Helping to Prevent Suicide

Every 40 seconds, someone attempts suicide. Every 17 minutes, someone succeeds. Over 400,000 failed attempts a year end up with serious injuries. In most cases, the person who commits suicide has tried before and made numerous attempts to reach out to others. Ninety percent of suicides are associated with mental illness, such as depression. And 50% of suicides are associated with alcohol or drug use.

Signs of Suicidal Thinking

A suicidal person may talk of self-destructive behavior: “Maybe I should just jump from that roof.” or “My family would be better off without me.” There may be sudden interest in firearms or poisons. They may write poetry about death or listen to music about suicide. If your friend or loved one is on medication, you may notice conspicuous overuse that could be lethal.

Other Warning Signs

Abuse of alcohol or drugs combined with depression, dramatic mood swings, statements of hopelessness, acting withdrawn from others, uncontrollable rage, a desire for revenge, or blatant recklessness represents emotional states of persons who have committed suicide or made serious attempts. Feeling trapped and having a high level of cynicism toward others or the employer are other risk factors associated with persons who have committed suicide in business and industry.

What Are They Feeling?

Many people have thoughts about suicide, but most will never make an attempt. Those that do make attempts may frequently focus on unresolved life problems. This can offer clues to their desperation. They may focus on unstoppable pain and say how there is no way out.

They may not be to able sleep, eat, or work. They may experience profound depression and the inability to make sadness go away. They may not see themselves as worthwhile, or be unable to get someone’s attention whom they value.

Who’s at Risk?

Those at greatest risk of suicide have often experienced a disruptive life event such as the following:

Loss of a loved one

• Divorce, separation, loss of child custody
• Serious or terminal illness
• Serious accident
• Violence: rape, assault, kidnapping
• Verbal, emotional, or sexual abuse
• Chronic illness
• Feeling that things will never get better
• Alcohol or drug abuse
• Ongoing bullying

Do’s and Don’ts

• Do take suicidal comments seriously.
• Do respond to suicidal statements.
• Don’t act shocked or panicked.
• Don’t say, “Oh, you don't mean that.”
• Do ask what means are of killing oneself are being considered.
• Don’t intervene alone.
• Do encourage the person to seek professional help. Help find resources.
• Do offer to take the person to get help.
• Do get rid of any lethal means of committing suicide: guns, poison, etc.

Don’t Wait...Act

When a person makes a decision to commit suicide, they may suddenly become calm. Their decision provides relief because the suicidal person has found a “solution” to their problems. Do not ignore this state of calm or apparent wellness. The suicidal person may create a checklist of “to-dos” or give away belongings. If you think a friend or loved one is planning suicide, ask. Don’t let your fear of the answer inhibit you from asking this question. Most people considering suicide will talk about it. If necessary, act to get emergency help from the police so they can intervene. You may have to contact the police over the suicidal person’s objection. But if the suicidal act is imminent, delay will only make the risk of suicide more likely.

Act Fast Resources

If you need immediate help for yourself or a loved one, call 911, 1-800-SUICIDE or

1-800-273-TALK. Other resources include your employee assistance program, www.suicide.org, www.afsp.com (American Society for Suicide Prevention), or www.suicide.org,

Effect on Others

Each suicide affects many other people. Blame and guilt are common, and so are shock and denial. Some may get angry with the victim for making that choice. Loneliness and sorrow in those left behind can result in depression. Support groups are extremely helpful in healing traumatic wounds caused by suicide.

What the EAP Can Do

It has been said, “Suicide is not chosen, it happens when pain exceeds resources for coping with pain.” This is also a strong rationale for getting help from your employee assistance program. The EAP can help you find resources in the community to help you if you are depressed and suicidal or know someone who is.

PART 2: Helping a Friend Experiencing Suicidal Ideation

Suicidal ideation refers to persistent thoughts about suicide. If you're wondering if you should be concerned if someone you know has these thought patterns, the answer is yes. Persistent suicidal thoughts are either severe enough to warrant mental health intervention now, or with intent or planning, they could lead to a medical emergency.

There are two different kinds of suicidal ideation:

Passive suicidal ideation can quickly turn to active ideation, and it isn’t necessarily less serious than active suicidal ideation. The type of suicidal thoughts and the degree of severity can vary between individuals and change over time. Anytime a friend or loved one admits to thinking about suicide, it’s essential to help them feel safe.

