What is suicidal thoughts

Thinking of suicide or suicidal thoughts or thinking about taking your own life, is a tragic reaction to stressful life situations. If you’re thinking about suicide, you’re not alone and there is hope. Lots of people have suicidal thoughts, but have got through without harming themselves. There is help at hand. Whether you’re considering suicide or know someone who feels suicidal, learn suicide warning signs and how to reach out for immediate help and professional treatment. You may save a life — your own or someone else’s.

It may seem like there’s no way to solve your problems and that suicide is the only way to end the pain. But you can take steps to stay safe — and start enjoying your life again.

• Take any suicidal talk or behavior seriously. It’s not just a warning sign that the person is thinking about suicide—it’s a Cry For HELP.

Most suicidal individuals give warning signs or signals of their intentions. The best way to prevent suicide is to recognize these warning signs and know how to respond if you spot them. If you believe that a friend or family member is suicidal, you can play a role in suicide prevention by pointing out the alternatives, showing that you care, and getting a doctor or psychologist involved.

Major warning signs for suicide include talking about killing or harming oneself, talking or writing a lot about death or dying, and seeking out things that could be used in a suicide attempt, such as weapons and drugs. These signals are even more dangerous if the person has a mood disorder such as depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide.

A more subtle but equally dangerous warning sign of suicide is hopelessness. Studies have found that hopelessness is a strong predictor of suicide. People who feel hopeless may talk about “unbearable” feelings, predict a bleak future, and state that they have nothing to look forward to.

Other warning signs that point to a suicidal mind frame include dramatic mood swings or sudden personality changes, such as going from outgoing to withdrawn or well-behaved to rebellious. A suicidal person may also lose interest in day-to-day activities, neglect his or her appearance, and show big changes in eating or sleeping habits.

Suicide warning signs

• Talking about suicide – Any talk about suicide, dying, or self-harm, such as “I wish I hadn’t been born,” “If I see you again…” and “I’d be better off dead.”
• Seeking out lethal means – Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt.
• Preoccupation with death – Unusual focus on death, dying, or violence. Writing poems or stories about death.
• No hope for the future – Feelings of helplessness, hopelessness, and being trapped (“There’s no way out”). Belief that things will never get better or change.
• Self-loathing, self-hatred – Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden (“Everyone would be better off without me”).
• Getting affairs in order – Making out a will. Giving away prized possessions. Making arrangements for family members.
• Saying goodbye – Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won’t be seen again.
• Withdrawing from others – Withdrawing from friends and family. Increasing social isolation. Desire to be left alone.
• Self-destructive behavior – Increased alcohol or drug use, reckless driving, unsafe sex. Taking unnecessary risks as if they have a “death wish.”
• Sudden sense of calm – A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to attempt suicide.

Why do I feel like this?

Finding yourself thinking about suicide can be frightening. You might feel alone, and like nobody can understand what you’re going through. It may help you to know that lots of people struggle with life, and that many people who have had similar thoughts to you have found a way through it.

Remember that there’s a big difference between thoughts and actions. Thoughts come and go, and don’t have to be acted on.

People have all sorts of reasons for contemplating suicide. It might be one big thing, or it might be a combination of things. Some of the most common reasons for suicidal thoughts are:

• personal problems – for example, relationship break-ups, being abused, or being bullied
• major stresses – like problems with money or getting a job
• mental health issues – such as overwhelming depression or anxiety
• loss or grief – for example, the death of someone close to you
• problems with drugs or alcohol
• long-term pain or ill health
• feeling alone and like you don’t belong.

Whatever your reason, life can be very hard and you may feel like there’s no hope for the future. That’s when it’s time to get help.

What should I do?

If you’re having suicidal thoughts, there are some things you need to do:

• Let someone know how you’re feeling. Talk to a friend, family member, counsellor, or doctor – or contact a crisis service like Lifeline.
• Keep yourself safe. If you feel in danger, call your local emergency number or go to your nearest hospital. Get rid of anything you could use to hurt yourself, and don’t go to any places where you’ve thought about killing yourself.
• Don’t make any hasty decisions. Remember that thoughts and feelings do pass with time.
• Avoid drugs and alcohol. They can make you feel worse or do things you wouldn’t do if you were sober.
• Try not to be alone. Stay with someone you trust until you feel better. If that’s not possible, talk to someone at a crisis service.
• Make a safety plan. Sit down with your doctor or another support person, and work out a plan to follow when you’re feeling suicidal.
• Help yourself – follow some tips for managing suicidal feelings to see if they help.

