Never in all my practicing have I seen such a high rate of persons who are being affected by suicide. Thankfully, awareness is growing and there is a strong movement in place to recognize the signs when someone is considering ending their life, and to prevent that most final of tragedies. But do you know what to look for in those that are struggling? And, do you know what steps to take when you learn a loved one is suicidal? Read on to learn more about preventing suicide in your loved-one.
Common Pre-Cursors to Suicidality
Long-Lasting and Severe Depressive Episode
Loved ones that are experiencing depressive episodes of two weeks or longer that include multiple symptoms of decreased functioning, low mood, and sleep/appetite disturbance should be monitored closely. When in an episode like this, your loved one may seem “not like his/herself.” He/she may be irritable, isolative, teary, detached, or even just absent. You may notice them having trouble concentrating and sleeping, or you may notice they are sleeping much more than normal for them. Often times, motivation to be hygienic (e.g., daily shower, grooming, etc.) is low to non-existent. Depressed persons may talk about feeling burdensome to others, hopeless about the future, and may express inappropriate guilt.
Manic Episodes, Co-Occurring Substance Use, and Problem Gambling
Deep depression is not the only mental state that can lead to suicidal thoughts and actions. Suicide is often common during the ending stages of manic episodes as well as with persons who are struggling with addictions. According to SAMHSA, of the 20.2 million American adults who struggled with some form of mental illness in the last year, 7.9 million of those also experienced a substance use disorder. Additionally, those who have turned to gambling in efforts to escape or distract themselves from their pain are also highly at-risk for suicide when at their lowest points.
There are many other things that are commonly precursors to suicide, such as experiencing trauma (any kind, be it Military/combat-related or not), losing someone very close, experiencing suicide within one’s family and/or peer group, experiencing financial catastrophes, and much more.
What to Do
First and foremost, DO ask your loved one, and ask them in a very clear way, if they are thinking of suicide. It is a myth that bringing up suicide with a person is going to “put the idea in their head.” If a person is considering ending their life, they will have been thinking of this before you bring it up with them. Second, and almost as important, when you ask if they are suicidal, make sure that you do not frame the question like this, “You aren’t thinking of suicide, are you?” It is hard enough to admit suicidality without having to deal with the judgment this sentence implies. Ask it clearly, like this: “Are you thinking of killing yourself?” Or, “Have you been considering suicide?” Trust me, it will likely be an enormous relief for your loved one to be able to admit where they are. Additionally, in asking them this most serious of questions in a clear and concise way, they are hearing that you care about them and that you are an ally. This produces a good foundation for you and your loved one to move forward from, in getting him or her the help they need.
Once you know your loved one has been considering suicide, it is time to involve the professionals. The person should be evaluated by a mental health professional, and this is often done at your nearest Emergency Room. If your loved-one already sees a therapist, psychiatrist, or other mental health provider, those persons should be alerted and a same-day appointment made if possible. If the professionals feel that your loved one requires the safety and security of a short inpatient hospital stay, they will recommend that to you and your loved one. However, there are other ways that the same goals can be met (ensuring the person’s safety) without the hospital stay. Whatever you and your loved-one decide to do, make sure you do it with compassion, acceptance, and kindness. Try to reserve your own painful emotions until the person has been cared for—they will likely be very sensitive to causing you pain and added guilt is not good in an already bad situation. If your loved-one does not wish to receive evaluation and treatment (and they are not a minor), there are a few isolated circumstances where your loved-one can be court-ordered to undergo a short period of evaluation and treatment.
Suicide and mental health are delicate and complicated subjects. If you have questions about any part of what you’ve read or what you are experiencing, please seek out help from someone who knows more. Your family doctor or GP, your pharmacist, your preacher or chaplain, your social worker friend or the nurse next door…any of these resources are a good place to start if you are unsure how to proceed. Other resources include calling 911, the 24/7 Free Suicide Prevention Hotline at 1-800-273-TALK, or even the Prevention Text Line—text “home” to 741-741. And lastly, if YOU are the one who has been thinking of ending your life, please reach out to any of the above resources, if you don’t feel you can talk to your friends or family. People DO care about you—give us a chance to show you.
It is also extremely important that you follow-up with your loved-one, following their treatment or other intervention. Check-in with them on how they are doing, and spend time with them if you can. Encourage them to get into therapy with a person they “click with,” as often times the real “life-changing” work is done in the therapy office—not in a hospital. In therapy, your loved-one will learn skills on how to better regulate his or her emotions and how to cope with them in a healthy way. If your loved one feels they are ready to start this journey, I would be honored to walk beside them on this path. If it is you that is need, call me today.