According to the CDC, someone dies by suicide every 15 minutes in the United States—and the number of people who think about suicide is even greater. You don’t have to feel helpless if a loved one is showing signs of suicidal thoughts. You can help a friend who is experiencing suicidal ideation. You can make a positive difference. Understand the common symptoms and learn the best strategies for giving them the help they need so you can be an ally.

What do you need to know so you can help? The American Association of Suicidology recommends memorizing this acronym for learning the warning signs of suicide: “I.S. P.A.T.H. W.A.R.M.?” This refers to Ideation, Substance Abuse, Purposelessness, Anxiety, feeling Trapped, Hopelessness, Withdrawal, Anger, Recklessness, and Mood Changes.

Understanding IS PATH WARM Warning Signs

Ideation refers to the idea of killing oneself or a sudden obsession with death. If someone who isn’t normally preoccupied with death starts expressing morbid thoughts or talking about suicide, they may be experiencing suicidal ideation.

Substance abuse is often linked to other symptoms of suicide, such as withdrawal, anger, and anxiety. People often turn to drugs or alcohol as a way to cope, which means they aren’t able to cope with life on their own.

If someone says or acts as if they don’t have a reason for living, they may be experiencing purposelessness.

Sleeping too much, trouble sleeping, and unexplainable health issues, such as headaches and digestive problems, can all point to anxiety.

When an individual feels trapped in a job, a relationship, or a way of life that they don’t want to be in, they may turn to suicide as the only way out.

Hopelessness can be overwhelming. If you notice a friend or loved one lose interest in activities they used to enjoy or if they act as if they feel powerless in their life, they may have lost hope.

Withdrawal is when someone stops engaging with their support network. They may not want to go out. They’ll talk on the phone and text less and engage less in social media.

Another sign is anger or rage. They may express anger at the outside world or themselves.

Risky behavior, drug use, and a disregard for one’s welfare are signs of recklessness.

When someone experiences unusual changes in their mood, they could be experiencing emotions that are out of their control. Many types of mood changes or personality changes can indicate suicidal ideation – it’s not just a change from happy to sad. People who are thinking of suicide can become overly excited, agitated, or even eerily calm.

Additional Warning Signs of Suicidal Ideation

Additional warning signs of “acute risk” of suicide include a person threatening to kill himself or herself, or even talking about wanting to hurt or kill themselves. If they are seeking access to firearms or other means of killing themselves, or even talking or writing about death and suicide when this behavior is not usual for them, it is crucial to seek help. These types of ideation are called “expressed” or “communicated” ideation.

The American Association of Suicidology recommends calling a mental health professional at 1-800-273-TALK (8255) if you observe someone exhibiting any of these behaviors. Understanding the common signs and symptoms thoroughly—as well as what to do when you encounter these signs—could ultimately save someone’s life.

Suicide Rates in the United States

It’s easy to overlook or dismiss the warning signs and symptoms of suicidal ideation. You may think it’s not that bad. However, suicide and suicide attempts are very real. When you look at the statistics, you can understand why it is worth it to take action if you think someone you know is reaching out for help.

According to the CDC, suicide is the tent^h leading cause of death for people ten years and older. More than 48,000 people died in the US in 2018 because of suicide. This is an average of one death every 11 minutes. 1.4 million Americans attempted suicide in 2018.

The number of people who think about suicide is much higher. Between 2008 and 2009, 8.3 million adults reported having suicidal thoughts, which was 3.7% of the adult population. 1% of the adult population, or 2.2 million adults, reported making plans for suicide within the past year during that period. In 2018, 10.7 million seriously thought about suicide and 3.3 million went as far as making a plan. ,

(I updated these stats to the more recent ones https://www.cdc.gov/violenceprevention/suicide/fa...

The statistics also show that men commit suicide at a much higher rate than women. In 2018, men died by suicide 3.56 times more often than women, and white men accounted for nearly 70% of suicide deaths. The demographic with the highest suicide rate is middle-aged white men. While older adults are more likely to commit suicide, young adults are impacted as well. In 2018, the suicide rate for young adults aged 15 to 24 was 14.45 per 100,000.

(https://afsp.org/suicide-statistics/)

All of these data show that suicide is a very real threat, and we shouldn’t ignore warning signs. Recognizing the signs of suicidal ideation and taking them seriously can save a life.

