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About Suicide

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RECOGNIZING WARNING SIGNS OF SUICIDE
Originally published by Mayo Clinic Health Letter October 1998

Certain warning signs may indicate serious depression and the possibility of suicide. Take any threat of suicide seriously, even if the person is already being treated for depression.

If you see any of these danger signs, call a doctor, mental health clinic or suicide hotline immediately:

  1. Pacing,
  2. agitated behavior,
  3. frequent mood changes,
  4. sleeplessness for several nights.
  5. Actions or threats of assault, physical harm or violence.
  6. Delusions or hallucinations, such as hearing voices.
  7. Threats or talk of death or suicide, such as "I don’t care any more," or "You won’t need to worry about me much longer."
  8. Withdrawal from activities and relationships.
  9. Putting affairs in order, such as saying good-bye to friends, giving away prized possessions or writing a will.
  10. A sudden brightening of mood after a period of being depressed.
  11. Unusually risky behavior, such as buying or handling a gun or driving recklessly.

What to look for

A person who is contemplating taking his or her own life may show one or more signs. However, Christine M. Sadowski, Ph.D., a child and family psychologist at Mayo Clinic, notes it's important to keep in mind that the warning signs listed below are only guidelines.

There is no one type of suicidal person. If you are concerned that someone is contemplating suicide for whatever reason arrange professional assistance for that person immediately.

Suicidal Threats

Someone may state outright that he or she is contemplating suicide, saying things like "I wish I'd never been born," or "Everyone will be better off when I'm gone." The popular assumption that people who threaten suicide never really do it simply is not true; all such threats should be taken seriously. Don't be afraid to be direct and ask if the person is having thoughts of hurting themselves. Let them know how you would feel if they weren't in your life anymore. Ask them what they are most angry about.

Withdrawal

The person may become unwilling to communicate or may exhibit an overwhelming urge to be alone. Trouble at work or poor grades in school can be indicators of withdrawal. Loosing interest in previously enjoyed activities or relationships is a form of withdrawal. Children may become panicky about having to go to school or may feign illness in order to stay home.

Depression

The person appears to be overtly depressed and may be unable to function socially or in the workplace. He or she may express feelings of despair, grief, guilt, shame, hopelessness and helplessness.

Moodiness

Mood swings may also be a significant sign. Also, be aware that someone who suddenly becomes inexplicably calm after a period of deep gloom or mood swings may not be well. He or she may have already decided on suicide as an out and thus feels "calm" in having made the decision.

Changes in Personality

A marked change in attitude, personal appearance or activities may precede a suicide attempt. You may see changes in eating or sleeping patterns. An unusually worried person might be suddenly calm or cheerful. Or a generally somber person might become aggressive or rege-full.

Self-destructive Behavior

A suicidal urge may be manifested by sudden participation in dangerous activities such as high-speed driving or unsafe sex. Alcohol and drug abuse often go hand in hand with suicide.

Experience of a Life Crisis or Trauma

Depression, divorce, grief over the loss of a loved one, or an accident may prompt a suicide attempt. A drop in self-esteem that may follow the loss of a job or a financial setback may lead to thoughts of suicide.

Gives Away Possessions

The person disposes of cherished belongings. Offering siblings prized collections (cards, music etc.) Sending e-mail to family and friends filled with appreciation. Giving gifts of thanks to teachers and friends.

The Very Young, And the Old Are Most at Risk

Suicide rates have been traditionally highest among adolescents, people in mid-life and the very old. Teen-agers are still developing emotionally at a time when they may frequently face difficult pressures at home or school. In fact, suicide is now the third leading cause of death among American adolescents. People in their middle years may lose a spouse or parent, have children leave home, or experience serious illness. Older people commonly experience life-altering changes — loss of a loved one, decline in health, loss of independence.

According to figures from the Centers for Disease Control and Prevention (CDC), males are at least four times more likely to die from suicide than are females. But females are far more likely to attempt suicide than are males. The risk that the suicide actually will be completed is greater in males, in people who have lost a spouse (by death or divorce), in people with substance abuse problems, in those with a history of previous suicide attempts, or in those with a family history of suicide.

According to the CDC, the largest relative increases in suicide rates from 1980 to 1997 occurred among those ages 80 to 84.

From 1952 to 1995, the incidence of suicide nearly tripled among adolescents and young adults. From 1980 to 1997, suicide rates among those ages 15 to 19 increased by 11 percent, and rates among children ages 10 to 14 rose by 109 percent.

What You Can Do

If someone you know mentions suicide — even casually — take it seriously. If someone doesn't mention suicide but his or her behavior has you concerned, it's not unreasonable to ask if he or she is contemplating suicide. Don't keep someone's suicidal threats a secret, and don't believe they can handle their problems all on their own.

Treatment likely will take time, persistence and professional guidance. Suicidal persons, experts note, often feel ambivalent about dying; intervention can make a difference.

"The first thing to do is not ignore your concerns but seek help," notes Dianne C. Shober, a Mayo Clinic licensed social worker and marriage and family therapist who heads Mayo's Employee Assistance Program. "Your first step may be to contact a suicide or crisis prevention center, a mental health clinic, or a hospital in your area. You may also find support and information from employee assistance programs, a family physician, a clergy-person, or a psychologist or psychiatrist," Shober suggests.

However, during a crisis — if someone is threatening suicide and tells you he or she has a means to kill himself or herself — contact emergency personnel immediately and remain with the individual, if possible, until help arrives.

Most unsuccessful suicide attempts are a cry for help. However this is in no way a reason to minimize the person's sincerity. Help may come in the form of professional counseling, drug therapy or even hospitalization. Help also comes in the form of listening. Talking about suicide won't make it happen. You can make a special effort to communicate with and be there for a suicidal person — but know your limitations. Unless you are trained to do so, do not attempt to manage someone's depression or suicidal tendencies by yourself.

Frequently Asked Questions on Suicide

 



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