunderstood. There's A LOT, too many actually, misconceptions about the subject. Here are the most common:

People who talk about suicide won't really do it. Almost everyone who commits or attempts suicide has given some kind of warning. Do not ignore suicidal threats.

People who attempt suicide must be crazy. Most suicidal people are not psychotic or insane. They're upset, grief-stricken, or depressed. But it's also important to remember that extreme distress and emotional pain are not necessarily signs of mental illness.

If someone is determined to kill themselves, nothing will stop them. Like I mentioned earlier, 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.

Those who have successfully committed suicide were unwilling to get help. Studies on suicide have shown that in over half of successful suicides, the person sought help in the six months before their death.

Talking about suicide will give the person the idea. You don't give a suicidal person morbid ideas by talking about suicide. Actually the opposite is true. Bringing up the subject of suicide and discussing it openly is one of the most helpful things you can do.

*Remember that suicide is no respecter of persons. It doesn't care if you're rich or poor, black or white. The feelings leading up to suicide affect everyone and anyone equally.

● Warning Signs

Most suicidal people give warning signs or signals of their intentions. The best way to prevent suicide is to recognize these warning signs and know how to respond if you see them. The following is a list of the more common suicide warning signs.

*Talking about killing or harming oneself
*Talking or writing about death/dying
*Seeking out things that can be used in a suicide attempt
*Hopelessness- unbearable feelings, seeing a bleak future, having nothing to look forward to
*Dramatic mood swings
*Sudden personality changes
*Losing all interest in day to day activities
*Neglecting personal appearance
*Drastic changes in eating and sleeping habits
*Withdrawing or wanting to be alone
*Increase in alcohol or drug use
*Risky and self-destructive acts
*Giving away belongings
*Getting affairs in order when there is no logical reason to do so
*Saying goodbye to people like you won't see them again

● Prevention

Speak up if you're worried! You can't make a person suicidal by showing that you care. What you can do is provide relief from loneliness and pent up negative feelings.

Here are some ways to start a conversation:
"I have been feeling concerned about you lately."
"I have noticed some differences in you recently and wondered how you are doing."
"I wanted to check in with you because you haven’t seemed yourself lately."

Here are some questions you can 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?"

And here are some things you can say that help:
"You are not alone in this. I’m here for you."
"You may not believe it now, but the way you’re 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."

It's also good to have a list in your head of Dos and Don'ts when talking to a suicidal person.

Do:
*Be yourself. Let the person know you care and that they are not alone. The right words are often unimportant. If you are concerned, your voice and actions will show it.
*Listen. Let the suicidal person unload despair and ventilate anger. No matter how negative the conversation seems, the fact that it even exists is a positive sign.
*Be sympathetic, non-judgmental, patient, calm, and accepting. Your loved one is doing the right thing by talking about their feelings.
*Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that their life is important to you.
*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 and that you take them seriously and that it’s okay for them to share their pain with you.

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, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, it's about how badly it’s hurting your loved one.

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 in the near future have a specific suicide plan, the means to carry out the plan, a time set for doing it, and an intention to do it. Ask questions to assess the immediate danger. These are good questions to ask:

"Do you have a suicide plan?" (plan)
"Do you have what you need to carry out your plan (pills, gun, etc.)?" (means)
"Do you know when you would do it?" (time set)
"Do you intend to commit suicide?"(intention)

Take all suicidal comments very seriously. Try not to act shocked. The person is already highly distressed, and if you are shocked by what is said, the person will become more distressed. Stay calm, and talk with them in a matter-of-fact manner, but get help immediately. Do not handle the situation by yourself. If you feel the suicide is imminent, or are just plain worried, call 911.

Listen attentively to everything that the person has to say. Let them talk as much as they want. Listen closely so that you can be as supportive as possible, and learn as much as possible about what is causing the suicidal feelings. Comfort with words of encouragement. Use common sense to offer words of support. Remember that intense emotional pain can be overwhelming, so be as gentle and caring as possible. Listen carefully and offer encouraging words when appropriate. Let the person know that you are deeply concerned. Tell them you are concerned, and show them that you are concerned. A suicidal person is highly vulnerable and needs to feel that concern. Don't be judgmental. Do not invalidate anything that the person says or feels. Be supportive and caring. Be careful of the statements that you make. You do not want to make the person feel any worse than they already do. I think the commom thread here is listen, listen, listen! Be gentle, be kind, and be understanding. Let the person express emotion in the way that they want. Allow the person to cry, yell, swear and do what is necessary to release the emotion. However, do not allow the person to become violent or harm themselves. If the person is at a high risk of suicide, DO NOT leave them alone. Do not leave a critically suicidal person alone for even a second. Only after you get professional help for the person can you consider leaving.

Offer help and support. Once again, the best thing you can do is offer an empathetic and listening ear.

Help your loved one get professional help. 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 a doctor's appointment. Then know and follow-up on their treatment. If the doctor prescribes medication, make sure your loved one takes it as directed. Be aware of possible side effects and be sure to 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 to return your calls. Drop by, call again, invite the person out.

Make a safety plan. Help the person develop a set of steps that they promise to follow during a suicidal crisis. It should also identify any triggers that may lead to a crisis. 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.

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

Be aware of feelings. Many people at some time in their lives think about suicide. Many decide to live. However people having a crisis sometimes perceive their dilemma as inescapable and feel a complete loss of control. These are some of the feelings and thoughts they experience:

Can't stop the pain
Can't think clearly
Can't make decisions
Can't see any way out
Can't sleep, eat or work
Can't get out of depression
Can't make the sadness go away
Can't see a future without pain
Can't see themselves as worthwhile
Can't get someone's attention
Can't seem to get control

If your loved one is experiencing any of these feelings, help them get help!

● Risk Factors

According to the U.S. Department of Health and Human Services, at least 90% of all people who commit suicide suffer at least one mental disorder.

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.

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

● Hope~

I know what it's like to feel and be suicidal. I know how scary and hopeless you feel. I know how heartbreaking it is to feel so utterly alone and defeated that all you want is to die. I know. I've been there. Many, many days I still am there. I know how bad it hurts. I also know how grateful I am for those people who have stuck by my side through it all. I understand how precious these beings are. Be that being. You can help save a life. If you're struggling with suicidal thoughts or actions, or even if you're not, know that I am here for you. Know that you are loved. You are worthwhile. You are worth every ounce of the fight. You are not alone. You can and you will survive. The feelings will pass. The sun will come out again. This I know. I love you, I care for you, and I need you. You are worth it.