Helping Teens Who Are at Risk

Suicide is the second leading cause of death for 10- to 24-year-olds in the US. The reality is, teens and young adults face a variety of challenges, but they may not have had the chance to develop coping skills that many adults have already developed. Every day, over 3,000 teens in grades 9 through 12 attempt to take their life. This is an alarming statistic, but it is possible to bring these numbers down through suicide prevention efforts.

(http://prp.jasonfoundation.com/facts/youth-suicide-statistics/)

What Are the Warning Signs for Teens?

The warning signs of suicide for teens are similar to the symptoms of depression:

If you notice these signs in your child or a friend, take action to make sure they are ok.

(https://www.hopkinsmedicine.org/health/conditions-and-diseases/teen-suicide)

Offering emotional support and empathy can make a positive difference for a teen who is thinking about ending their life. One survey of teens and young adults who attempted suicide found that most teens prefer to talk to a friend or family member when they are depressed and want help. After face-to-face communication, they’ll turn to texting, phone calls, instant messaging, or posting on social media over talking to a healthcare provider or calling a suicide prevention hotline.

(source: the consider a text for teen suicide doc)

How Teens Can Help Their Friends

How Parents Can Help Prevent Suicide

Teens who have attempted suicide before have said there isn’t one specific reason that compelled them to try and take their life. It’s more a state of despair that develops rather than one trigger event. These young people have also indicated that not having a way to express or communicate their emotions is one of the biggest drivers of these developing emotions. Teaching adolescents and teens better problem-solving skills and providing channels for expressing emotions are two prevention strategies that can help.

(source: the provided teens no hotlines pdf)

Resources for Preventing Teen Suicide

Talk to your teen or your friend about mobile apps for teen suicide prevention. You can also download them on your smartphone. Apps such as A Friend Asks, MY3, Operation Reach Out, and HELP Prevent Suicide are useful resources. They offer prevention strategy plans, tips for friends and family, and easy access to prevention hotlines, support groups, and community support.

Risk Factors: An Important Variable to Understand

In addition to knowing how to recognize the warning signs of suicide, it’s also important to understand what the risk factors are. If someone you know has experienced or is currently facing any of these risk factors, they could be more at risk for suicidal ideation.

Know these risk factors. Being aware of them could help save someone’s life.

Protecting Your Friend: What Are the Best Suicide Prevention Strategies?

If you believe your friend is thinking of suicide, you can help.

Step one, seek expert help. If you aren’t a professional, you don’t have the expertise or training necessary to deal with someone who is experiencing suicidal ideation. Instead of trying to handle the situation alone, get help. Seek the appropriate resources to make sure you’re approaching the situation in the best way possible.

If there is an immediate threat of suicide, you can call 911. If the threat isn't imminent, you can start by referring him or her to an expert, encouraging them to talk to their doctor or mental health professional, or offering to go with them to a suicide support group.

Giving them the number of the National Suicide Prevention Lifeline (1-800-273-8255) is another way to encourage them to speak to someone experienced in dealing with suicidal ideation.

The Mayo Clinic recommends that if you encounter someone who is in immediate need of help, that you shouldn’t leave them alone. Instead, stay with them and consult the proper authorities—call 911 if it’s an emergency. You can even take your friend to a hospital emergency room yourself if you want to make sure they get the treatment they need.

If possible, find out if your friend has taken any drugs or alcohol—or both. And be sure to alert any of their family as to what is going on.

Suicide Prevention

When there appears to be no imminent threat to suicide, but you are concerned about your friend, you can still help. Offering them your support as they take steps toward treatment can be invaluable to someone who feels like they’re alone in the world. Encouraging them to communicate with you will also help them not only to feel better about their bottled-up feelings but can also help you figure out how much help your friend really needs.

If you suspect suicidal ideation in a friend but aren’t sure if you should take action, the Mayo Clinic recommends first asking them a series of direct questions such as “Do you ever feel like just giving up?” and “Are you thinking about dying?” These pointed questions can be difficult to ask, but coupled with the warning signs you learned above, they can be a way to determine whether you should take action.

It’s important that during this process, you aren't judgmental. Platitudes such as “you have everything to live for” often do not help. In fact, they may make your friend feel more isolated because they think you can’t understand what they’re going through. Instead, be sure that you’re open, direct, caring, and honest—and as part of that honesty, do not promise to keep their suicidal ideation a secret. You may have to share the information about their ideation with a professional if you want your friend to get the proper treatment.

Most importantly, take suicidal behavior and its associated warning signs as seriously as possible. There are too many suicides nationwide to act as if there is no real threat to your friend. In the long run, you won’t regret stepping in to help. Your help may be the difference that makes all the difference in the world.