How to Deal with Suicidal Thoughts

You’re not alone; many of us have had suicidal thoughts at some point in our lives. Feeling suicidal is not a character defect, and it doesn’t mean that you are crazy, or weak, or flawed. It only means that you have more pain than you can cope with right now. This pain seems overwhelming and permanent at the moment. But with time and support, you can overcome your problems and the pain and suicidal feelings will pass.

No matter how much pain you’re experiencing right now, you’re not alone. Some of the finest, most admired, needed, and talented people have been where you are now. Many of us have thought about taking our own lives when we’ve felt overwhelmed by depression and devoid of all hope. But the pain of depression can be treated and hope can be renewed. No matter what your situation, there are people who need you, places where you can make a difference, and experiences that can remind you that life is worth living. It takes real courage to face death and step back from the brink. You can use that courage to face life, to learn coping skills for overcoming depression, and for finding the strength to keep going.

Remember:

1. Your emotions are not fixed – they are constantly changing. How you feel today may not be the same as how you felt yesterday or how you’ll feel tomorrow or next week.
2. Your absence would create grief and anguish in the lives of friends and loved ones.
3. There are many things you can still accomplish in your life.
4. There are sights, sounds, and experiences in life that have the ability to delight and lift you – and that you would miss.
5. Your ability to experience pleasurable emotions is equal to your ability to experience distressing emotions.

To help keep yourself from feeling suicidal:

• Get the treatment you need. If you don’t treat the underlying cause, your suicidal thoughts are likely to return. You may feel embarrassed to seek treatment for mental health problems, but getting the right treatment for depression, substance misuse or another underlying problem will make you feel better about life — and help keep you safe.
• Establish your support network. It may be hard to talk about suicidal feelings, and your friends and family may not fully understand why you feel the way you do. Reach out anyway, and make sure the people who care about you know what’s going on and are there when you need them. You may also want to get help from your place of worship, support groups or other community resources. Feeling connected and supported can help reduce suicide risk.
• Remember, suicidal feelings are temporary. If you feel hopeless or that life’s not worth living anymore, remember that treatment can help you regain your perspective — and life will get better. Take one step at a time and don’t act impulsively.

Why do I feel suicidal?

Many kinds of emotional pain can lead to suicidal thoughts. The reasons for this pain are unique to each one of us, and the ability to cope with the pain differs from person to person. We are all different. There are, however, some common causes that may lead us to experience suicidal thoughts and feelings.
Why suicide can seem like the only option

If you are unable to think of solutions other than suicide, it is not that other solutions don’t exist, but rather that you are currently unable to see them. The intense emotional pain that you’re experiencing right now can distort your thinking so it becomes harder to see possible solutions to problems, or to connect with those who can offer support. Therapists, counselors, friends or loved ones can help you to see solutions that otherwise may not be apparent to you. Give them a chance to help.

A suicidal crisis is almost always temporary

Although it might seem as if your pain and unhappiness will never end, it is important to realize that crises are usually temporary. Solutions are often found, feelings change, unexpected positive events occur.

• Remember: suicide is a permanent solution to a temporary problem. Give yourself the time necessary for things to change and the pain to subside.

Even problems that seem hopeless have solutions

Mental health conditions such as depression, schizophrenia, and bipolar disorder are all treatable with changes in lifestyle, therapy, and medication. Most people who seek help can improve their situation and recover. Even if you have received treatment for a disorder before, or if you’ve already made attempts to solve your problems, know that it’s often necessary to try different approaches before finding the right solution or combination of solutions. When medication is prescribed, for example, finding the right dosage often requires an ongoing process of adjustment. Don’t give up before you’ve found the solution that works for you. Virtually all problems can be treated or resolved.

Reaching out for help

Even if it doesn’t feel like it right now, there are many people who want to support you during this difficult time. Reach out to someone. Do it now. If you promised yourself 24 hours or a week in step #1 above, use that time to tell someone what’s going on with you. Talk to someone who won’t try to argue about how you feel, judge you, or tell you to just “snap out of it.” Find someone who will simply listen and be there for you.

It doesn’t matter who it is, as long as it’s someone you trust and who is likely to listen with compassion and acceptance.

How to talk to someone about your suicidal thoughts

Even when you’ve decided who you can trust to talk to, admitting your suicidal thoughts to another person can be difficult.

• Tell the person exactly what you are telling yourself. If you have a suicide plan, explain it to them.
• Phrases such as, ‘I can’t take it anymore’ or ‘I’m done’ are vague and do not illustrate how serious things really are. Tell the person you trust that you are thinking about suicide.
• If it is too difficult for you to talk about, try writing it down and handing a note to the person you trust. Or send them an email or text and sit with them while they read it.

