Suicide threats and behaviours are brought on by complex influences that are different for each person. Most suicidal behaviours are acts to end intolerable feelings. What defines "intolerable" varies over time for the same person and between persons. Often the person feels she/he has not been heard, not been understood, or not been responded to by important people in his/ her environment. During the crisis, the person’s coping mechanisms are suspended. Motivation for suicide may not be attaining death but escaping emotional pain, making a change in life, making a change in relationship, or attempting to be heard.

People considering suicide in response to unhappy life situations are typically ambivalent, they don’t seem to care. They talk about their intentions, thus inviting intervention. Their reaching out in this manner is their way of saying they need help with living.


Warning Signs of Suicide

There is no typical suicide victim. It happens to young and old, sick and well, rich and poor. Fortunately however, there are some common warning signs which, when acted upon, can save lives. There are three types of warning signs in suicide: psychological, behavioural, and situational.

1. Psychological

• History of a diagnosed psychiatric disorder
• Depression (and depressive symptoms), despair, hopelessness
• Anhedonia (extreme loss of interest)
• Obsessive thinking (including death fantasies)
• Mood swings (emotionally liable)
• Extreme guilt or shame
• Extreme anxiety (panic attacks)
• Somatic symptoms (headaches, stomach aches, back pain, rashes, etc.)

2. Behavioural

• Prior suicide attempts
• Verbal indications: overt or subtle
• Difficulty in making decisions
• Acute loss of energy
• Change of habits, curtailment of pleasurable activities
• Giving away prized possessions
• Insomnia/Excessive sleep
• Sexual dysfunctions
• Withdraw, alienation from support system
• Risk taking behavior: speeding, drunk driving, self mutilation
• Frequent alcohol or drug abuse

3. Situational

• Loss of significant other
• Loss of health or functions/abilities
• Loss of status and/or role
• Threatened major change: family/marital status, job, home, security, legalities
• Sexual or physical abuse
• Self-image changes
• Trauma / accident
• Isolation
• Absent support system
• Family history of abuse/suicide/violence/discord

Specific Stressors for Youth

• Recently in trouble
• Experienced recent disappointment
• Recent rejection

Additionally, a PTSD sufferer may suddenly become very calm, withdrawn or silent shortly before committing suicide. So watch for a sudden change in behaviour, especially following a crisis or confrontation.


The Suicidal Person

May Make Statements Like:

• I can’t take it anymore.
• It’s just not worth it.
• They won't have me around to hurt anymore.
• It doesn’t matter anymore.
• They’ll miss me when I’m gone.
• I just can’t stand the pain.
• I’m so lonely I wish I could die.

May Feel That They Can’t:

• Stop the pain
• Think clearly
• Make decisions
• See any way out
• Sleep, eat, or work
• Get out of depression
• Make the sadness go away
• See a future without pain
• See themselves as worthwhile
• Get someone’s attention
• Seem to get control

How To Be Helpful

Never ignore a suicide threat. If your loved one confides in you or if you recognize warning signs, confront them in a gentle way. Your concern and willingness to talk about this topic will show them that you do not condemn him/her for having those thoughts or feelings.

Be calm and reassuring when talking to someone who has expressed a desire to commit suicide. Avoid giving advice or making comparisons like, "You’ll feel better tomorrow." "Think about how much better off you are than most people." "You should appreciate how lucky you are." These kind of comments can make the suicidal person feel even more worthless or guilty.

Encourage your troubled person to call a crisis service or help her/him arrange to talk to a counselor, clergy member, or other trustworthy person. If they refuse, you can benefit from talking to one of these people to get help for yourself in this difficult situation. You can also have them forcibly taken to hospital for assessment in extreme cases.

More Ways To Be Helpful

• Be aware. Learn the warning signs.
• Get involved. Become available. Show interest and support.
• Ask if he or she is thinking about suicide.
• Be direct. Talk openly and freely about suicide.
• Be willing to listen. Allow expression of feelings. Accept the Feelings.
• Be non-judgmental. Don’t debate whether suicide is right or wrong, or if feelings are good or bad. Don’t lecture on the value of life.
• Don’t dare him or her to do it.
• Don’t give advice by making decisions for someone else or tell him or her to behave differently.
• Don’t ask “why.” This encourages defensiveness.
• Offer empathy (saying that you recognize the person is suffering) not sympathy (saying you know what the person is going through).
• 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. It only proves you don't understand.
• Take action. Remove means. Get help from persons or agencies specializing in crisis intervention and suicide prevention.

I wish to add a point, as at the moment I have a loved one in hospital for suicidal ideation. She sometimes has troubles articulating her feelings, however we have an agreed-upon "code word" that she is to use if she feels suicidal. She came to us with the code word and that alerted us that matters were very serious. Having good rapport with your sufferer, being able to speak with them openly and having them trust you are very important.