Download suicide awareness and indicators

SUICIDE AWARENESS
AND INDICATORS
Risk factors for suicide
Risk factors for suicide vary with age, gender, and ethnic group. One risk factor
that is common across all groups, however, is that over 90% of people who commit
suicide have clinical depression or another diagnosable mental disorder. Another
common factor is substance abuse. In addition, adverse or traumatic life events,
combined with the above risk factors, may lead to suicide.
Other risk factors for suicide include:
• Previous suicide attempts – between 20% and 50% of people who kill
themselves had previously attempted suicide.
• Family history of mental disorder or substance abuse – substance use can
also contribute to impulsivity. Studies have shown that up to 80% of all suicide
attempts are done on the spur of the moment, with very little planning.
• Family history of suicide
• Family violence
• Physical or sexual abuse
• Keeping firearms in the home
• Chronic physical illness, including chronic pain
• Incarceration
• Exposure to the suicidal behaviour of others
Warning signs of suicide
Warning signs that someone may be thinking about or planning to commit suicide
include:
• Always talking or thinking about death – people who commit suicide often
talk about death directly or indirectly. Be alert to statements like, “My family
would be better off without me”. Sometimes those contemplating suicide
talk as though they are saying goodbye or going away. Suicidal behaviour is a
process. The person thinks about it, lets go of the idea, then thinks about it
again. It can then take a small event to push that person over the edge.
• Clinical depression – some of the signs of clinical depression are deep sadness,
loss of interest in things the person previously found enjoyable, trouble
sleeping and eating too little or too much. Although most depressed people
are not suicidal, most suicidal people are depressed. Serious depression can
be manifested in obvious sadness, but often it is expressed instead as a loss of
pleasure or withdrawal from activities that had once been enjoyable.
Be particularly concerned about depressed individuals if at least five of the
following symptoms have been present nearly every day for at least two weeks:
• Depressed mood, change in sleeping patterns
• Change in appetite or weight
• Speaking and/or moving with unusual speed or slowness
• Loss of interest or pleasure in usual activities
• Decrease in sexual drive
• Fatigue or loss of energy
• Feelings of worthlessness, self-reproach, or guilt
• Diminished ability to think or concentrate, slowed thinking or indecisiveness
• Thoughts of death, suicide, or wishing they were dead
Additional factors that point to an increased risk for suicide in depressed
individuals are:
• Extreme anxiety, agitation, or enraged behaviour
• Excessive drug and/or alcohol use or abuse
• History of physical or emotional illness
• Feeling hopeless or desperate
• Having a “death wish,” i.e. tempting fate by taking risks that could lead to
death, such as driving fast or running red lights
• Losing interest in things they used to care about
• Making comments about being hopeless, helpless, or worthless
• Putting their affairs in order, tying up loose ends, or changing a will. They may
also give away articles they value, or pay off debts or a bond on a house.
• Saying things like “it would be better if I wasn’t here”, or “I want out”
• Sudden, unexpected switch from being very sad to being very calm or
appearing to be happy
• Talking about suicide or killing themselves
• Visiting or calling people to say goodbye
• Internet searches – signs that someone is considering suicide may also be
evident in the person’s web-browser history, showing that they have been
researching suicide and ways to kill themselves. The content the person posts
on Facebook and Twitter is also important to take note of.
What should I do if someone shows warning signs of suicide?
Asking about suicidal impulses does not “put ideas” into a person’s head. If you’re
concerned about suicide, you need to ask the person about it directly.
Firstly, if someone you know appears to be depressed and is contemplating
suicide, take that person seriously. Seventy-five percent of all suicides give some
warning of their intentions to a friend or family member. All suicide threats and
attempts must be taken seriously, even those of teenagers among whom such
threats are more common.
Listen to what the individual is saying. Take the initiative to ask that person what
they are planning, but don’t attempt to talk them out of committing suicide.
Rather, let the person know that you care and understand and are listening and
that they are not alone. You can also reassure them that suicidal feelings are
temporary, that depression can be treated, and that problems can be solved.
Avoid the temptation to say, “You have so much to live for”, or “Your suicide will
hurt your family”.
If someone you know appears to be depressed and talks about suicide, makes
a suicidal gesture, or attempts suicide, take it as a serious emergency. Listen to
the person, but don’t try to argue with him or her. Seek immediate help from a
healthcare professional.
Where can I get help for suicide and depression?
Encourage a suicidal or depressed person to seek the help of a mental health
professional. Because the person probably doesn’t think it’s possible to be helped,
you’ll most likely have to be persistent and go with that person. Get actively
involved.
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If your loved one appears to be in imminent danger of committing suicide,
do not leave them alone until help is available. Remove from the vicinity any
weapons or drugs they could use, such as firearms, razors or scissors that could
be used in a suicide attempt. In an acute crisis, take the person to the nearest
emergency room or walk-in clinic at a psychiatric hospital.
Medication and/or hospitalisation may be indicated and may be necessary at
least until the crisis abates. During treatment, be supportive. Help the person to
remember to take antidepressant medication and to continue any other therapy
that has been prescribed.
What is happening in this person’s life? Have they experienced any life
changes recently?
• Recent loss (of a loved one, a job, an income/livelihood, a relationship, a
pet)
• Major disappointment (failed exams, missed job promotions)
• Change in circumstances (separation/divorce, retirement, redundancy,
children leaving home)
• Mental disorder or physical illness/injury
• Suicide of a family member, friend or a public figure
• Financial and/or legal problems
• Traumatic experience, for example, fire, rape or an accident.
How to be helpful to someone who is threatening suicide
• Be direct. Talk openly and matter-of-factly about suicide.
• Be willing to listen. Allow expressions of feelings. Accept the feelings.
• Be non-judgmental. Don’t debate whether suicide is right or wrong, or
whether feelings are good or bad. Don’t lecture on the value of life.
• Get involved. Become available. Show interest and support.
• Don’t dare him or her to do it.
• Don’t act shocked. This will put distance between you.
• Don’t be sworn to secrecy. Seek support.
• Offer hope that alternatives are available but do not offer glib reassurance.
• Ask if you may contact a family member.
• Take action. Remove means of committing suicide, such as guns or stockpiled pills.
• Don’t leave potential suicides alone; get help from professionals who
specialise in crisis intervention and suicide prevention.
• If necessary get in touch with the police.
Be aware of feelings
Many people at some time in their lives think about suicide. Most decide to live
because they eventually come to realise that the crisis is temporary and death is
permanent. On the other hand, people having a crisis sometimes perceive their
dilemma as inescapable and feel an utter loss of control. These are some of the
feelings and thoughts they experience:
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Can’t stop the pain
Can’t think clearly
Can’t make decisions
Can’t see any way out
Can’t sleep, eat or work
Can’t get out of depression
Can’t make the sadness go away
Can’t see a future without pain
Can’t see themselves as worthwhile
Can’t get someone’s attention
Can’t seem to get control
Feel hopeless and helpless
If you experience these feelings, get help from a psychologist. If someone you
know exhibits these symptoms, offer your help and recommend they go and see
a healthcare professional.