WHAT TO DO IF SOMEONE YOU KNOW BECOMES SUICIDAL by Elizabeth Lofgren Recently, I intervened to prevent a friend from committing suicide. My friend is alive and I have the satisfaction that I knew what to do and had the opportunity to do it. That means a great deal to me because I value my friend. Her decision to live redresses some of the loss I feel because I was unable to prevent my son's death by suicide.
MOOD DISEASE. Stressful events cause temporary depression in most people. Others suffer from major depression or manic depression, inheritable illnesses that may lead to suicide. People with schizophrenia also may attempt suicide. Accompanied by abnormalities in brain chemistry, episodes of depression arise with or without apparent cause. Depression frequently goes hand-in-hand with alcohol or drug abuse.
Fortunately, mood illnesses can be treated with medications and therapy; unfortunately, they often go unrecognized, undiagnosed and untreated. The risk of suicide sky rockets if depression is coupled with chemical dependency. Historically, mental health and chemical dependency treatment have traveled on separate tracks. One condition may be treated while the other is ignored, depending on which type of program a patient enters. Some people medicate their underlying depression with alcohol or drugs, while others become depressed as a result of their addiction. It's important to discover which is the case. When a person quits using addictive substances, the underlying depression may overwhelm them.
SUICIDAL BEHAVIOR runs on a continuum — a long process during which suicidal people try various ways to reduce their emotional pain. Ambivalent, they have contradictory desires to live and to die and the balance between the two shifts back and forth. SIGNS TO WATCH FOR: DEEPENING DEPRESSION. A depressed, uncommunicative and withdrawn person is at risk for committing suicide. Although stressful life events do not cause depressive diseases, people who have these illnesses are more vulnerable. FINAL ARRANGEMENTS: A person puts their affairs in order, changes a will, washes all their clothes, gives away possessions, talks about going away. RISK TAKING OR SELF DESTRUCTIVE BEHAVIOR may represent a death wish. A person isn't ready to take their own life but tempts fate, for instance, by reckless driving. SUDDEN ELEVATED MOOD may precede a suicide attempt. Paradoxically, a person emerging from an incapacitating episode of depression may regain the will and energy to end their life. Be alert to evidence of final arrangements. PRE SUICIDAL STATEMENTS—Direct or indirect statements about suicide, hopelessness or death, even when said in a joking or off hand manner. Sometimes suicidal people leave hints. It is not true that a person who talks frequently about committing suicide won't do it. Some keep their suicidal thoughts secret, others don't. ASK "ARE YOU THINKING OF SUICIDE?" Contrary to popular belief, you aren't putting ideas into a person's head. Surprisingly, they may respond to your supportive concern. You need to assess how likely an attempt may be. DO YOU HAVE A PLAN? A METHOD? A MEANS? Is it deadly? Is it available, such as a gun or enough pills for an overdose? WHEN? Today, next week, a vague future time? Listen with respect. This is an illness not a moral defect. Don't challenge or dare a person to commit suicide thinking you will shock them out of the idea. If suicide seems to you to be “a permanent solution to a temporary problem,” that's not the way a suicidal person sees it. One may be overwhelmed by a sudden suicidal impulse; another may make a deliberate plan and set the date.
TAKE CHARGE. Do not worry about invading someone's privacy even though they try to get you to promise secrecy. This is not a test of friendship but a response to a deadly illness. Don't leave it up to them to get help on their own. Try to arrange for professional evaluation and treatment. Some people experience suicidal impulses even though they are under treatment. The patient needs to have their treatment plan adjusted. Some people have no control over the death wish that sweeps over them, yet they understand their impulse is irrational. They want people to intervene. If a chronically suicidal person lives alone, arrange for friends to check- in with the patient by phone every day. Ask for the phone number of their treatment doctor and which hospital accepts their insurance should a crisis occur.
IF THE CRISIS IS ACUTE: Treat it as an emergency. Call 911, a hot-line, or take the person to a crisis center, hospital emergency room, mental health center, their psychiatrist or family doctor. DO NOT LEAVE THE PERSON ALONE. YOU WOULD INTERVENE IF SOMEONE WERE HAVING A HEART ATTACK. The suicidal impulse is just as deadly. There is no certain way to prevent suicide. The late Adina Wrobleski, founder of SA\VE warns us that the taboo against suicide is so strong, some people, even professionals may “...be reluctant to do the normal things a person should to help someone who is sick and in danger of dying." Be persistent in seeking help. That persistence by friends and family "...will eventually put pressure on doctors and mental health professionals to do better intervention, diagnosis and treatment." “YOU CANNOT CONTROL ALL THE OUTCOMES” was the best advice my counselor gave me as I struggled to save my son from suicide.
Vist our Are you thinking suicide right now link, for a list of state by state 24 hr hotlines, keep the number handy, it could mean the difference betweeen life and death.
In your struggle,
May God grant you the serenity to accept the things you cannot change, courage to change the things you can; and wisdom to know the difference. Source: SA\VE From an article that appeared in the Minnesota Depressive and Manic-Depressive Newsletter - March 1992. Revised in 1997 by the author Reprinted by permission of the author. 9/23/91 Updated 12/6/97 |