PART 3

When There Are Thoughts of Suicide

You are not alone. You are not broken. People love you, and there is hope.

If you’ve ever had thoughts of suicide, know that you are not alone—according to the Centers for Disease Control, 3.7% of U.S. adults have suicidal thoughts in a given year.

Second, you aren’t broken. Suicidal thoughts occur when you have more pain than you can cope with. Thinking about suicide doesn’t mean you have a character flaw; that you’re weak-willed or crazy. Suicidal thoughts happen to all kinds of people, of all ages, gender, and background.

Third, there is help, and there is hope. No matter how overwhelmed you feel right now, there are people who care about you and know how to help you recover. You will get better.

If you’re thinking about hurting yourself right now:

Follow these four steps:

1.Promise yourself not to do anything to harm yourself in the next 24 hours. No matter how hopeless or overwhelmed you feel, remember that suicidal feelings are NOT permanent. You WILL get better. Give yourself a chance to get to a better mental state before doing something you can never take back.

2.Avoid drugs and alcohol. If you’re currently under the influence, stop right now.

3.Make your surroundings safe. Hide, destroy, or get rid of potentially dangerous objects like firearms, knives, and medication.

4.Call someone and talk. Whether it’s a trusted friend or a professional, don’t stop talking until your suicidal thoughts have passed. Dial either of these numbers, and someone will be there to help you:

1-800-SUICIDE (1-800-784-2433)

1-800-273-TALK (1-800-273-8255)

If you feel like you can’t talk things out, dial 911 and ask for someone to take you to the emergency room. Stay on the phone until they arrive.

Suicidal thoughts are a crisis point, and they will pass. You don't have to analyze your feelings in this state. All you have to do is reach out for help.

What causes my suicidal thoughts?

Thoughts of suicide can be triggered by one or more factors. Sometimes these factors work in combination with one another to trigger a suicidal response.

Why professional help is critical

It’s hard to see things clearly when you’re in pain, and multiple factors may be contributing to your mental state. Do not try to self-diagnose. A qualified professional has the necessary training to help you get well.

If you don’t know where to start, there are several options.

1.Tell your family doctor what’s going on and ask for a referral.

2.Confide in a trusted friend and ask for help.

3.Use the resources provided by your company’s Employee Assistance Program. If you don’t know how, ask your HR representative. Your inquiry will be held in confidence.

Don’t let embarrassment, cost or inconvenience stop you from seeking out the help you need. Nothing is more important or valuable than your life, your happiness, and your well-being. Take action today and worry about the details later—things will work out.

“Tell” to get well

One of the hardest things about seeking help when you’re feeling suicidal is telling another person what’s going on. For your own long-term safety and wellness, it’s important that you seek out one or more trusted friends and family members and let them know what’s going on—your thoughts, your struggles, and what, if any, suicidal plans you’ve made.

Be honest and upfront about your situation. Vague statements can be misinterpreted. Specifics are what will allow those who love you to help you the most. If you find some things are too hard to say, write them down. It’s ok. There’s no wrong way to let others know what’s happening.

Managing your triggers

While you can’t always control your suicidal thoughts, you can limit how often they occur and their impact on you.

First, identify your triggers. Only you know which situations or thoughts are most likely to send you into a downward spiral. Some people find themselves getting depressed during the holidays. For others, it can fatigue, job stress, or having too much to drink.

Next, find ways to eliminate, limit, or cope with your triggers. Here are some tips to help you:

Develop an emergency plan. Make a promise to the most trusted and supportive people in your life that you will call them immediately before taking any harmful action when you have suicidal thoughts. Have a list of suicide prevention numbers you can call readily available. Include your doctor and any mental health professionals you’re seeing.

Don’t dwell on despairing thoughts. Break the negative feedback loop that leads to feelings of hopelessness by quickly shifting to a distracting thought or activity. Plan these ahead of time—whether it’s a book, a physical activity, or something else. Know exactly what you’re going to use to help distract you ahead of time.

Schedule weekly activities that get you out of the house and in contact with other people. Isolation is a common trigger for suicidal thoughts.

Let your family and friends know about events that trigger depression and ask them to be on alert and available for you during these times.

Exercise and stay as physically active as you can. Even 20 minutes of moderate exercise per day can make a positive difference in your mental state.

Keep doing the things you love. Everyone has things in their lives that bring them joy. Give them top priority, and don’t let them go.