“Place your hand over your heart; can you feel it? That is called purpose. You’re alive for a reason, so don’t ever give up.” – Unknown
It is important to take someone seriously¹ that expresses suicidal ideation – from fleeting thoughts about suicide to having a detailed plan set out on how to commit suicide. About 1 in 10 deaths in SA are by people committing suicide. It is scary, but if we know what to look for and what to do, we can prevent suicide. Feeling suicidal shouldn’t be kept a secret. It is crucial to reach out for help.
Often people who are thinking about suicide share the same feelings and thoughts: they feel alone, isolated and hopeless; they believe no one understands them; they assume they are a burden to their families. It is symptoms of an underlying problem – and often, there is more than one problem.
The Mental Health Foundation of New Zealand ² provided the following tips on coping with suicidal thoughts.
- Thoughts about killing yourself are just thoughts. You don’t have to act on a thought, no matter how overwhelming they are or how often you have them. The good thing is that thoughts come and go all the time. It means you won’t always have them
- Remove anything that you could use to harm yourself or ask others to do this for you.
- Make a “distraction box” – fill it with things that provide comfort, remind you of the good things in your life, and help lift your mood. You can include anything meaningful and helpful to you, e.g. a book, photos, letters, poems, music, notes to yourself, a toy, perfume, jokes etc.
- Get a fair amount of sleep, rest, and exercise, and eat regularly.
- Try to avoid drinking alcohol or taking non-prescription or recreational drugs. They can change the way you think and feel, mostly in unhelpful ways.
- If you’re taking prescribed medications for an illness (whether it be a physical illness or a mental health problem), don’t stop taking them without talking to your doctor first.
- Talk to someone you trust about what’s on your mind, whenever you need to. Keep a list of phone numbers of people you could call. If you’re not sure who you can talk to, try phoning a helpline or texting a text counselling service.
- Spend time with people who you like and trust.
- Take time off work if you need to. Your doctor can help arrange this.
- Write down your feelings. Keeping a journal or diary can help you understand what you’re thinking or feeling, or how you’re reacting to situations in your life. It can also make it easier for you to find different solutions to any problems you’re facing.
- Think about what kind of help you may need when you feel unwell. You may want friends to visit you, or help you with the shopping or cooking. Let people know, so they can do their best to support you.
- Learn from others – reading about other people who have managed difficult times can be inspirational. Reading the book, Lost Connections by Johann Hari ³ is recommended.
- Make a plan for recovery – write down what helps you to feel better about yourself, or what helps you when you’re feeling distressed. This might include going for a walk, or talking to someone you trust. Refer back to your plan when you need to.
- Be kind to yourself – just as your suicidal thoughts took time to appear, so it will take a while for them to fade. Live from day to day and don’t expect too much of yourself.
Even if you can’t see a way forward now, you can be certain that the way you are thinking and feeling about things will change.
What people close to a suicidal person need to know
1. People who die by self-death mostly talk about it first. They are in pain and oftentimes reach out for help because they do not know what to do and have lost hope.
2. Always take talk about “feeling suicidal” seriously.
3. People who talk about wanting to die by suicide oftentimes do kill themselves.
4. Suicide can be prevented. Most people who are suicidal do not want to die; they just want to stop their pain.
5. To feel suicidal can happen to anyone.
6. People who attempt suicide and survive will oftentimes make additional attempts.
7. Telling them that they “just want something” or “are trying to manipulate” is both insensitive and ignorant.
8. Suicide is the third leading cause of death for young people aged 15-24. Sometimes children younger than ten years old die by suicide.
9. Oftentimes, people who die by suicide are under the influence of alcohol or drugs.
10. Untreated mental illness (including depression, bipolar disorder, schizophrenia, and others) is the cause for the vast majority of suicides.
11. Some people die by suicide because of depression that was caused by genetics.
What are the warning signs of suicide?
