This is a topic that is very difficult for most people because we’ve either lived it in some way, or we haven’t and don’t understand it. I understand it because I’ve lived it and I work with it every day, so I want to talk about it, educate others, and hopefully prevent this horrific tragedy.
From the time I was 11 until I was 29, I was suicidal. I prayed every day to die. My depression and anxiety were so bad that I was in excruciating emotional pain, which manifested into physical health issues. I just wanted it to end and the only way I could conceptualize that happening was to die. I couldn’t see a light at the end of the tunnel. It was a very dark time for me. I was in therapy since age 11 and not one therapist asked if I ever thought about suicide. I planned my suicide a couple of times in my 20s and bargained with God that if I called someone and they agreed to come over, I wouldn’t do it. Obviously, they came over because I’m still here. Finally, when I was 29, I went to an amazing therapist who suggested that I try antidepressant/antianxiety medication. I resisted for months. Then one day I had a very serious breakdown and knew something had to change or I would end up completing suicide. I called the doctor and started on medication. After about two weeks, I remember saying to a friend, “I had no idea this is what normal felt like.” Not that everything was perfect from there, but with the medication, I was able to manage my anxiety and depression and still do so to this day with medication and therapy. I might add since then, I have lived a very happy life!
The thing is, no one actually “wants” to die when they’re suicidal. We want the emotional pain/physical pain to stop. We want to matter to someone. We want to be noticed and cared for. Being suicidal is very lonely and confusing. We know we don’t want to die, but we are in so much emotional and sometimes physical pain that the only way we think it could end is to end it. There’s also sometimes the factor that we believe that no one would care if we die. No one who is suicidal is mentally stable. In that instability, ending the pain is hyperfocus and it’s hard to think of anything else, let alone look beyond the moment of intense pain.
Keep in mind, it’s common for people to think of suicide at intensely difficult times in their lives. Just because someone is thinking of it, doesn’t mean they will follow through with it, but we should take every single thought of suicide or the threat of suicide very seriously. If someone is thinking about it, they could follow through with it. No one uses it as a manipulation tactic, so again, always take it seriously if someone tells you they feel suicidal.
When most people hear the word, suicide, it’s terrifying for them. It is a myth that anyone uses this as a manipulation tactic. If they say it, they’re thinking about it. For the general public, when we hear the word “suicide,” we often shut down mentally and may possibly avoid dealing with the person who is crying out as it’s very disturbing and overwhelming. I cannot stress enough to always, always take this threat seriously!
There are some filters many in the mental and behavioral health field recommend for assessing suicide risk. I will post the clinical assessments and policies and procedures from the National Suicide Lifeline. Below is a rating scale that person may use to briefly assess suicide, but I will post the clinical assessments further below.
1 – I feel fine. I am happy and do not feel suicidal at all
2 – I feel pretty good and do not feel suicidal at all
3 – I feel fine and may have a few fleeting thoughts of suicide
4 – I feel okay and have more than a few fleeting thoughts of suicide
5 – I am a little down and am having some thoughts of suicide, but I don’t think I would hurt myself
6 – I am feeling down and am having more suicidal thoughts, but I’m not sure if I would hurt myself
7 – I am feeling really down, and am thinking about suicide, I have a plan on how I would do it, and I might hurt myself
8 – I am very down and am thinking about suicide, I have a plan, and I will self-harm, but not complete suicide
9 – I am really down, am thinking about suicide, I have a plan and have self-harmed and I am afraid I will complete suicide
10- I am very down and am thinking about suicide, I have a plan, and I will act on it
Risk Factors and Warning Signs:
- Mental health conditions
- Substance use problems
- Bipolar disorder
- Personality traits of aggression, mood changes, and poor relationships
- Conduct disorder
- Anxiety disorders
- Serious physical health conditions including pain
- Traumatic brain injury
- Access to lethal means including firearms and drugs
- Prolonged stress, such as harassment, bullying, relationship problems, or unemployment
- Stressful life events, like rejection, divorce, financial crisis, other life transitions, or loss
- Exposure to another person’s suicide, or to graphic or sensationalized accounts of suicide
- Previous suicide attempts
- Family history of suicide
- Childhood abuse, neglect, or trauma
- Access to mental health care, and being proactive about mental health
- Feeling connected to family and community support
- Problem-solving and coping skills
- Limited access to lethal means
- Cultural and religious beliefs that encourage connecting and help-seeking, discourage suicidal behavior or create a strong sense of purpose or self-esteem
Something to look out for when concerned that a person may be suicidal is a change in behavior or the presence of entirely new behaviors. This is of sharpest concern if the new or changed behavior is related to a painful event, loss, or change. Most people who take their lives exhibit one or more warning signs, either through what they say or what they do.
If a person talks about:
- Killing themselves
- Feeling hopeless
- Having no reason to live
- Being a burden to others
- Feeling trapped
- Unbearable pain
Behaviors that may signal risk, especially if related to a painful event, loss, or change:
- Increased use of alcohol or drugs
- Looking for a way to end their lives, such as searching online for methods
- Withdrawing from activities
- Isolating from family and friends
- Sleeping too much or too little
- Visiting or calling people to say goodbye
- Giving away prized possessions
People who are considering suicide often display one or more of the following moods:
- Loss of interest
- Relief/Sudden Improvement
What to do
If you or someone you know has exhibited any of the above risk factors or warning signs for suicide, get help immediately!
- Call 911 (Be aware that if you call 911, they will handcuff the person who may be suicidal)
- Take the person to the nearest Emergency Room
Information from the National Suicide Lifeline