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Eunoia

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What To Do if Someone You Know is Suicidal
MayoClinic, April 16, 2004

Talking to someone about suicide won't plant the idea in their mind. Instead, your support and guidance may help someone find treatment - and renewed hope.

Hearing someone talk about suicide may make you uncomfortable. You may not be sure how to step in and help or even if you should take them seriously.

Not everyone who thinks or talks about suicide actually attempts it. But it's not true that people who talk about suicide won't really try it. That's why it is important to take them seriously, especially if they have depression or another mental disorder or are intoxicated or behaving impulsively.

Potential warning signs
You may notice possible indications that a friend or loved one is thinking about suicide. Here are some typical warning signals:

* Talking about suicide, including such statements as "I'm going to kill myself," "I wish I was dead" or "I wish I hadn't been born."
* Withdrawing from social contact and increased desire to be left alone
* Wide mood swings, such as being emotionally high one day but deeply discouraged the next
* Preoccupation with death and dying or violence
* Changes in routine, including eating or sleeping patterns
* Personality changes, such as becoming very outgoing after being shy
* Risky or self-destructive behavior, such as drug use or unsafe driving
* Giving away belongings or getting affairs in order
* Saying goodbye to people as if they won't be seen again

Some people don't reveal any suicidal feelings or actions. And many who consider or attempt suicide do so when you think they should be feeling better - during what may seem like a recovery from depression, for instance. That's because they may finally be able to muster emotional energy to take action on their feelings.

Questions to ask
The best way to find out if someone is considering suicide is to directly ask. Asking them won't give them the idea or push them into doing something self-destructive. To the contrary, your willingness to ask can decrease the risk of suicide by giving them an opportunity to talk about their feelings.

You may have to overcome your own discomfort to discuss the issue. Here are some questions you can ask someone you're concerned about:

* Are you thinking about dying?
* Are you thinking about hurting yourself?
* Are you thinking about suicide?
* Have you thought about how you would do it?
* Do you know when you would do it?
* Do you have the means to do it?

Remember, you're not trying to take on the role of doctor or mental health professional or to conduct psychotherapy sessions. But these questions can help you assess what sort of danger your friend or loved one might pose to themselves.

Don't swear your discussions to secrecy. Not only is that an unwanted burden for you, but if you do make such a promise, you risk having to betray that trust if you need to enlist professional help. Don't worry about losing a friendship to mistrust when it's a life that could be lost.

Do be supportive and empathetic, not judgmental. Listen to their concerns. Reassure them that help is available and that with appropriate treatment they can feel better. Don't patronize them by simply telling them that "everything will be OK," that "things could be worse" or that they have "everything to live for."

If possible, assess their home for potentially dangerous items. You may have to remove items that could become weapons of self-destruction, such as guns or knives. But don't put yourself in harm's way, either.

Getting help
If the person is at imminent risk of suicide, call the police or emergency personnel, or take them to a hospital emergency room if possible. Some people who are a danger to themselves may need to get help against their will, such as involuntary hospitalization. If possible, find out if they are under the influence of alcohol or drugs or may have taken an overdose.

If the danger isn't imminent, offer to work together to find appropriate help, and then follow through. Someone who is suicidal or has severe depression may not have the energy or motivation to find help. You may be able to make phone calls to set up medical appointments or go along with them, or help sort through health insurance policies for benefits information.

Many types of help and support are available. If your loved one doesn't want to consult a doctor or mental health professional, suggest finding help from a support group, faith community or other trusted contact.

Offering new options
There's no way to predict for sure who will attempt suicide. And although you're not responsible for preventing someone from taking their own life, your intervention may help them see that other options are available.

Direct questioning, supportive listening and gentle but persistent guidance can help you bring hope and appropriate treatment to someone who believes suicide will offer the only relief.
 
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healthbound

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Great post, Eunoia. I haven't been writing on my blog for a while now, but I'm going to add this now :)
 

Eunoia

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thanks healthbound. it's nice to know this info is helpful. :eek:)
 

stargazer

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I have a friend who is suicidal. I posted in some detail about him on the schizophrenia forum recently. He's doing pretty well right now, but has had at least four suicide attempts in the past two years. A lot of people say he's not really trying to kill himself, otherwise he would succeed, but I don't know about that. He's landed in the hospital every time, and they've had to pump his stomach of intentional overdoses of over-the-counter medication. People say he's just trying to get attention, but I somehow don't buy that. Also, I never know if something I am going to say is going to trigger this, so I'm concerned.
 

David Baxter

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Even if it is attention-seeking, that isn't a reason not to take it seriously. Some attention-seeking suicide gestures succeed.
 

stargazer

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My feelings exactly. Most of us seek attention from time to time, but not to the point of attempting suicide in order to get it.
 

Eunoia

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you know, as much as some people may think this is for attention (just like people believe other behaviours, symptoms etc. are for attention) I wonder what it will take to believe that someone is suffering in one way or another? even if it is for attention, then there's a problem right there: why does the person feel like they need more attention or aren't getting enough? are they getting enough? and so on... if your friend has tried to comitt suicide multiple times, there's a reason- he has a problem and his solution when it comes down to it is to end all the pain- suicide. If that's not serious, then I don't know what is...