- Talking or joking about suicide
- Preparing for death
- Changes in personality
- Loss of interest in appearance, drop in hygiene
- Risk-taking behaviour
- Excessive feelings of guilt
- Suddenly feeling better
- Writing poems, essays about death, SMS or painting images of death.
What causes a person to commit self-death?
It is very rare that someone dies by suicide because of one cause. Thus, there are usually several causes, and not just one, for suicide.
Some of the negative life experiences that may cause depression, and some other causes for depression, include:
- The death of a loved one.
- A divorce, separation, or breakup of a relationship.
- Losing custody of children, or feeling that a child custody decision is not fair.
- A serious loss, such as a loss of a job, house, or money.
- A serious or terminal illness.
- A serious accident.
- Chronic physical pain.
- Intense emotional pain.
- Loss of hope.
- Being victimized (domestic violence, rape, assault, etc).
- A loved one being victimized (child murder, child molestation, kidnapping, murder, rape, assault, etc.).
- Physical, verbal or sexual abuse.
- Unresolved abuse (of any kind) from the past.
- Feeling “trapped” in a situation perceived as negative.
- Feeling that things will never “get better.”
- Feeling helpless.
- Serious legal problems, such as criminal prosecution or incarceration.
- Feeling “taken advantage of.”
- Inability to deal with a perceived “humiliating” situation or perceived ”failure”.
- Alcohol and/or drug abuse.
- A feeling of not being accepted by family, friends, or society.
- A horrible disappointment.
- Feeling like one has not lived up to his or her high expectations or those of another.
- Bullying. (Adults, as well as children, can be bullied.)
- Low self-esteem.
Is it possible to determine the risk level of someone that feels suicidal?
”I am not as okay as I pretend to be.”
As a general rule, the level of danger suicidal people present to their own lives increases as they progress along with the steps towards suicide. A person’s risk goes up as he/she moves from:
LEVEL 1: thinking about suicide (e.g., suicidal ideation)
LEVEL 2: planning their suicide
LEVEL 3: collecting the necessary equipment
LEVEL 4: a suicide attempt
The earlier in this progression they can be identified and helped, the better.
Maybe a friend shows signs of suicidal behaviour and you are missing the signs. You might be the person who is supposed to save that someone’s life. Learn the signs by doing a self-test Quiz.
How to help a person who feels suicidal
If you have a friend who is showing signs of suicidal behaviour, don’t wait and hope it will get better or go away. Talk to the person about it. Talking helps in many ways. It allows you to get help for the person. Talking about it may help the person feel less alone and isolated. The person wants to know someone cares and understands. Talking may help them find a solution to the problem. It can be difficult to confront someone about this. Try:
“I’ve noticed that you’ve been talking a lot about wanting to be dead. Have you been having thoughts about injuring or killing yourself?”
Listen to the person without judging and offer reassurance that you are there and you care. Stay close and don’t leave the person alone.
Even if you’re sworn to secrecy and you feel like you’ll be betraying your friend if you tell, you should still seek help as soon as possible. It is always safest to get help. Suicide should not be a secret ever.
The following form can assist healthcare workers to determine the level of suicide risk:
Suicidal feelings and thoughts are part of depression. They are real and they won’t just go away. Depression is a real medical illness. You are not crazy if you are having these feelings and thoughts. No one will be ”disappointed” if you say how you feel when you suffer from depression and suicidal thoughts. Just like things can go wrong in your body, things can go wrong in your brain. You need medical help just like with any other illness.
Here are things you can do if you feel this way:
- Tell someone right away. A parent, family member, friend or a National helpline.
- Make sure you are not alone.
- Don’t use alcohol or drugs to numb what you are feeling.
- Ask your family to lock away stuff that you can use to hurt you – guns, knives, ropes, pills.
- Keep pictures of your favourite people with you.
- Spend time with your family or friends. Even though you want to be alone – withdrawing and isolating yourself is not a good idea.
² Suicidal thoughts | NZDF Health. http://health.nzdf.mil.nz/mind/worried-about-how-i-think-or-feel/suicidal-thoughts/