Suicide: Risks and Warnings

Those words have haunted me for the past three weeks. An old friend had committed suicide. Was it my fault? We had parted on poor terms. She tried to write to me a couple months ago and I had never read the e-mail. Was she reaching out to me and my bitterness killed her because I refused to read it? I was wracked with doubt. She had never seemed like the kind who would kill herself, but I knew she had issues. It is only recently I have been able to set aside my feelings of guilt and realize that it was her choice and not my fault.

According to Dr. Cooper-Lewter of the University of South Carolina psychology department, 80% of those who will attempt suicide give some sort of warning. That is one of five who will not. That is good news if you fear someone you know may want to commit suicide. What are the risks, the warning signs, that everyone should be aware of in order to prevent more tragedies like the one of my friend?

One risk factor for suicide is presence of mental illness. Depression and Bi-polar disorder are most common in suicide victims followed closely by alcoholism and schizophrenia. If someone you know has one of these illnesses, take it seriously when they are experiencing an episode. Not every episode will be like the last one. If suicide is associated with a depressive episode, it most often will occur within three months of improvement of symptoms. Yes, improvement.

Suicide risk increases with concurrent substance abuse. If the person you care about has a history of drug use or abuse, be on guard. Drug or alcohol use is not always easy to see and can be easy to hide if the person is not strongly dependent.

A person who is going to commit suicide usually has a specific plan in mind. If someone says they want to kill themselves, ask how they will do it. Vague assurances of impending death is a mild warning, however, if the person knows how they will do it, what they will use and when then that is a blaring alarm. Risk increase if the individual has access to tools; ropes, knives, drugs or firearms. Do not assume hidden in a drawer or closet is secure. If you have these in your home, keep them under lock and key. Suicide can often be caused by many different factors. Among adolescents, it is common for suicide to accompany interpersonal conflicts and loss, abuse, family discord, mood disorders, conduct disorder, substance abuse. There is a higher chance of suicide among youth hiding homosexual feelings. Bullying has been seen in the news as a cause of several cases, but there is little research indicating how strong a factor it is. Adolescent suicide attempts are often impulsive, and motivated by a desire to influence others, to gain attention or affection, to express anger, or to escape an undesirable situation.

Despite sensationalistic claims to the contrary, there is no support for claims that listening to certain types of music or dressing certain ways increases risk of suicide. However, preoccupation with depressive music while crying or isolating self from others may be indicative of depression, which is a risk factor.

General warning signs to look for are varied. Previous attempts make it much more likely a person may try again if they become depressed again. Anxiety, exhaustion or depression is a warning. Suicidal ideation is sometimes expressed in subtle warning signs such as giving away possessions to others, even prized possessions. They will sometimes show abnormal concern for the well-being of those they may leave behind. Making plans for death, like making a last will and testament is a warning sign.

This is just an overview of some things to look for. What you do with it is up to you. It is important that you take all threats seriously. Really look at the situation surrounding the person you care for and consider if there is risk. If you feel there is, then minimize chances for harm by putting obvious tools where they cannot get to them. If appropriate, get family and friends involved to intervene. Sometimes gestures of caring is all they really need to become motivated for help. If you think they need more help than you can give, do not hesitate to get them help from a local mental health facility. If they feel there is imminent danger to self or others, they can even commit someone against their wishes.

No matter what happens, continue to provide support for the person and their friends and family. This is a matter that affects everyone close to the person; often each person wonders if they had a role in the problem. It is important not to assume the blame and to realize that there is no one factor that will bring a person to this point. Be willing to talk about it and always follow the plans set by therapists involved. If medication is prescribed, compliance is of utmost importance.

No matter what happens, realize this one fact: sometimes there is no warning. It is not your fault. Get help if you feel guilt that becomes overwhelming. If you did see the signs and sought to help or get help, you did everything you could. Sometimes it just comes down to whether they were going to accept help.