What if you don’t feel understood?

If the first person you reached out to doesn’t seem to understand, tell someone else or call a suicide crisis helpline. Don’t let a bad experience stop you from finding someone who can help.

If You Have Suicidal Thoughts and Feelings

Things TO DO:

• Talk with someone every day, preferably face to face. Though you feel like withdrawing, ask trusted friends and acquaintances to spend time with you. Or continue to call a crisis helpline and talk about your feelings.
• Make a safety plan. Develop a set of steps that you can follow during a suicidal crisis. It should include contact numbers for your doctor or therapist, as well as friends and family members who will help in an emergency.
• Make a written schedule for yourself every day and stick to it, no matter what. Keep a regular routine as much as possible, even when your feelings seem out of control.
• Get out in the sun or into nature for at least 30 minutes a day.
• Exercise as vigorously as is safe for you. To get the most benefit, aim for 30 minutes of exercise per day. But you can start small. Three 10-minute bursts of activity can have a positive effect on mood.
• Make time for things that bring you joy. Even if very few things bring you pleasure at the moment, force yourself to do the things you used to enjoy.
• Remember your personal goals. You may have always wanted to travel to a particular place, read a specific book, own a pet, move to another place, learn a new hobby, volunteer, go back to school, or start a family. Write your personal goals down.

AVOID:

• Being alone. Solitude can make suicidal thoughts even worse. Visit a friend, or family member, or pick up the phone and call a crisis helpline.
• Alcohol and drugs. Drugs and alcohol can increase depression, hamper your problem-solving ability, and can make you act impulsively.
• Doing things that make you feel worse. Listening to sad music, looking at certain photographs, reading old letters, or visiting a loved one’s grave can all increase negative feelings.
• Thinking about suicide and other negative thoughts. Try not to become preoccupied with suicidal thoughts as this can make them even stronger. Don’t think and rethink negative thoughts. Find a distraction. Giving yourself a break from suicidal thoughts can help, even if it’s for a short time.

Recovering from suicidal thoughts

Even if your suicidal thoughts and feelings have subsided, get help for yourself. Experiencing that sort of emotional pain is itself a traumatizing experience. Finding a support group or therapist can be very helpful in decreasing the chances that you will feel suicidal again in the future. You can get help and referrals from your doctor.

5 steps to recovery from suicidal thoughts

1. Identify triggers or situations that lead to feelings of despair or generate suicidal thoughts, such as an anniversary of a loss, alcohol, or stress from relationships. Find ways to avoid these places, people, or situations.
2. Take care of yourself. Eat right, don’t skip meals, and get plenty of sleep. Exercise is also key: it releases endorphins, relieves stress, and promotes emotional well-being.
3. Build your support network. Surround yourself with positive influences and people who make you feel good about yourself. The more you’re invested in other people and your community, the more you have to lose—which will help you stay positive and on the recovery track.
4. Develop new activities and interests. Find new hobbies, volunteer activities, or work that gives you a sense of meaning and purpose. When you’re doing things you find fulfilling, you’ll feel better about yourself and feelings of despair are less likely to return.
5. Learn to deal with stress in a healthy way. Find healthy ways to keep your stress levels in check, including exercising, meditating, using sensory strategies to relax, practicing simple breathing exercises, and challenging self-defeating thoughts.

Suicidal thoughts causes

The World Health Organization estimates that approximately 1 million people die each year from suicide. What drives so many individuals to take their own lives? To those not in the grips of suicidal depression and despair, it’s difficult to understand what drives so many individuals to take their own lives. But a suicidal person is in so much pain that he or she can see no other option.

Suicide is a desperate attempt to escape suffering that has become unbearable. Blinded by feelings of self-loathing, hopelessness, and isolation, a suicidal person can’t see any way of finding relief except through death. But despite their desire for the pain to stop, most suicidal people are deeply conflicted about ending their own lives. They wish there was an alternative to suicide, but they just can’t see one.

Suicidal thoughts have many causes. Most often, suicidal thoughts are the result of feeling like you can’t cope when you’re faced with what seems to be an overwhelming life situation. If you don’t have hope for the future, you may mistakenly think suicide is a solution. You may experience a sort of tunnel vision, where in the middle of a crisis you believe suicide is the only way out.

There also may be a genetic link to suicide. People who complete suicide or who have suicidal thoughts or behavior are more likely to have a family history of suicide.