Talking to someone about suicide won't plant the idea in their mind. Instead, your support and guidance may help someone find treatment — and renewed hope
I don't think you're triggering your friend, you're just concerned and want to help... it would probably be more devastating if you wouldn't say anything to your friend at all. sometimes, having a person to listen helps a lot, so don't feel obligated to say the 'right thing' or a whole lot really when your friend just wants someone to listen or sit with...
 

healthbound

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I agree that even IF those attempts were attention seeking - GIVE EM THE ATTENTION - he obviously really needs it. I get very frustrated when I hear people saying, "oh, he/she just wants attention". Like, so what?!?!? Give it to him !!!

Second, the chances of suicide increase with every attempt, so every attempt-regardless of how "serious" should be taken very seriously. And like Dr Baxter wrote, some attention-seeking gestures succeed (some people think that was the case with my sister).

I also think that if someone makes an attempt "for attention" and no one responds - or if they do they respond with - "don't be so silly" or "you're just doing it for attention" or even worse...they ignore it all together...it may re-affirm a distortion that they are not worth living, thus making it "easier" to make an early exit. At least, that's how I felt after telling my dad that I was suicidal.

Anyway, I think all attempts should be taken very seriously. Your friend is lucky to have you.

One thing I would like to caution you about...

Also, I never know if something I am going to say is going to trigger this, so I'm concerned.

My sister attempted suicide and was hospitalized a few times before she finally succeeded. This tells me that she, like your friend, had been suffering for a long, long time. Also, you wrote that you posted about this in the schizophrenia forum, so I'm assuming he is also battling schizophrenia? Both schizophrenia and suicide are very complex. The reason for his attempts or desire to die could never be due to something you said or didn't say. The reasons for suicide are intricate and there are many many varying factors in each case.

I bring this up, because I feel/felt responsible for my sister's death. I even thought that I could save her by making a special pact with her after her second to last attempt (obviously didn't work). And while I definitely believe that we can all make an impact on reducing the ridiculously high number of suicides, I also know -all too well- that sometimes you can do everything in your power to prevent suicide and somehow it still happens anyway. This is very sad and frustrating.

Now after all of that rant...I'm assuming he is getting professional help??? If not, then you could absolutely help him here (actually-maybe not- if he's paranoid schizophrenic :)). The best thing someone did for me when they found out I was planning my own death was "forcing" me to tell my doctor. This must have been very difficult for him to do as I was literally begging him to keep my plans a secret (he had given me an ultimatum - either I tell my doctor or he would). But, as much as I didn't want to tell anyone about my plans, I KNEW he must have cared about me to make sure I got professional help. That in itself was helpful.

Your friend is VERY lucky to have you, stargazer. You obviously care very much about him and truly want to help him in the best way you can. Keep us posted.
 

stargazer

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I think I see what you (Eunoia) mean. Even if it *were* only for "attention," then there is still a problem. What is lacking in the individual's life that he feels he isn't getting the attention he needs?

I think what is probably happening is that people don't want to feel that they have any responsibility in his when he becomes suicidal, they are just tired of it, and they don't want to go out of their way. Perhaps they are frustrated at seeing the pattern repeat itself again and again. They feel that they don't know what to do, they're a little fed up, and maybe they've tried a number of times in the past to get through to him to no avail. So the solution is just to write him off, and not even try to give him the attention he needs, even though he seems not to know how to get it through normal social means.

I think that in my case, I probably ought to just call him more-or-less casually every now and then and ask how he's doing, see if he wants to go out for coffee, etc., not with any real purpose other than to let him know he has a friend. I think everyone tends to wait until he contacts them, which he usually only does for some sort of business reason, or to see if they would liked to be involved in a project of his. So a good idea might be to initiate the contact, and to see if we can get together for the friendship alone, with no other particular motive.
 

stargazer

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(Note: to avoid confusion, I posted the above in response to Eunonia, and then Healthbound's post appeared, which I've not yet read. Please let me read it & then I'll respond in a little while.)
 

stargazer

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(Now I'm replying to Healthbound.)

Yes, he's getting help. He's on disability for his schizophrenia, and he sees both a therapist and a psychiatrist regularly. He tells me a little bit about his discussions with the therapist, and he seems dedicated. In fact, he's a very responsible person, as I posted on the other thread--disciplined, frugal, sober, etc.

I think you are right on the mark about giving him attention. I'm not sure how much of the therapy involves improving his social relationships, but I think that the way he comes across probably keeps enough people at a distance that he is probably unsure who his friends are. He's certainly unsure how to sustain friendships. Almost every time he calls me (or anyone else) it's to try and engage them in a project of his, not just to see how they're doing.

So again, part of the solution might be simply to call *him* and see how *he's* doing. It's sort of late right now, but I can at least send him an e-mail.
 

healthbound

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hm...that's a good idea. I know what it's like to support someone who has many characteristics that often challenge me.

