Suicide can have a devastating effect, yet is rarely discussed. Here's some basic information.
Given that depression is the highest risk factor of suicide, once a person starts receiving treatment for depression they are immediately at a lower risk of suicide.
The risk of suicide is actually higher once a person's mood begins to lift. This is because a person suffering from major depression can be very lethargic, and although they may desire to die, they simply do not have the energy to attempt to harm themselves. Once treatment is commenced, they may find they have more energy, though as they are not yet properly treated for depression, their outlook on the future remains hopeless.
Which of the following is NOT an early warning sign that a person may be intending suicide?
Usually, a person planning to commit suicide displays some warning signs. Unfortunately, it is often only in hindsight that these are recognized.
There are many behaviors that could suggest a person may be contemplating suicide. Some of most common include; changes to eating habits, sleep pattern, personal hygiene or drug use; risk-taking behaviour; expressing thoughts of hopelessness, helplessness or despair; feelings of guilt, failure or shame; an increased interest in suicide or death; making arrangements for loved ones or pets; or having suffered a recent bereavement or other loss (e.g. job or relationship). It is crucial that anybody experiencing any of these symptoms receive help immediately.
What does CBT stand for?
Suicidal thoughts are often a symptom of depression. CBT, used in conjunction with medication, has been proven effective in treating depression.
Cognitive behavioural therapy (CBT) is a form of psychotherapy for people affected by mental illness. CBT involves a qualified health professional talking to the person about their symptoms, and working on alternative ways of thinking about and coping with them and their effects.
Suicide only affects individuals with a mental health condition
Many individuals with mental illness are not affected by suicidal thoughts and not all people who attempt or die by suicide have mental illness. Relationship problems and other life stressors such as criminal/legal matters, persecution, eviction/loss of home, death of a loved one, a devastating or debilitating illness, trauma, sexual abuse, rejection, and recent or impending crises are also associated with suicidal thoughts and attempts.
Once you have established that a person is suicidal, what is the next important thing to ask?
Often, people don't want to ask a loved one if he or she is thinking of suicide as they are afraid they will "put the idea in their head". This is not the case and is an important question to ask.
While a person with vague suicidal thoughts is at a high risk of committing suicide, a person with an actual plan of HOW they will commit suicide is at extreme and imminent risk. This is especially true if the method is easily available and they have set a time. This does not mean that a person without any well thought out plan will not attempt suicide, and indeed a person with only passive suicidal ideation (e.g. I wish I would just die in my sleep) is still at risk of suicide and in need of immediate professional attention.
A suicide contract can be a verbal agreement, but more commonly is a written contract signed by the person at risk of suicide. The contract will obviously include a clause not to harm themselves, but what else should be included in the contract?
Never used on its own, a suicide contract is a tool that can be utilized in the long term management of a person with suicidality.
A suicide contract is NOT a guarantee that a person will not commit suicide, and is always used in conjunction with counseling and/or medication. While a medical practitioner may use a suicide contract, its effectiveness in preventing suicide has not been clinically proven. A suicide contract can, however, be useful in establishing rapport and trust between the clinician and client. If it is decided that a suicide contract would be useful, then the contract should be as simple as possible, including a guarantee not to suicide and who to contact if the person is feeling suicidal. The contract should be kept in an easily accessible area in the home.
Along with grief, family and friends may feel stigmatized and isolated after a suicide death. What would be a helpful response to a person in this situation?
Just being available to listen is the most important thing you can do. Suicide usually comes as a shock as the death is not expected, and the survivors need time to grieve. There still remains a social stigma attached to suicide that family members may have to deal with. Offering practical support such as shopping or cooking and finding information on support groups is another way you can help. Remember suicide is preventable. If you're having suicidal thoughts or you know someone who is, please, contact us @mentallyawareng on Social media or reach us on our suicide helplines: 08091116264; 08091196264.
OK, you have established that your friend is suicidal. Under what circumstances would it be safe to leave them alone?
A person who is actively suicidal should not be left alone at all. Even the average bedroom contains items such as sheets, electrical cords, belts and shoelaces that can be used in an attempted hanging. If you are unable to stay with them, arrange for another trusted person to be with them or take them to where they can see a mental health professional. A sudden change in mood from depressed to happy or at ease is a warning sign for suicide. Often once a person makes the decision to suicide, they feel relieved as their perceived problems will soon be over.
What should you NOT do if a person tells you they are having suicidal thoughts?
A person with suicidal thoughts often believes that he or she is beyond help. You are not violating a privileged communication by talking to a mental health professional in order to ensure they receive the help they need. All suicide threats should be taken seriously. Although it can be difficult, it is important not to judge the person and to discuss the topic freely without showing shock or disapproval.
A person's risk of suicide is increased if he or she attempted suicide in the past.
Past suicide attempts are one of the major risk factors of suicide, and recent attempts are of particular importance. This is one of the first questions a mental health professional will ask when assessing a person's suicide risk. Having a family member who has committed suicide is also a risk factor.