Suicidal Ideation: The Red Flags and How You Can Help

(Also published in ‘Bonjour France Magazine’ July, 2017)

PLEASE NOTE : **Although the author of this personal blog is a psychologist, this article is aimed to provide further information and is not the equivalent of therapeutic intervention. If you believe you or someone you know might be suffering from depression/suicidal thoughts, please contact your local suicide support line or a healthcare professional**

For every attempted suicide, there is thought to be one or more people where the thought of suicide is still very present but has never resulted into an actual attempt. With over a half a million people making a suicidal attempt each year, this translates into a huge problem that largely gets ignored.

Suicide or Suicidal thoughts are very complex. They are often a symptom of mental health concerns such as depression paired with life stressors that only exacerbate the idea of feeling hopeless, being lost or feeling like a burden.

Often people who attempt suicide don’t actually want to die, but see it as their only way out.  Sometimes, such attempts might be viewed as a ‘cry for attention’, but they can’t be ignored.  If you’re concerned about someone who might be suicidal or harbor these thoughts, it’s important to take them seriously.

One of the common misconception about suicide states that someone who is determined to end their life will do it one way or another; this is not true. More often than not, people who contemplate suicide give out warning signs (intentional or not) and you may be in a position to help them before they make a decision that can never be taken back.

Even if you see it as merely a ‘cry for attention’ , it is still a cry for help, regardless, and needs to be addressed.

The following signs are no sure indicators that someone will in fact attempt, but they are red flags to keep in mind and address:

Signs of Possible Red flags Concerning Suicidal Thoughts

1.Talking about suicide

One of the most obvious red flags). They might seriously conciser it or casually mention it’s on their minds, but listen. Sometimes (especially amongst teenagers) it could be seen as ‘getting attention’ or being ‘dramatic’. Regardless of our own prejudges or whether we things the person is just going through a bad spell, it’s important to take this seriously and listen to what they have to say.

2. Alcohol and drug abuse.

Often people who are suffering from depression or anxiety turn to alcohol or drugs as a temporary relief of some sorts. Although this might be a quick fix, more often than not substance abuse only escalates the depression/anxiety as the underlying reasons or not addressed. A band aid might stop the bleeding but eventually it peels off. The risk of suicidal thoughts turning into a more realistic action is greatly increased with substance abuse … someone who may not take that step sober, might find themselves with the ‘liquid courage’ or diminished reasoning to push themselves over the edge and take their own lives.

3. Withdrawal from others.

Another red flag is when someone decides to cut themselves off from their friends and family. They become withdrawn and don’t want to talk to anyone about it as they don’t feel it’s worth the effort. Although the withdrawal might again be a temporary fix, it only enhances their isolation and feeling that they are handling all of this on their own

4. Not seeing a future.

When someone says they can’t see a clear future, sometimes may indicate that they have lost all hope for what’s ahead… they might not find themselves strong enough or worthy enough to get out of this bad period they find themselves in. Again, just because someone doesn’t see a clear cut out future, doesn’t make them suicidal, but put together with some of the other signs we are mentioning here, it could also be a red flag

5.’Saying goodbye’

This isn’t always in a form of a letter or note that has come to be so largely associated with suicide. Sometimes people will make fleeting comments like ‘I won’t be around to bother anyone for much longer’, there’s just no way out of this or giving away personal possessions or getting their affairs in order … These may be indicators that they are contemplating life without them in it

6. They are no longer sad, they are numb, which somehow seems worse

Sometimes an eerie ‘calmness’ might come over someone who has made the decision to take their own life. When someone who is usually very social and outgoing suddenly becomes withdrawn and isolated , take note. When someone who is usually rational and careful, displays reckless behaviors. Take note. When someone seems to ‘not care anymore’ about anything. Take note. Perhaps they’re going through a rough time and suicide is not on their mind at all… but you won’t know that for sure until you listen and talk to them

What can I do to help?
You don’t need to be a mental health professional in order to be part of helping someone who is contemplating suicide. Of course professional help is highly recommended to support someone through the underlying issues that are causing them to feel like there are no other options. But before getting them to see a therapist, doctor, counsellor or any other health professional, here are a few things you could do to help them get there:
     1. Be prepared

Make sure you yourself are ready to hear the possible answer that they are indeed planning to end their own life. What actions would you take to help them and prevent them from making that choice. What are your own beliefs around the topic and how would you handle supporting them)

2. Be direct

You may not want to offend them (because we live in a society where we all step on eggshells around each other when it comes to certain topics) but be direct.  People who have such thoughts may not always know how to ask for help, and they might try and push people away as they try and process what’s going through their own minds.  Ask them if they are thinking of suicide… don’t be vague. If the answer is no, that doesn’t mean they don’t need help … Prevention is not only about stopping a planned attempt, but about helping someone before they even get to that place

3. Don’t panic and stay calm

Focus on asking questions and get as much information on what is happening in their life that got them to feel they have no way out. Panicking could only escalate the situation and add extra misery to an already chaotic mind. Tough love comments such as ‘the coward way out’, it’s selfish and idiotic can backfire as it will only reinforce their own thoughts of feeling useless and unworthy.  Stay calm and help them through this

4. What can I (not) say

As mentioned before, you don’t need to be a healthcare professional in order to help someone you know or care about, just being supportive and a listening ear can be a great start. However, be mindful about the following : a) don’t be judgmental or guilt-trip: they already feel pretty low about themselves b) saying things like ‘don’t worry, it will get better’ may be said with the best intentions, but it may also make them feel like you are minimizing what they are going through or feeling. What may seem trivial or ‘not as serious’ to you, may feel like the end of the world for them. Try and focus on giving examples of how they could work through this c) Everyone’s story is different so don’t tell them you know what they are going through (even if you had a similar experience). This isn’t about you, it’s about them and acknowledging that you hear it’s tough for them rather than claiming you already know what it’s like.

5. Most importantly, encourage them to seek professional help.

Be it a hotline, a general practitioner or a mental health professional. Show them that they have you there for support no matter what, but that speaking with someone could help them work on possible outcomes to work through this…. A network is stronger than one individual.

Responding in a Crisis Situation

When you feel someone’s suicidal thoughts might be putting them at immediate risk of harm, ask the following questions:

– Do they have a suicide plan

– Do they have the means to carry our their plan? (eg: pills, knives, guns, …)

– Do they know when they would do it?

– Do they intend to take their own life?

If a suicide attempt seems imminent, contact your emergency services or take them to the hospital. Remove all weapons, knives, medication or other potentially lethal object from their environment, and never, under any circumstances, leave a suicidal person alone.                                                                              (source: helpguide.org) 

At any one time, people may exhibit many of the warning signs mentioned above, without harboring suicidal thoughts. But a lower rate in a larger population is still a lot of people – and many completed suicides had only a few of the conditions listed above. In a one person to another person situation, all indications of suicidal ideation need to be taken seriously.

Remember, nothing is more terrifying than battling with your own mind every single day.

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