Risk factors for suicide

According to the U.S. Department of Health and Human Services, at least 90 percent of all people who die by suicide suffer from one or more mental disorders such as depression, bipolar disorder, schizophrenia, or alcoholism. Depression in particular plays a large role in suicide. The difficulty suicidal people have imagining a solution to their suffering is due in part to the distorted thinking caused by depression.

Although attempted suicide is more frequent for women, men are more likely than women to complete suicide because they typically use more-effective methods, such as a firearm.

You may be at risk of suicide if you:

• Social isolation and loneliness
• Feel hopeless, worthless, agitated, socially isolated or lonely
• Experience a stressful life event, such as the loss of a loved one, military service, a breakup, or financial or legal problems
• Have a substance abuse problem — alcohol and drug abuse can worsen thoughts of suicide and make you feel reckless or impulsive enough to act on your thoughts
• Have suicidal thoughts and have access to firearms in your home
• Have an underlying psychiatric disorder, such as major depression, post-traumatic stress disorder or bipolar disorder
• Have a family history of mental disorders, substance abuse, suicide, or violence, including physical or sexual abuse
• Have a medical condition that can be linked to depression and suicidal thinking, such as chronic disease, chronic pain or terminal illness
• Are lesbian, gay, bisexual or transgender with an unsupportive family or in a hostile environment
• Attempted suicide before

Children and teenagers

Suicide in children and teenagers often follows stressful life events. What a young person sees as serious and insurmountable may seem minor to an adult — such as problems in school or the loss of a friendship. In some cases, a child or teen may feel suicidal due to certain life circumstances that he or she may not want to talk about, such as:

• Having a psychiatric disorder, including depression
• Loss or conflict with close friends or family members
• History of physical or sexual abuse
• Problems with alcohol or drugs
• Physical or medical issues, for example, becoming pregnant or having a sexually transmitted infection
• Being the victim of bullying
• Being uncertain of sexual orientation
• Reading or hearing an account of suicide or knowing a peer who died by suicide

Suicide in the elderly

The highest suicide rates of any age group occur among persons aged 65 years and older. One contributing factor is depression in the elderly that is undiagnosed and untreated.

Other risk factors for suicide in the elderly include:

• Recent death of a loved one, isolation and loneliness
• Physical illness, disability, or pain
• Major life changes, such as retirement or loss of independence
• Loss of sense of purpose

Murder and suicide

In rare cases, people who are suicidal are at risk of killing others and then themselves. Known as a homicide-suicide or murder-suicide, some risk factors include:

• History of conflict with a spouse or romantic partner
• Current family legal or financial problems
• History of mental health problems, particularly depression
• Alcohol or drug abuse
• Having access to a firearm — nearly all murder-suicides are committed using a gun

Starting antidepressants and increased suicide risk

Most antidepressants are generally safe, but the Food and Drug Administration requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The risk of suicide is the greatest during the first two months of antidepressant treatment. The FDA advises that anyone on antidepressants should be watched for increases in suicidal thoughts and behaviors.

However, keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

Suicide prevention

How to Help Someone who is Suicidal and Save a Life

A suicidal person may not ask for help, but that doesn’t mean that help isn’t wanted. People who take their lives don’t want to die—they just want to stop hurting. Suicide prevention starts with recognizing the warning signs and taking them seriously. If you think a friend or family member is considering suicide, you might be afraid to bring up the subject. But talking openly about suicidal thoughts and feelings can save a life.

Start by asking questions

The first step is to find out whether the person is in danger of acting on suicidal feelings. Be sensitive, but ask direct questions, such as:

• How are you coping with what’s been happening in your life?
• Do you ever feel like just giving up?
• Are you thinking about dying?
• Are you thinking about hurting yourself?
• Are you thinking about suicide?
• Have you ever thought about suicide before, or tried to harm yourself before?
• Have you thought about how or when you’d do it?
• Do you have access to weapons or things that can be used as weapons to harm yourself?

Asking about suicidal thoughts or feelings won’t push someone into doing something self-destructive. In fact, offering an opportunity to talk about feelings may reduce the risk of acting on suicidal feelings.

