This week I was asked, “What are the warning signs for suicide?”
This is a great question, and one that everyone should learn the answer to. In fact, the Detroit Wayne Mental Health Authority has trained over 10,000 people in Mental Health First Aid (MHFA), which teaches about types and symptoms of mental health disorders, how to recognize crises such as suicide thoughts, and how to get help.
Some risks that increase the likelihood of suicide include major depressive episode; substance use or abuse, such as alcohol or cocaine; divorce or widowhood; recent loss (such as losing a job, or a loved one); physical illness and chronic pain. Suicide warning signs are listed below, but in general, look for signs of depression as this has the greatest correlation with suicide attempts.
Depression doesn’t look the same for everyone, but some hints are feeling sad, or being agitated and angry (especially in children and adolescents); changes in sleep and appetite; loss of interest in activities that were previously enjoyed, such as spending time with friends, or playing sports; difficulty with concentration or memory; feelings of guilt or worthlessness; and fatigue or decreased energy.
Warning signs of suicide include:
• Talking about death, wanting to die, or wanting to kill oneself.
• Looking into ways to kill oneself, such as buying a gun, or searching online for ways to die.
• Talking about feeling helpless, hopeless, or having no reason to live.
• Talking about being a burden on others.
• Having thoughts that one is trapped or in unbearable pain (physical and/ or psychological).
• Increasingly reckless behavior, including use of alcohol or drugs.
• Becoming more withdrawn or feeling isolated.
• Feeling enraged or talking about getting revenge.
• Loss of interest in the things one cares about.
• Making arrangements or setting one’s affairs in order, including giving away one’s possessions, or saying goodbye to people.
• Finally, suddenly seeming happier or calmer. This is because the person has made the choice to die and has a sense of relief that their suffering will soon end.
What can you do? Always make sure to get help, for yourself and the person who may be considering suicide. In Wayne County, the crisis line number is 1-800-241-4949. This will connect you to the suicide line, as well as the access center for mental health services. You can also call the National Suicide Prevention Lifeline anywhere in the US: 1-800-273- TALK (8255). I suggest you put these numbers everywhere, — on the refrigerator, in your wallet or purse, in your phone, etc. If you can’t remember these numbers, you can always call 911. You can also take yourself/ the person threatening suicide to the nearest hospital emergency room.
Other tips: Talk to someone who can help you get help, whether that is a friend, teacher or school social worker, your minister/pastor/priest/rabbi/ imam, or human resources person at work. Make sure you stay away from things that might hurt you, or remove things a person can use to hurt themselves. For example, take firearms out of the house, secure medications, and guard against “sharps” – knives, needles, scissors …
I want to address a few myths about suicide.
“People who talk about suicide won’t really do it.” This is false. Almost everyone who commits suicide has given some warning or clue. Never ignore suicide threats.
“If a person really wants to kill themselves, there is nothing you can do to stop them.” This is a frustrating myth. The truth is that most people thinking about suicide have mixed feelings about death, and waver until the last moment. They move between wanting to live, and wanting their pain to end. It is rare for someone to move instantly from the first thought of suicide to an attempt.
“Talking about suicide may give someone the idea.” This is the worst of the myths. The opposite is true. Bringing up the subject and discussing it openly can give a person a sense of relief. They have been struggling with their emotions and thoughts, but may be afraid or too ashamed to talk about them. Giving them the opening to discuss it shows that you care, and are willing to help them.
Finally, a word about how to talk about suicide. Be open, direct, and compassionate. Stay away from using terms such as “failed” or “successful.” This is not a contest. Rather than focusing on persons who complete suicide, I would much rather celebrate the lives and recovery of those who survive suicide thoughts.
Dr. Carmen McIntyre is the chief medical officer at the Detroit Wayne Mental Health Authority. She is committed to ensuring that the Authority meets the mental health needs of those with substance use disorders, children with serious emotional disturbance, mental illness, and persons with intellectual and/or developmental disorders in Wayne County. If you have a question for Dr. McIntyre, please submit it to AskTheDr@ dwmha.com