“If I was going to kill myself, I wouldn’t tell you or anyone else.”
As a Psychiatric Nurse Practitioner who specializes in crisis intervention and Emergency Room Psychiatry, I hear that a lot. Over 30,000 Americans will take their own lives this year. More people die by suicide each year than homicide, yet suicides rarely make the nightly news. Sometimes it’s hard to know when someone you love and care about may be hurting inside and may need help. If your friends or family are thinking about killing themselves, and they don’t tell you, how can you help them? You can help because there are signs and clues before someone attempts to hurt or kill themselves, a prelude that you may be able to recognize after reading this information.
Anyone can commit suicide. Suicides occur in every ethnic group, gender, occupation, geographic area and socioeconomic status. Suicide is the third leading cause of death in teens and young adults, ages 15-24.
Suicide is preventable. Once you recognize these signs and symptoms in someone, you can help save their life by taking action and getting them to the nearest ER.
In most cases, there are many factors involved in a combination that leads someone to take their own life. Here are some of the potential reasons:
- Social isolation and loneliness
- Intense loss and grief feelings caused by the death of a loved one or the break-up of a relationship
- Sever family, work, financial, legal or social problems
- Alcohol or other substance abuse
- Severe depression or other mental illness
- Severe chronic stress
- Victims of domestic violence
- Post Traumatic Stress Disorder
- Low self-esteem
- Difficulties dealing with life changes
- Serious illness
- Loss of hope
- Intense embarrassment or humiliation before family, friends, colleagues
- Overwhelming guilty feelings
Now that you know the factors that may lead a person to kill themselves, you also need to learn some clues. Some are obvious like the person makes a direct statement such as “I am going to kill myself,” or “I’d be better off dead,” or “I wish I was dead.” Some people make funeral arrangements and tell people about it. Having weapons and drinking excessively or using drugs to gain “courage” to do it is also a warning sign.
But some clues aren’t that obvious, such as loneliness for a long time and living alone, isolation, excessive spending, giving away possessions, talking about being rejected, changes in personality, making a will, buying a weapon, loss of clear thinking or rigid thinking, not being able to problem-solve, frustrations with everyday life, and feeling out of place or confused.
As you can see, it isn’t just people with mental illness who commit suicide. But having a mental illness, a previous suicide attempt, or a family history of mental illness can increase the above risk factors. Also increasing someone’s risk may be chronic pain, chronic illness, a family history of suicides, and physical or sexual abuse as a child.
One of the areas often overlooked because we are so focused on the risk factors, is someone’s motivation. What is a person’s motivation for wanting to kill them selves? Some of the more common motivations are:
- To avoid or end pain
- To gain attention
- To be perceived as a martyr for a cause
- To avenge a perceived wrong
- To express grief over a relationship
- To escape an intolerable situation
- To manipulate others
- To respond to an internal impulse (like hearing voices telling you to kill yourself)
- To avoid humiliation
If you think someone might hurt themselves, here are some things to try:
- Listen, don’t judge
- Ask if they have a specific plan (there is great risk if there is a plan)
- Provide emotional support
- Don’t leave the person alone
- Call 911
- Get rid of firearms or other weapons and look for drugs, medicines, and alcohol
Remember, suicide is preventable. You now have the tools to help recognize people in your life who may be at risk, both now and in the future.
National Suicide Prevention Lifeline: 1-800-273-TALK. The lifeline is funded by a grant from the US Department of Health and Human Services Substance abuse and mental health administration.
Jobes, D. (2006). Managing Suicidal Risk. New York: The Guilford Press.
Joiner, T (2005). Why People Die By Suicide. Cambridge: Harvard University Press.