Suicide

Does that word scare you?  It scares the crap out of me (and I'm trained mental health professional).   It especially frightens those who have thoughts about suicide and are considering following through.  The families and loved ones also suffer.

I've met with quite a few individuals who experienced so much relentless and unrelieved pain, hopelessness, helplessness and depression that they couldn't envision the notion that they could feel better.  Some contemplated taking their lives. 

Suicidal ideation is a common psychological term for thoughts about suicide but without follow-through.  These thoughts may be fleeting or come on a more regular basis.

Ideation may involve:

• a detailed plan
• imagining what it would be like
• self-harming
• unsuccessful, failed attempts

Having a detailed plan is when a person decides the where, how and when of a suicide.  For those who develop them, it's a concrete attempt to control their anguish in a chaotic and painful life.  A completed plan can actually bring temporary relief to the person's torment. 

Thoughts of hurting or killing oneself is pretty common among the general population.  Surprised?  Sometimes when one is in the depths of misery and despair, the mind goes to "what would happen if I..."  Again, it's an internal cognitive strategy to assess one's pain and consider the consequences of following through.   

Self-harming is a coping mechanism used by people who cannot and do not express the negative feelings that cause them immense distress (they often report feeling "numb"), and the act of damaging their bodies provides pain which temporarily pushes their anguish aside.  Some ways in which people harm themselves include pulling off fingernails or toenails, peeling skin off of fingers or feet, smashing fingers/toes with a hammer, and scratching the skin until it bleeds.  For example, people who cut often report a sense of being alive and the ability to feel something.  Guilt about cutting then sets in, and unfortunately the cycle continues. 

A failed suicide attempt refers to a harmful, self-administered act that did not result in death. Some are regarded as not true attempts at all, but rather what's called "parasuicide" (a non-fatal act in which a person deliberately causes injury to him or herself or takes an excessive dose of any prescribed or over-the-counter medications, but not enough to be fatal).

An important and disturbing statistic to think about is that one-third of people who attempt suicide will repeat the attempt within one year, and about 10% of those who threaten or attempt suicide eventually do kill themselves.  Therefore, we never take any of these ideations lightly.

[For suicide warning signs, go to this blog entry.]

--------------------------------------------------------------------------------------

There's a saying that "Suicide is a permanent solution to a temporary problem."  If you or someone else has developed a detailed plan, is having disturbing thoughts, self-harming or is tempted to try parasuicide, call 911 immediately for help.  

(c)2012 Robyn M. Posson

Suicide (Part 2)

According to the American Foundation for Suicide Prevention, suicide can be prevented. While some suicides occur without any outward warning, most people who are suicidal do give warnings. Prevent the suicide of loved ones by learning to recognize the signs of someone at risk, taking those signs seriously and knowing how to respond to them.

WARNING SIGNS:

• Observable signs of serious depression
  Long-lasting low mood
  Pessimism
  Hopelessness
  Desperation
  Anxiety, psychic pain and inner tension
  Withdrawal
  Sleep problems

Increased alcohol and/or other drug use

Recent impulsiveness and taking unnecessary risks

Threatening suicide or expressing a strong wish to die

Making a plan:

Giving away prized possessions

Sudden or impulsive purchase of a firearm

Obtaining other means of killing oneself such as poisons or medications

Unexpected rage or anger

The emotional crises that usually come before suicide are often recognizable and treatable. Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is rather expressed as a loss of pleasure or withdrawal from activities that had been enjoyable. One can help prevent suicide through early recognition and treatment of depression and other psychiatric illnesses.

WHAT TO DO:

Take it Seriously

• Fifty to 75 percent of all suicides give some warning of their intentions to a friend or family member.
• Imminent signs must be taken seriously.

Be Willing to Listen

• Start by telling the person you are concerned and give him/her examples.
• If he/she is depressed, don't be afraid to ask whether he/she is considering suicide, or if he/she has a particular plan or method in mind.
• Ask if they have a therapist and are taking medication.
• Do not attempt to argue someone out of suicide. Rather, let the person know you care, that he/she is not alone, that suicidal feelings are temporary and that depression can be treated. Avoid the temptation to say, "You have so much to live for," or "Your suicide will hurt your family."

Seek Professional Help

• Be actively involved in encouraging the person to see a physician or mental health professional immediately.
• Individuals contemplating suicide often don't believe they can be helped, so you may have to do more.
• Help the person find a knowledgeable mental health professional or a reputable treatment facility, and take them to the treatment.

In an Acute Crisis

• If a friend or loved one is threatening, talking about or making plans for suicide, these are signs of an acute crisis.
• Do not leave the person alone.
• Remove from the vicinity any firearms, drugs or sharp objects that could be used for suicide.
• Take the person to an emergency room or walk-in clinic at a psychiatric hospital.
• If a psychiatric facility is unavailable, go to your nearest hospital emergency room or clinic.
• If the above options are unavailable, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

(c)2012 Robyn M. Posson, All Rights Reserved