Again, he truly is lucky to have you in his life :)
 
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can someone fix the formatting and odd characters in the original post? i think the info is very useful and some easier reading would be helpful. the wide mood swings were a definite sign with me and i don't often see that as a warning sign in other articles. they're kind of dangerous in that your high you think you are perfectly fine and think you don't need help. anyway long story short if it's formatted better people will pick up on that warning sign as well as others more easily. thanks :)
 

stargazer

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Another friend of mine (an online friend, but a good friend) is considering suicide now. She scared me quite a bit, because she began a blog with the sentences -- "Have you ever wondered how someone could actually get to the point where they believed that to take their own life would actually be a viable alternative? Well, here's how." Then she went on to describe very vividly the state of mind in which suicide appeared to her not only to be the beneficial alternative, but actually the most "pleasant" one. Her description of that mental place was eerie, because it actually made some sense to me, although I'd never been there before. So she freaked me out.

I've been corresponding with her for over a year now, and I'd never gotten the faintest idea she could ever be suicidal. I left a brief comment on her blog that I was worried, then I sat in a chair and reflected, and something told me to detach (for my own sake); however, maybe I should send her an e-mail.

She said if she had been alone in the house at the time, and there had been no one there to talk to, she would probably have been dead by now. It's pretty scary.
 

stargazer

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I'm wondering what to do. She's posted again and is still suicidal. I went back and read her posts throughout the past couple months, and I must have been blind not to realize she was headed in this direction. She's writing so calmly about it, as though detached, and rationalizing it to be for the best. What do you do? All I know is she's in Mississippi somewhere...I'm almost afraid to say anything to her, for fear of triggering the wrong reaction.
 

Halo

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To be honest being that she is an online friend, it is so much more difficult to help someone but there are a few things that you can do. You can first of all be her friend as you are and really try to encourage her to reach out for face-to-face help from her health care provider and also you can provide her with the contact numbers for crisis centers in her area. Other than giving her the information and numbers there is not a lot you can do from afar, unfortunately.

As for being afraid of what to say to her, I would just be honest with her and tell her that you are afraid and that that you would miss her a lot and you truly appreciate her friendship. Hearing those things, however small you may think they are may make a huge difference to her.
 

Mari

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H! I have no specific answers on what to do but I can tell you about some of my thoughts and feelings after my son died by suicide. Very few people knew that my son was suicidal but those who knew and who could have done something to help him did nothing - each one offering their own excuses and/or reasons after his death. With his on line friends - they only realized after his death by going back over things that he had said as you have mentioned about your friend. What his on line friends regret now is that when my son started changing and sending odd/angry messages they dropped correspondence with him. They realize now why his messages changed so drastically and wish that they had continued to correspond with him - not to question or advise him but just to let him know that they were there for him no matter how rude he was in response. They realize now that they took my son's messages as a personal insult rather than as an expression of his own personal pain. Since you do not have personal information to contact anyone I do not think it matters so much what you say but that you just say something and that you say it as a caring friend. Caring and sharing do matter. :heart: Mari
 

stargazer

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As for being afraid of what to say to her, I would just be honest with her and tell her that you are afraid and that that you would miss her a lot and you truly appreciate her friendship. Hearing those things, however small you may think they are may make a huge difference to her.

I'm glad you guys were here to reply. I did leave a comment that I was concerned (worried) and that she is valued and I would have a hard time taking to the loss of her. Others also commented, and one person did so very eloquently. I wish I could recall what she said, but it was very good. About the hot lines, she is already aware of those numbers but has not called. She has my number too.

There are four other people who read her posts regularly, and I also wrote to all of them asking if anyone had any ideas. The thing that is freaky is that she is describing the psychic state in which suicide appears to be acceptable in such a way that convinces us that she's seriously considering it. It's twisted thinking, but she believes that her husband and son will benefit from her "removal."

Mari, I just read your post, and I am sorry about your son. I did not know that this had happened. I have lost two friends to suicide, and a third has attempted it three times and been hospitalized for those attempts. So it can happen, and I think you're right in that people tend to reject or detach themselves from the person, thereby worsening the situation. I was not suicidal when I had the manic episode, but the fact that everyone in my family ignored me completely did not help. To this day, I think the episode would have subsided sooner if someone had come to my aid in some way, or showed more concern or even contact. I lived in a world of unreturned phone calls and unanswered e-mails.

So definitely I should send Rana another e-mail if I don't hear back from her in a few days. I went to her HaloScan where we had been corresponding, and she has not yet answered my post there (or anyone else's.) I'll wait another day or so, because I know it's hard for her to find much online time. (So it's not abnormal that she wouldn't respond for a few days.)

Thanks for what both of you have said.
 
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ThatLady

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I wish your friend luck, stargazer. There's little we can do from a distance. Online friends are the most difficult to help because we can't reach out to them as easily as to someone who lives nearby. I hope she's able to get past this dark place in her life. It sounds like she needs all the help, and all the friends she can get. As long as you, and the others, are leaving her messages, I think that's about the best thing you can do. You're letting her know you care.
 

stargazer

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I see that. I was reading the comments on her HaloScan, and we're pretty much doing what we can do. I understand what you mean about it being more difficult with an online friend.
 
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