Suicide: Know the Signs and What To Do

Suicide is a rapidly growing public health crisis: But by learning about it and reducing its stigma, you can help save lives

September 10, 2021

Suicide is among the leading causes of death in the United States and it is actively becoming more common among particular groups. Because of this, it is important to have a discussion about why people take their lives and how to prevent suicide.

There is a dire need for education around suicidal thoughts and behaviors, with an emphasis on teaching people to recognize the signs as early as possible.

The truth is that everyone deserves to know that their life matters and that help is available.

By definition, suicide is caused by self-harming behavior with an intent to die. Attempted suicide is a self-directed, intentional behavior with an attempt to die that does not result in death.

When people talk about “suicidal ideation,” this refers to thoughts of suicide. Some people may have thought about or devised a plan to kill themselves yet have not acted on it.

To put suicide’s impact into perspective, it leads to twice as many deaths every year as homicide.

Four people die by suicide every hour in the U.S.

Suicide isn’t just an adult concern: children struggle with suicidal thoughts and actions as well. Close to 8% of high school students report having attempted suicide at least once during the preceding year.

Dispelling Myths About Suicide

Though there has been progress around encouraging people to openly discuss suicide, there is still a lot of work to be done. Some of the most common misconceptions that surround suicide include:

Myth: People Talk About Suicide but They Likely Won’t Act on It

If someone is talking about suicide, it is a sign that they potentially need help. You should use this as an opportunity to ask them how they are feeling and ensure that they are safe.

Myth: People Who Kill Themselves Must Be Crazy

First, there are some people who accidentally take their own lives. Second, not everyone who dies by suicide has a diagnosed mental health condition. People take their lives for many reasons, including because they are overcome with grief, are in a state of despair, are experiencing intense emotional pain, or are struggling with undiagnosed mental illness.

Myth: People Kill Themselves Because They Do Not Want To Seek Help

The overwhelming majority of people who die by suicide seek help before attempting or completing this action. More than half of all victims of suicide sought medical care during the months prior to their death.

Myth: We Shouldn’t Talk About Suicide Because We Will Put the Idea Into People’s Heads

Talking about suicide doesn’t make people more likely to take their lives. The reverse is true. By talking honestly about issues that lead to suicide, it is possible to convince people to get the help they need.

In Her Own Words

Deconstructing Stigma participants Jessika

Jessika has worked tirelessly in the field of suicide prevention—urging those who are desperate to step forward and seek help. What she never told anyone until recently was that she, too, tried to end it all when she was just 17.

Read more about Jessika and her mental health story.

Deconstructing Stigma participants Jessika

Changing Our Current Thinking About Suicide

To reduce suicide rates, it is important to change the way we talk about those affected by suicide.

Sadly, there is a stigma related to suicide, and the people impacted by this stigma include friends and family of those who have died as well as those who have survived a suicide attempt. The causes of this type of stigma often include misunderstanding, fear, and ignorance.

Society can view those who attempt or complete suicide as “not normal” and therefore apply this view onto the survivors. Avoidance, shaming, stereotyping, and distrust toward those affected by suicide only help to reinforce the idea that they are different, even though suicide can affect any family at any time.

So what can be done to dispel stigma? The following are some of the ways we can reduce the stigma surrounding suicide:

1. Inform Everyone That Suicide Is Complex

It is usually caused by multiple factors. There is often no single cause of suicide.

2. Be Aware That People With Suicidal Thoughts Don’t Always Go On To Take Their Lives

Many people do not realize just how common suicidal ideation is. They are only aware of completed suicide attempts.

3. Let Everyone Know Support Is Available

If people understand that mental health resources exist, the stigma surrounding suicide and suicidal ideation will begin to fade.

4. Be Honest and Upfront About the Grieving Process for People Who Died by Suicide

It’s important that people understand the severe impacts of suicide loss on survivors, including dealing with a sudden loss and the questions that are often left unanswered.

5. Use Nonjudgmental Language When Discussing Suicide

If we change the language we use to discuss suicide, we can also shift thoughts about suicidal behavior.

If you are suicidal or are a danger to yourself or others, please call 911 or visit your nearest emergency room immediately.

Understanding the Risk Factors of Suicidal Behavior

It is possible to identify people who are at greater risk of attempting suicide, with some of the most important risk factors being:

Mental Health Issues

People who have been diagnosed with a mental health disorder are at a greater risk of completing suicide. For example, people who have depression or anxiety are more likely to have suicidal thoughts, attempt suicide, and complete suicide.

