Suicide is death caused by an injury inflicted by self with the intent to die. When people say they are contemplating suicide or say things that signal that they are considering such a possibility, it can be pretty upsetting for their loved ones, or sometimes the friends and family may feel quite helpless or confused about what to do to help, whether it is prudent to talk of suicide seriously or if any intervention might make things worse. Dr Trideep Choudhury, Consultant Psychiatrist, Dept Of Mental Health And Behavioural Science, Fortis Healthcare, shares five steps to help someone deal with suicidal thoughts.
How To Identify Suicidal Individuals?
The first step to dealing with someone with suicidal thoughts is to identify these individuals. Studies show that a person who dies by suicide shows signs and symptoms which sometimes are missed by friends, family and health care providers. In addition, individuals with suicidal intent offer certain common risk factors:
These individuals may have a prior history of- suicidal attempts, family history of suicidal attempts, mental health conditions like depression, mood disorders, anxiety disorders, schizophrenia, and substance abuse problems.
They may have long-term stress in the forms of disabling or terminal illness, financial or legal issues etc. In addition, lack of social support or social isolation and access to lethal means like keeping firearms in the home can markedly increase the chances of death by suicide.
The best way to deal with such ideas is to learn to be aware of these warning signs:
The person may often mention dying by suicide in their conversations or may write about it. During the discussions, they may mention being hopeless, helpless or worthless. They might manifest expressions of having no reason for living and no sense of purpose in life. Sometimes signs may be subtle, like increased reckless behaviour or more risky activities.
People who are close to the person at risk may notice specific behavioural changes like the person is making a plan or researching ways to die, emotionally distancing from friends and family members and becoming detached from life in general, saying goodbye to friends, giving away essential items or making a will, eating or sleeping more or less, using drugs or alcohol more often.
Similarly, a person feeling suicidal may lose interest in everyday activities and things they once enjoyed.
Follow Their Mood Pattern
People considering suicide display the following moods - sudden irritability, agitation or anger, shame and humiliation, or sometimes there might be sudden relief or calmness. People expressing suicidal thoughts should always be taken seriously, and their opinions should be explored further.
The first step of active intervention is to ask the person about his beliefs. People who know a person they suspect has suicidal behaviour can assist them by asking directly if the person is contemplating dying by suicide.
The questions can be framed by asking the person," Are you thinking about suicide?" Such an unbiased and direct manner can open the door for effective dialogue about their emotional pain. A promise should never be made about keeping someone's suicidal feelings secret.
What Should A Listener Do?
The listener should take the answers seriously and not ignore them.
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It is always helpful to focus on their reasons for living and avoid trying to impose others' reasons for staying alive.
This non-conflicting approach to connecting the person at risk with others increases the sense of belonging and connectedness of the person at risk and decreases their isolation.
However, if the person has persistent thoughts of dying by suicide or strong suicidal intent, then the priority should be to find ways to establish immediate safety.
It must be ensured the person at risk does not have access to highly lethal means or chosen methods for a suicide attempt. They have to be under constant observation in such situations. Admission to a psychiatric facility may sometimes be required if the need arises.
Such a person at risk may often need professional help in the form of psychological assessment and counselling along with medicines once the immediate crisis has been handled to prevent further suicidal thoughts.
Suicide is preventable if appropriate measures are taken promptly, reassuring the person at risk, being non-judgemental and providing medical treatment and psychotherapy at the right time.
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