Marriage and Relationships: Suicide Prevention

When there is a high profile suicide or someone we know commits suicide, it is alarming and can reverberate through a community.  We may start to worry more about loved ones who seem fragile and stressed.  Suicide or suicidal behaviors are not a normal response to stress.  Even though in 2007 suicide was the 10th leading cause of death in the U.S., it is a preventable condition if we know what to look for.

Some warning signs to look for:

• Thinking or talking a lot about death;

• Symptoms of depression that persist: loss of interest in daily activities; sadness or feeling of emptiness; trouble sleeping or eating; fatigue;

• Risk taking behaviors that tempt fate such as driving at high speeds or running red lights;

• Mentioning suicide or the idea of killing one’s self;

• Sudden, unexplainable change in mood from sad to calm or happy;

• Settling one’s affairs i.e. changing a will or visiting people to make amends or say goodbye

• Making comments about being worthless, being tired and not wanting to be here anymore;

• Feeling trapped, like there is no way out;

• If the person has attempted suicide before and has any of the symptoms mentioned above, they are an even higher risk.

What to do if you are worried that someone is suicidal?

Take time to listen to their feelings and concerns. Take them seriously. You don’t have to be able to solve their problems, just showing them that you are interested and care can help them to feel less alone.

Loved ones are often afraid to talk about suicide directly as if it is going to give the person the idea. Asking a person if they are thinking about killing themselves will not encourage them to do so. If the answer is affirmative, ask them about their plan. If they have a clear and accessible method for killing themselves, they are a greater risk for doing it. It is important not to minimize feelings, thoughts, or their intention to commit suicide.

Survivors of suicide, family and friends who cared about the person are prone to feeling of shock, guilt, anger, and depression. It’s normal to think, ‘’what if I did this or that differently?’’ People don’t commit suicide because of losing a job, a boyfriend, or because of the way they were parented. Suicide usually happens when there is a biochemical imbalance and depression and agitation take hold of the brain.  The person is in pain and sees no way out.

People with suicidal thoughts have usually lost hope that anyone can help them so it may be difficult to convince them to get professional help. You may have to accompany them to a doctor or urgent care to be evaluated for appropriate treatment.

Therapy and medicines can help most people who are depressed or have suicidal thoughts — treatment has been found to be very effective in reducing symptoms of depression and helping improve coping and resiliency skills. It is essential to seek treatment for clinical depression, substance abuse, and other persistent mental and emotional distress – especially if they don’t get better or get worse over time.

Risk factors for suicide include:

•depression and other mental disorders, or a substance-abuse disorder (often in combination with other mental disorders). More than 90 percent of people who die by suicide have these risk factors.

•prior suicide attempt

•family history of mental disorder or substance abuse

•family history of suicide

•family violence, including physical or sexual abuse

•firearms in the home, the method used in more than half of suicides

•incarceration

•exposure to the suicidal behavior of others, such as family members, peers, or media figures.

Everyone gets down sometimes.  When life gets especially challenging or disappointing in some way, or we suffer the loss of someone we love, people may temporarily experience feelings akin to depression.  It’s normal to feel this way from time to time.

After a suicide, healing for the survivors involves a more complex grieving process. In the long run, it’s important to remember people who committed suicide, not for their final act of desperation, but for the quality life that they led when they were here.

Some resources for Suicide Prevention

•The National Suicide Prevention Lifeline:If you or someone you know has suicidal thoughts, this is a free, 24 hour hotline available to anyone in suicidal crisis or emotional distress. 1-800-273-TALK (8255)

•The American Association of Suicidology

•The American Foundation for Suicide Prevention (AFSP) (www.afsp.org)

•The American Psychological Association (www.apa.org)

•Survivors of Suicide (www.survivorsofsuicide.com)

This column is intended to be educational and not intended to take the place of medical evaluations or professional treatment.

Diana Weiss-Wisdom, Ph.D. is a licensed clinical psychologist (Psy#12476) in private practice in Rancho Santa Fe.  (858) 259-0146; www.cottageclinic.net

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