Suicide Warning Signs

You can’t always tell when a loved one or friend is considering suicide. But here are some common signs:

• Talking about suicide — for example, making statements such as “I’m going to kill myself,” “I wish I were dead” or “I wish I hadn’t been born”
• Getting the means to take your own life, such as buying a gun or stockpiling pills
• Withdrawing from social contact and wanting to be left alone
• Having mood swings, such as being emotionally high one day and deeply discouraged the next
• Being preoccupied with death, dying or violence
• Feeling trapped or hopeless about a situation – feelings of helplessness, hopelessness, and being trapped (“There’s no way out”). Belief that things will never get better or change.
• Self-loathing, self-hatred – Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden (“Everyone would be better off without me”).
• Increasing use of alcohol or drugs
• Changing normal routine, including eating or sleeping patterns
• Doing risky or self-destructive things, such as using drugs or driving recklessly
• Giving away belongings or getting affairs in order when there is no other logical explanation for doing this
• Saying goodbye to people as if they won’t be seen again
• Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above
• Sudden sense of calm – A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to attempt suicide.

Warning signs in teens

Additional warning signs that a teen may be considering suicide:

• Change in eating and sleeping habits
• Withdrawal from friends, family, and regular activities
• Violent or rebellious behavior, running away
• Drug and alcohol use
• Unusual neglect of personal appearance
• Persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork
• Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
• Not tolerating praise or rewards

Warning signs in older adults

Additional warning signs that an elderly person may be contemplating suicide:

• Reading material about death and suicide
• Disruption of sleep patterns
• Increased alcohol or prescription drug use
• Failure to take care of self or follow medical orders
• Stockpiling medications or sudden interest in firearms
• Social withdrawal, elaborate good-byes, rush to complete or revise a will

For immediate help

If someone has attempted suicide:

• Don’t leave the person alone.
• Call your local emergency number right away. Or, if you think you can do so safely, take the person to the nearest hospital emergency room yourself.
• Try to find out if he or she is under the influence of alcohol or drugs or may have taken an overdose.
• Tell a family member or friend right away what’s going on.

If a friend or loved one talks or behaves in a way that makes you believe he or she might attempt suicide, don’t try to handle the situation alone:

• Get help from a trained professional as quickly as possible. The person may need to be hospitalized until the suicidal crisis has passed.
• Encourage the person to call a suicide hotline number. In the U.S., call the National Suicide Prevention Lifeline at 800-273-8255 to reach a trained counselor. Use that same number and press “1” to reach the Veterans Crisis Line.

Take all signs of suicidal behavior seriously

If someone says he or she is thinking of suicide or behaves in a way that makes you think the person may be suicidal, don’t play it down or ignore the situation. Many people who kill themselves have expressed the intention at some point. You may worry that you’re overreacting, but the safety of your friend or loved one is most important. Don’t worry about straining your relationship when someone’s life is at stake.

You’re not responsible for preventing someone from taking his or her own life — but your intervention may help the person see that other options are available to stay safe and get treatment.

Offer support

If a friend or loved one is thinking about suicide, he or she needs professional help, even if suicide isn’t an immediate danger. Here’s what you can do.

• Encourage the person to call a suicide hotline number. In the U.S., call the National Suicide Prevention Lifeline at 800-273-8255 to reach a trained counselor.
• Encourage the person to seek treatment. A suicidal or severely depressed person may not have the energy or motivation to find help. If the person doesn’t want to consult a doctor or mental health provider, suggest finding help from a support group, crisis center, faith community, teacher or other trusted person. You can offer support and advice — but remember that it’s not your job to substitute for a mental health provider.
• Offer to help the person take steps to get assistance and support. For example, you can research treatment options, make phone calls and review insurance benefit information, or even offer to go with the person to an appointment.
• Encourage the person to communicate with you. Someone who’s suicidal may be tempted to bottle up feelings because he or she feels ashamed, guilty or embarrassed. Be supportive and understanding, and express your opinions without placing blame. Listen attentively and avoid interrupting.
• Be respectful and acknowledge the person’s feelings. Don’t try to talk the person out of his or her feelings or express shock. Remember, even though someone who’s suicidal isn’t thinking logically, the emotions are real. Not respecting how the person feels can shut down communication.
• Don’t be patronizing or judgmental. For example, don’t tell someone, “Things could be worse” or “You have everything to live for.” Instead, ask questions such as, “What’s causing you to feel so bad?” “What would make you feel better?” or “How can I help?”
• Never promise to keep someone’s suicidal feelings a secret. Be understanding, but explain that you may not be able to keep such a promise if you think the person’s life is in danger. At that point, you have to get help.
• Offer reassurance that things can get better. When someone is suicidal, it seems as if nothing will make things better. Reassure the person that with appropriate treatment, he or she can develop other ways to cope and can feel better about life again.
• Encourage the person to avoid alcohol and drug use. Using drugs or alcohol may seem to ease the painful feelings, but ultimately it makes things worse — it can lead to reckless behavior or feeling more depressed. If the person can’t quit on his or her own, offer to help find treatment.
• Remove potentially dangerous items from the person’s home, if possible. If you can, make sure the person doesn’t have items around that could be used for suicide — such as knives, razors, guns or drugs. If the person takes a medication that could be used for overdose, encourage him or her to have someone safeguard it and give it as prescribed.