History of Abuse

People who suffered abuse in the past, or who are currently experiencing abuse, are at a greater risk of suicidal behavior. This includes emotional, physical, and sexual abuse.

Family History of Suicide

People who have a family history of mental health issues are at a greater risk of developing these conditions themselves. This includes suicidal behavior. Those who have family members who attempted or completed suicide are at a greater risk of attempting or completing suicide themselves.

Substance Use Disorders

Substance addiction and other mental health issues often go hand in hand. People with a history of substance misuse are also at a greater risk of suicide.

The Legal System

People who are involved in the legal system, particularly those who are incarcerated, are at a greater risk of attempting suicide.

Marginalized Communities

Members of marginalized communities are also at a greater risk of attempting and completing suicide. For example, those of Native American descent and members of the LGBTQ+ community are at an increased risk of suicidal behavior.

Armed Forces

Members of the armed forces, including veterans, are at a greater risk of suicide. Factors include exposure to combat leading to PTSD, difficulties adjusting to civilian life, and strained relationships with family members and friends.

Bereavement

People who have recently lost a loved one are also at a greater risk of suicidal ideation and behavior. People can become overwhelmed with grief in a short amount of time, leading to unhealthy ways of coping.

Chronic Medical Conditions

People of all ages who have been diagnosed with chronic medical conditions are at a greater risk of attempting suicide.

Prior History of Suicide Attempts

People who have attempted suicide in the past are at a greater risk of attempting suicide again. Unfortunately, some people who complete suicide have tried and failed several times in the past. Anyone who has attempted suicide deserves access to immediate medical assistance.

This is not an exhaustive list, but it shines a light on some of the many risk factors that play a role in suicidal behavior. It is critical to identify people who are at a higher risk of attempting and completing suicide. That way, they can receive the help they deserve.

Know the Signs and Symptoms of Suicidal Ideation

Research on suicidal ideation and behavior shows we must do a better job of connecting people to help. This starts with understanding what suicidal ideation and suicidal behavior look like.

So, who needs help?

First, the vast majority of people who attempt or complete suicide have given warning signs about their intentions. They are also often clear in their attempts to access help.

Anyone who believes that a friend or family member is considering suicide must help as soon as possible.

It can make a big difference to reach out and let someone know you are there. It is also possible to prevent suicide by being supportive and helping them to receive care.

A major warning sign is when someone talks about harming or killing themselves. For example, some people may write notes that mention dying. Other people may joke that they are planning to kill themselves. Some people may even buy weapons and drugs with the express purpose of taking their lives.

It is important to pay even closer attention to people who have been diagnosed with mental health issues. People who have alcohol dependence, depression, anxiety, or bipolar disorder are at higher risk.

Those with a family history of suicide are also at a greater risk of suicidal ideation.

Finally, people who have attempted suicide in the past are more likely than the average person to attempt suicide again in the future.

Other warning signs that are slightly less common, but are no less important, include:

  • Having a preoccupation with death, almost to the point of fascination
  • Saying goodbye in unusual ways, as if one will never see family or friends again
  • Withdrawing from family members and friends completely
  • Engaging in self-destructive behavior, such as reckless driving, taking unnecessary risks, and having unsafe sex (to a greater degree than before)
  • Statements of self-hatred or self-loathing
  • Getting affairs in order, such as making a will or giving away prized possessions
  • Sudden calmness after being distressed in the past

These are a few of the most common warning signs. If you notice anyone with these symptoms, help them seek the care of a mental health professional immediately.

Prevention Resources

2 people sitting down and holding hands.

Talking about suicide is the best way to prevent it. Find access to more resources, including 24-hour hotlines like those shared below.

2 people sitting down and holding hands.

So How Do We Prevent Suicide?

If someone is showing signs that they may be considering suicide, what is the next step? Often people are unsure if they should tell someone they are worried about them.

Many people are afraid to bring up suicide because they think it is awkward. They also do not want to put the idea in someone’s head.

While it may feel uncomfortable, it is very important to discuss suicide openly and without judgment.

The best way to find out if someone is thinking about attempting suicide is simple: ask. Remember that showing someone you care may help them openly express their feelings of loneliness or hopelessness.

