Suicide. Have you ever considered it? If you have, it is likely you have never told anyone. In fact, you may not admit it to yourself. Social stigma and your own shame have kept you silent.

What do statistics tell us? Suicide ranks tenth as a cause of death. Most suicides are a result of firearms. About half as many are caused by suffocation. Half again are caused by poisoning. In a 2013 report by the Center for Disease Control, 383,000 emergency room visits were a result of self-inflicted injuries. Of those, 42,826 people died.

Could any of those who took their own lives have been saved? What would it take to prevent someone from taking that final step?

What are some clues that a person is contemplating suicide? Most people have heard the adage that many people who talk about taking their own lives don’t truly want to do it and won’t succeed. Whether that is true or not, every warning should be taken seriously. You may think only a “crazy” person would commit suicide. In fact, most suicidal individuals are not insane. Usually a suicidal individual is upset about something. She may be depressed, a failed relationship, a lost job, grief stricken over the loss of a loved one, or even in dire financial straits. A person who feels hopeless may not see any option other than suicide. Emotional distress can feel overwhelming and mind numbing. Usually the suicidal person wants their pain to stop. It isn’t death that is sought, but a release from emotional agony. Often, he may have seen a doctor recently, hoping for answers.

So, how do you know if someone in your life is contemplating suicide? Certainly, if the person says things like, “I’d be better off dead”, “I have nothing to look forward to”, or “I feel so hopeless”, she is sending out signals she sees only one way out. Some people may write notes, poetry, or talk about death. Sudden inexplicable mood changes or mood swings, withdrawal from social groups or activities, or reckless behaviors can be indicators as well. Abrupt interest in weapons that could be used like guns or drugs that could be used to overdose or the acquisition of these should trigger warnings.

“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.” HelpGuide.org. https://www.helpguide.org/articles/suicide-prevention/suicide-prevention.htm

You’re worried, what should you do? Some people think it’s not a good idea to mention suicide to someone they suspect is considering taking his own life. You should talk about it. Don’t be afraid to ask. You may be giving him the opportunity to discuss his feelings. By eliminating that feeling of isolation you can provide an outlet for pent up fears, frustrations, and feelings of worthlessness.

“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.” HelpGuide.org (see above)

            It doesn’t matter what you say, if you are being yourself. More important than what you say, is that you listen. He may say negative things, may sound hopeless. However, talking is a beginning. It may be difficult to be patient and non-judgmental, but it is important to listen calmly. Let him know you understand but offer hope, reminding him help is available. Knowing that he is important to you and that you care is important.

You want to avoid appearing shocked. Don’t argue or tell him he’ll feel better soon. Certainly, do not be judgmental and say suicide is wrong or a sin, or that it will hurt his family. Don’t offer advice or solutions. You can’t “fix” another person’s problems. And, although it may seem difficult, don’t offer to keep their revelations a secret. It’s possible you will have to reach out to a mental health professional and it could be devastating for your friend or family member if you break your promise.

“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)

What is the 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 911, 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.” HelpGuide.org (see above)

The best way to help a loved one who is suicidal is to let her know she is loved and she is not alone. Listening empathetically and being supportive is all you can do. And don’t forget the pain and stress such revelations can cause for you. Find someone you can talk to; another family member, a close friend, a counselor, or a religious leader can provide an outlet for your own feelings.