Suicide prevention tip 1: Speak up if you’re worried

If you spot the warning signs of suicide in someone you care about, you may wonder if it’s a good idea to say anything. What if you’re wrong? What if the person gets angry? In such situations, it’s natural to feel uncomfortable or afraid. But anyone who talks about suicide or shows other warning signs needs immediate help—the sooner the better.

Talking to a person about suicide

Talking to a friend or family member about their suicidal thoughts and feelings can be extremely difficult for anyone. But if you’re unsure whether someone is suicidal, the best way to find out is to ask. You can’t make a person suicidal by showing that you care. In fact, giving a suicidal person the opportunity to express his or her feelings can provide relief from loneliness and pent-up negative feelings, and may prevent a suicide attempt.

Ways to start a conversation about suicide:

• “I have been feeling concerned about you lately.”
• “Recently, I have noticed some differences in you and wondered how you are doing.”
• “I wanted to check in with you because you haven’t seemed yourself lately.”

Questions you can ask:

• “When did you begin feeling like this?”
• “Did something happen that made you start feeling this way?”
• “How can I best support you right now?”
• “Have you thought about getting help?”

What you can say that helps:

• “You are not alone in this. I’m here for you.”
• “You may not believe it now, but the way you’re feeling will change.”
• “I may not be able to understand exactly how you feel, but I care about you and want to help.”
• “When you want to give up, tell yourself you will hold off for just one more day, hour, minute—whatever you can manage.”

When talking to a suicidal person

DO:

• Be yourself. Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it.
• Listen. Let the suicidal person unload despair, ventilate anger. No matter how negative the conversation seems, the fact that it exists is a positive sign.
• Be sympathetic, non-judgmental, patient, calm, accepting. Your friend or family member is doing the right thing by talking about his/her feelings.
• Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important to you.
• Take the person seriously. If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head, you are showing that you are concerned, that you take them seriously, and that it’s OK for them to share their pain with you.

DON’T:

• Argue with the suicidal person. Avoid saying things like: “You have so much to live for,” “Your suicide will hurt your family,” or “Look on the bright side.”
• Act shocked, lecture on the value of life, or say that suicide is wrong.
• Promise confidentiality. Refuse to be sworn to secrecy. A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe. If you promise to keep your discussions secret, you may have to break your word.
• Offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your friend or loved one.
• Blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness, or lack thereof, is not your responsibility.

Suicide prevention tip 2: Respond quickly in a crisis

If a friend or family member tells you that he or she is thinking about death or suicide, it’s important to evaluate the immediate danger the person is in. Those at the highest risk for suicide in the near future have a specific suicide PLAN, the MEANS to carry out the plan, a TIME SET for doing it, and an INTENTION to do it.

The following questions can help you assess the immediate risk for suicide:

• Do you have a suicide plan? (PLAN)
• Do you have what you need to carry out your plan (pills, gun, etc.)? (MEANS)
• Do you know when you would do it? (TIME SET)
• Do you intend to take your own life? (INTENTION)

Level of Suicide Risk

• Low – Some suicidal thoughts. No suicide plan. Says he or she won’t attempt suicide.
• Moderate – Suicidal thoughts. Vague plan that isn’t very lethal. Says he or she won’t attempt suicide.
• High – Suicidal thoughts. Specific plan that is highly lethal. Says he or she won’t attempt suicide.
• Severe – Suicidal thoughts. Specific plan that is highly lethal. Says he or she will attempt suicide.

If a suicide attempt seems imminent, call a local crisis center, dial your local emergency number, or take the person to an emergency room. Remove guns, drugs, knives, and other potentially lethal objects from the vicinity but do not, under any circumstances, leave a suicidal person alone.

Suicide prevention tip 3: Offer help and support

If a friend or family member is suicidal, the best way to help is by offering an empathetic, listening ear. Let your loved one know that he or she is not alone and that you care. Don’t take responsibility, however, for making your loved one well. You can offer support, but you can’t get better for a suicidal person. He or she has to make a personal commitment to recovery.

It takes a lot of courage to help someone who is suicidal. Witnessing a loved one dealing with thoughts about ending his or her own life can stir up many difficult emotions. As you’re helping a suicidal person, don’t forget to take care of yourself. Find someone that you trust—a friend, family member, clergyman, or counselor—to talk to about your feelings and get support of your own.