Certain phrases can help start a conversation about suicide. Some examples include:

  • I’ve been concerned about you lately. Is it okay if we talk about this?
  • I wanted to check in with you. It seems you haven’t been yourself lately. You don’t seem to enjoy activities you previously enjoyed. Is it okay to talk about that?
  • I have noticed a bit of a personality shift in you recently. Is it okay if I ask you about it?
  • I understand you have been feeling alone recently. Know that whatever you are experiencing, you do not have to go through it alone. I am here for you. Is there something I can do to help?
  • I know it is hard to believe this now, but it will get better. Things will change. What do you have to look forward to?
  • Even if you feel like giving up, you do not have to. Remember that you can reach out to me for a helping hand. Is there something I can help you with?

Fact: there is no singular “best” way to help. The most important thing you can do is just to ask how someone is feeling or if they are thinking about hurting themselves.

If people are more comfortable talking about suicide, it is possible for them to get the help they need.

Helping a Loved One Who Is Struggling

What should you do if a loved one is thinking about harming themselves or taking their own life?

Do not argue with someone who is suicidal. Let them know that their feelings are valid. This is not about you. It’s about them.

Do not act shocked or let your emotions take over. It is common for people to be surprised when they hear someone is thinking about killing themselves because it is hard to put yourself in their shoes. Do everything you can to remain emotionally grounded.

Talking About Suicide Is the Best Way to Prevent It

Do not promise to keep their suicidal thoughts to yourself. Even though you want the other person to open up to you, you will have to tell someone else about what they are going through. That is the only way you can get them the help they need.

Do not promise to fix everything for them. Even a psychiatrist cannot singlehandedly help someone with their suicidal thoughts Remember that you will need to ask for help from other people.

Do not say you understand what the other person is going through. Unless you are having suicidal thoughts yourself, you cannot understand what they are experiencing.

Do not blame yourself. You are not responsible for someone else’s actions. Your loved one’s problems are much bigger than yourself.

While the list of things not to do can seem like a lot, there are easy ways to show your support as well.

Try to be yourself. Simply let the other person know that they do not have to go through this alone. If you cannot find the right words, start by saying that.

Make sure to listen. Make sure the other person knows that you are listening to what they have to say. No matter how heartbreaking it is to hear, they need you to listen.

Be nonjudgmental. Be aware of your body language and remain as open as you can. The other person is doing the right thing by telling you what they are experiencing.

Make sure the other person knows there is hope. Reassure them that help is available. Let them know that they have something to look forward to.

Take what they have to say seriously.

You should make sure the other person gets help. Calling a suicide hotline, taking them to an emergency room, or dialing 911 are all good starting points.

In an Immediate Crisis? Here’s How To De-Escalate It

What should you do if someone you know is saying they are going to kill themselves immediately? Get curious and ask questions. The more information you have, the more help can be provided.

  • Ask if they have a suicide plan
  • Ask if they have everything they need to kill themselves: If so, you know they have the means to end their life
  • Ask if they have a time during which they are going to carry this out; if they do, you need to act now
  • Ask if they know where they are going to do it; this could include another location, their house, or their workplace
  • Ask if they intend to do it
  • If you believe that a suicide attempt appears imminent, you should call 911; you can also call a local crisis center or take the person to the emergency room
  • If you are with the person, remove anything they could use to possibly kill themselves, including drugs, alcohol, knives, guns, over-the-counter medications, and even loose cords and strings

In addition to calling 911, several hotlines are available. These resources can help you before the ambulance arrives:

  • If you or someone you know is experiencing a crisis, call the toll-free National Suicide Prevention Lifeline at 800.273.TALK (8255), available 24 hours a day, 7 days a week; calls are confidential and the service is always available
  • Befrienders Worldwide provides helplines worldwide – befrienders.org
  • Trevor Project for LGBT youth in the U.S. – 866.4.U.Trevor or text START to 678-678
  • 24/7 Samaritans Hotline – 877.870.4673
  • Crisis Text Line – Text HELLO to 741-741 for free, 24-hour support

Do not leave the other person alone. Whether they are an elderly person, an adult, a teenager, or a child, they should not be left by themselves. This could save someone’s life.

With the help of people who care and trained professionals, individuals experiencing suicidal ideation can be helped.

McLean is here to help. Call us today at 617.855.3141 to find the mental health treatment option that’s right for you or a loved one.

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