How To Practice Suicide Prevention

Suicide is a devastating consequence of depression that has not been successfully treated. 95% of all suicides happen at the peak of a depressive episode. If someone's underlying depression is recognized, addressed and successfully treated, his suicide can be prevented.  In fact, many suicide attempts themselves are desperate cries for help.  Here are a few tips on how to practice suicide prevention:

  1. Know the warning signs.  Most people exhibit warning signs before a suicide attempt.  These may include:
    • Depression
    • Persistent feelings of sadness or emptiness
    • Feelings of worthlessness
    • Hopelessness and helplessness
    • Panic and anxiety
    • Irritability and anger
    • Moodiness that is out of character
    • Feelings of guilt and/or shame

  2. Recognize behavioral changes.  Certain changes in behavior can indicate that someone is considering suicide.  These behavioral clues include:
    • Giving away prized possessions
    • Increases or decreases in sleep
    • Impulsive or dangerous behavior
    • Increase in alcohol or drug use
    • Hurting oneself through cutting, burning or other injurious behavior
    • Deteriorating self-care (i.e. grooming habits, appearance)
    • Isolating oneself from family or friends
    • Losing interest in things that normally bring joy
    • Getting one's affairs in order  (i.e. preparing a will, preparing for the care of pets, etc.)
    • Verbalizing a suicide plan or a preoccupation with death
    • Sudden euphoria or happiness
    • Purchasing a weapon or other means of self-destruction
    • Significant agitation that can manifest as anger or mania

  3. Contributing factors.  Certain experiences in someone's personal history contribute to the likelihood that he may be considering suicide.  These experiences include:
    • Death of a significant other
    • Divorce, separation or other broken relationship
    • Loss of job, status, money or respect
    • Loss of physical health
    • Rejection (by peers, institutions or authority figures)
    • Anniversary of a significant loss
    • Beginning an anti-depressant or increasing or decreasing anti-depressant dosages

  4. How to talk to someone who is suicidal.
    • Show your interest, support and availability.  Due to the stigma attached to mental illness, many suicidal people are reluctant to discuss their mental health, including depression and suicidal ideation (the medical term for thoughts about suicide).  By showing your interest in your friend's state of mind, and your availability to hear him out, you demonstrate your support.
    • Don't judge.  You won't be able to convince a suicidal person of anything (such as the value of life), so don't even try.  The person is immersed in unbearable pain that is preventing him from seeing clearly.  Be empathetic to his pain:  No lectures allowed.
    • Ask if he is thinking about suicide.  Don't act shocked:  Be direct and talk freely about the possibility that your friend may be considering suicide.  Some people believe that discussing suicide can plant the idea in someone else's mind; this is not the case.  If your friend admits to having thoughts of suicide, try to find out how seriously he has considered it.  Is there an actual plan or are the thoughts more vague?  The more detailed and concrete a plan, the more likely he will execute that plan. 
    • Listen. Don't try to solve or give advice.  You won't be able to change the person's point of view, but you will be able to give him the experience of being cared for.  Use your voice and body language to show your concern.  Being able to share his feelings with another person will relieve your friend's sense of isolation.
    • No secrets.  Don't agree to be sworn to secrecy.  If your friend is suicidal, then both you and your friend will need help handling the tensions and responsibilities of suicide prevention.  

  5. Take action.  If someone has indicated to you that he is suicidal, you will need to get both short-term and long-term help.  Remember that the sufferer is in a state of severe pain that feels unbearable.  It is part of the nature of an intense depressive episode to believe that the immediate pain will not end. 
    • Short-term strategy  If you feel that a suicide attempt is imminent, do not leave the person alone.   You may need to call 911 or take your friend to the emergency room of a hospital with psychiatric doctors.  Once there, be sure that your concerns are heard by someone who is a properly trained mental health professional.
    • Long-term strategy  Once the imminent danger has passed, a long-term strategy needs to be implemented.  Long-term strategies will require addressing depression or any other mental or physical health issues that affect the sufferer.  If you are in a position of knowing about someone's inclination to commit suicide, then you are in a position to help.  Although you may wonder if another person is not more appropriate, put those thoughts aside and focus on what you can do to help. 

      Many times a suicidal person is so emotionally depleted that he has neither the energy nor the ability to take the steps necessary to seek other help or treatment.  You will need to help find an appropriate doctor or mental health professional; make sure that this is someone who has experience in dealing with suicidal patients and who is available for phone contact in the case of an emergency.  You may need to make the initial phone call to set up an appointment time yourself or verify that your friend has indeed made an appointment and then accompany your friend to his first appointment. 

    Remember that suicide is preventable.  While depression itself is a long-term problem, a suicide crisis is usually a short-term issue.   Imagine being in the position where you might have been able to help but chose not to.  Your emotional presence may be the last tie holding someone to this earth; use it well.


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