Helping a suicidal person:

• Get professional help. Do everything in your power to get a suicidal person the help he or she needs. Call a crisis line for advice and referrals. Encourage the person to see a mental health professional, help locate a treatment facility, or take them to a doctor’s appointment.
• Follow-up on treatment. If the doctor prescribes medication, make sure your friend or loved one takes it as directed. Be aware of possible side effects and be sure to notify the physician if the person seems to be getting worse. It often takes time and persistence to find the medication or therapy that’s right for a particular person.
• Be proactive. Those contemplating suicide often don’t believe they can be helped, so you may have to be more proactive at offering assistance. Saying, “Call me if you need anything” is too vague. Don’t wait for the person to call you or even to return your calls. Drop by, call again, invite the person out.
• Encourage positive lifestyle changes, such as a healthy diet, plenty of sleep, and getting out in the sun or into nature for at least 30 minutes each day. Exercise is also extremely important as it releases endorphins, relieves stress, and promotes emotional well-being.
• Make a safety plan. Help the person develop a set of steps he or she promises to follow during a suicidal crisis. It should identify any triggers that may lead to a suicidal crisis, such as an anniversary of a loss, alcohol, or stress from relationships. Also include contact numbers for the person’s doctor or therapist, as well as friends and family members who will help in an emergency.
• Remove potential means of suicide, such as pills, knives, razors, or firearms. If the person is likely to take an overdose, keep medications locked away or give out only as the person needs them.
• Continue your support over the long haul. Even after the immediate suicidal crisis has passed, stay in touch with the person, periodically checking in or dropping by. Your support is vital to ensure your friend or loved one remains on the recovery track.

Suicidal thoughts signs and symptoms

Suicidal behavior signs or suicidal thoughts include:

• Talking about suicide — for example, making statements such as “I’m going to kill myself,” “I wish I were dead” or “I wish I hadn’t been born”
• Getting the means to take your own life, such as buying a gun or stockpiling pills
• Withdrawing from social contact and wanting to be left alone
• Having mood swings, such as being emotionally high one day and deeply discouraged the next
• Being preoccupied with death, dying or violence
• Feeling trapped or hopeless about a situation
• Increasing use of alcohol or drugs
• Changing normal routine, including eating or sleeping patterns
• Doing risky or self-destructive things, such as using drugs or driving recklessly
• Giving away belongings or getting affairs in order when there’s no other logical explanation for doing this
• Saying goodbye to people as if they won’t be seen again
• Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above

Warning signs aren’t always obvious, and they may vary from person to person. Some people make their intentions clear, while others keep suicidal thoughts and feelings secret.

Suicidal thoughts diagnosis

Your doctor may do a physical exam, tests and in-depth questioning about your mental and physical health to help determine what may be causing your suicidal thinking and to determine the best treatment.

Assessments may include:

• Mental health conditions. In most cases, suicidal thoughts are linked to an underlying mental health issue that can be treated. If this is the case, you may need to see a doctor who specializes in diagnosing and treating mental illness (psychiatrist) or other mental health provider.
• Physical health conditions. In some cases, suicidal thinking may be linked to an underlying physical health problem. You may need blood tests and other tests to determine whether this is the case.
• Alcohol and drug misuse. For many people, alcohol or drugs play a role in suicidal thinking and completed suicide. Your doctor will want to know whether you have any problems with alcohol or drug use — such as bingeing or being unable to cut back or quit using alcohol or drugs on your own. Many people who feel suicidal need treatment to help them stop using alcohol or drugs to reduce their suicidal feelings.
• Medications. In some people, certain prescription or over-the-counter drugs can cause suicidal feelings. Tell your doctor about any medications you take to see whether they could be linked to your suicidal thinking.

Children and teenagers

Children who are feeling suicidal usually need to see a psychiatrist or psychologist experienced in diagnosing and treating children with mental health problems. The doctor will want to get an accurate picture of what’s going on from a variety of sources, such as the young person, parents or guardians, others close to the child, school reports, and previous medical or psychiatric evaluations.

Treatment for suicidal thoughts

Treatment of suicidal thoughts and behavior depends on your specific situation, including your level of suicide risk and what underlying problems may be causing your suicidal thoughts or behavior.

Emergencies

If you’ve attempted suicide and you’re injured:

• Call your local emergency number.
• Have someone else call if you’re not alone.

If you’re not injured, but you’re at immediate risk of harming yourself:

• Call your local emergency number.
• Or, if you can do so safely, take the person to the nearest hospital emergency room
• Call a suicide hotline number.
  • In the U.S., call the National Suicide Prevention Lifeline at 800-273-8255. Use that same number and press “1” to reach the Veterans Crisis Line. Or call the National Hopeline Network at 1-800-784-2433
  • In the UK and Ireland – call the Samaritans at 116-123
  • In Australia – call Lifeline Australia at 13-11-14
  • In other countries – Visit International Association for Suicide Prevention at http://www.iasp.info/resources/Crisis_Centres or Suicide.org to find a helpline in your country at http://www.suicide.org/international-suicide-hotlines.html.

At the emergency room, you’ll be treated for any injuries. The doctor will ask you questions and may examine you, looking for recent or past signs of attempted suicide. Depending on your state of mind, you may need medications to calm you or to ease symptoms of an underlying mental illness, such as depression.

Your doctor may want you to stay in the hospital long enough to make sure any treatments are working, that you’ll be safe when you leave and that you’ll get the follow-up treatment you need.

Nonemergency situations

If you have suicidal thoughts, but aren’t in a crisis situation, you may need outpatient treatment. This treatment may include:

• Psychotherapy. In psychotherapy, also called psychological counseling or talk therapy, you explore the issues that make you feel suicidal and learn skills to help manage emotions more effectively. You and your therapist can work together to develop a treatment plan and goals.
• Medications. Antidepressants, antipsychotic medications, anti-anxiety medications and other medications for mental illness can help reduce symptoms, which can help you feel less suicidal.
• Addiction treatment. Treatment for drug or alcohol addiction can include detoxification, addiction treatment programs and self-help group meetings.
• Family support and education. Your loved ones can be both a source of support and conflict. Involving them in treatment can help them understand what you’re going through, give them better coping skills, and improve family communication and relationships.

Helping a loved one

If you have a loved one who has attempted suicide, or if you think your loved one may be in danger of doing so, get emergency help.

If you have a loved one you think may be considering suicide, have an open and honest discussion about your concerns. You may not be able to force someone to seek professional care, but you can offer encouragement and support. You can also help your loved one find a qualified doctor or mental health provider and make an appointment. You can even offer to go along.

Supporting a loved one who is chronically suicidal can be stressful and exhausting. You may be afraid and feel guilty and helpless. Take advantage of resources about suicide and suicide prevention so that you have information and tools to take action when needed. Also, take care of yourself by getting support from family, friends, organizations and professionals.

Lifestyle and home remedies

There’s no substitute for professional help when it comes to treating suicidal thinking and preventing suicide. However, there are a few things that may reduce suicide risk:

• Avoid drugs and alcohol. Alcohol and street drugs can worsen suicidal thoughts. They can also make you feel less inhibited, which means you’re more likely to act on your thoughts.
• Form a strong support network. That may include family, friends or members of your church, synagogue or other place of worship. Religious practice has been shown to help reduce the risk of suicide.
• Get active. Physical activity and exercise have been shown to reduce depression symptoms. Consider walking, jogging, swimming, gardening or taking up another form of physical activity that you enjoy.

Coping and support

Don’t try to manage suicidal thoughts or behavior entirely on your own. You need professional help and support to overcome the problems linked to suicidal thinking. In addition:

• Go to your appointments. Don’t skip therapy sessions or doctor’s appointments, even if you don’t want to go or don’t feel like you need to.
• Take medications as directed. Even if you’re feeling well, don’t skip your medications. If you stop, your suicidal feelings may come back. You could also experience withdrawal-like symptoms from abruptly stopping an antidepressant or other medication.
• Learn about your condition. Learning about your condition can empower and motivate you to stick to your treatment plan. If you have depression, for instance, learn about its causes and treatments.
• Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your suicidal feelings. Learn to spot the danger signs early, and decide what steps to take ahead of time. Contact your doctor or therapist if you notice any changes in how you feel. Consider involving family members or friends in watching for warning signs.
• Make a plan so you know what to do if suicidal thoughts return. You may want to make a written agreement with a mental health provider or a loved one to help you anticipate the right steps to take when you don’t have the best judgment. Clearly stating your suicidal intention with your therapist makes it possible to anticipate it and address it.
• Eliminate potential means of killing yourself. If you think you might act on suicidal thoughts, immediately get rid of any potential means of killing yourself, such as firearms, knives or dangerous medications. If you take medications that have a potential for overdose, have a family member or friend give you your medications as prescribed.
• Seek help from a support group. A number of organizations are available to help you cope with suicidal thinking and recognize that there are many options in your life other than suicide.