“This is extremely, extremely difficult,” he said. “You can look back in time when someone has had an attempt or has died, and say, ‘Oh, look at all these things that were going on in their life.’ The difficulty is that many people handle or experience these types of stressors but never follow through (suicide attempt). What’s more, there isn’t always a long time between someone thinking about suicide and showing signs — and it can be as little as 5 to 15 minutes between someone deciding to kill themselves and actually doing it, Baker added. “What we understand collectively is that there is an emotional dysregulation and a cognitive error,” Baker said. “They can’t fix the situation or they can’t think of a way to overcome the situation, so suicide becomes a viable option as a way of managing the pain they’re experiencing. So they can take action in this really short, short window .” But there are some situations where a person who has been suicidal and planning for a longer period of time will show behavioral changes, Baker added. “If you’re seeing something like that, obviously it’s someone who is very close to being an immediate danger — someone who is very close to making that decision to end their life,” he said. “But I would say most people don’t get that kind of warning.” If you think you or someone you know is at risk, trained counselors with the National Suicide Prevention Lifeline 24/7 could help you address any signs you experience or see. To increase its accessibility, every state began circulating the 988 as the new life preserver on July 16. The current number is 1-800-273-8255 (TALK) and will always remain available to people in emotional distress or a suicidal crisis, according to the Substance Abuse and Mental Health Services Administration. Here are some of the most common behavioral, verbal and emotional signs and risk factors to look out for, according to experts.
Behaviors to watch out for
Some people may seem like their usual selves in the weeks or days before a suicide attempt, while others may show behavioral changes that don’t follow what you know about them, said Michael Roeske, a clinical psychologist and senior director at Newport Healthcare. Center for Research & Innovation. These can include practicing or preparing for suicide, which can look like exhibiting unusual behaviors with guns, pills or other potentially lethal objects, according to SAMHSA. Other possible behavioral red flags include giving away favorite objects, sleeping too much or too little, withdrawing or isolating, showing anger or a desire for revenge, and acting anxious or agitated, according to Roeske, Baker and SAMHSA. Getting really drunk one night or driving recklessly could also be signs to watch out for, Roeske said. One such behavior might be that they’re “testing themselves to see if they can really do it,” Baker said. “A lot of times people have to work up to that real attempt because it’s a biological thing you have to deal with, your own survival.”
About comments
Talking about wanting to die — by suicide or otherwise — is another warning sign that should always be taken seriously, Roeske said. Such comments are sometimes just expressions of discomfort, pain, boredom or a desire for closeness rather than a reflection of a real desire to die, but that doesn’t mean you’re not watching the person making them, he added. Some people may say they feel they have no reason to live. “If someone is struggling to find a reason to live, they are a much higher risk person than someone who can even identify a (reason),” Baker said. Others talk about feeling like a burden to those close to them, Roeske said, or that they don’t belong anywhere or with anyone. Such comments might include “You don’t need me for this anymore” or “I feel like I’d be better off not being here.” Teens who are thinking about suicide may not want their guardians to use their money for college, he added.
Mood and other risk factors
Psychological factors, distressing situations or genetics can increase the likelihood that someone will think about, attempt or die by suicide, according to SAMHSA. These risk factors cannot cause or predict a suicide attempt, but awareness of them is important, according to SAMHSA:
Desperation. “They don’t have a sense that the future is going to get better, or they just feel really unable to imagine not being in pain,” Roeske said. Extreme mood swings. This includes if someone who is usually really stressed or depressed suddenly seems calm or cheerful, according to Roeske and Johns Hopkins Medicine. This person may have decided to attempt suicide without telling anyone and feel relieved about it. Also indicative of this is cheerfulness after a depressive episode. Obsession with death or lethal means. Some people have artistic or musical interests that are more somber than others, but if their engagement with those things goes beyond what’s normal for them, that would be a concern, Roeske said. Experiences of abuse, neglect or other trauma Substance abuse problems Mental disorders such as schizophrenia, depression or anxiety and personality disorders, especially in combination with lack of treatment Serious physical illnesses, including chronic pain. “Especially if it’s kind of reckless and very difficult to deal with, people can get very desperate,” Roeske said. “It’s really just, ‘I don’t want to feel this anymore and I can’t find another way.’ I feel trapped.” Family or personal history of suicide. “The biggest predictor of completed suicide is previous suicide attempts — the reason is because you’re going to see an escalation of mortality or the means by which someone does it,” Roeske said. Job or financial loss Relationship problems or loss Loss of interest in activities or school Prolonged stress from other causes, such as harassment or bullying Easy access to potentially lethal means Exposure to a suicide or dramatic or dramatic accounts of suicide. “On the one hand, we don’t want people to avoid the topic of suicide. We want people to approach, even use the word with others and have conversations around it,” Roeske said. But if a depiction or description unduly romanticizes or justifies the sense of relief that can come from suicide, that’s problematic. Inadequate social support or feeling isolated
What to do
If any of these signs resonate with you, seek professional help and talk to someone you can trust and feel supported, Baker said. Psychotherapy and certain psychiatric medications, such as antidepressants, can help, Roeske said. If a loved one is showing signs that they may be at risk of suicide, “it’s not really your job to be able to predict the future,” Baker said. But you can be supportive and intentional when you ask them what’s going on, Roeske and Baker said. “You’re not going to get someone to kill themselves by asking directly about suicide,” Baker said. “The worst they’ll say is ‘no’ and they’re not offended. When checking someone out, use what experts call a narrative, person-centered approach, Baker recommended. This might look like an open-ended question: “Hey, I’ve noticed that life has gotten overwhelming the last couple of days. Do you want to tell me?” As the person responds, you can, to some extent, listen to them, express appreciation for them sharing their story, and offer to help them figure it out together, without offering advice on how to handle it, Baker said. . But if your loved one seems more at risk or is in the process of attempting suicide, “you no longer have the time or the luxury to get their opinion,” she added. Get medical attention or call 911. When Roeske first started working as a clinician, he had a young patient who was a very successful equestrian, went to a prestigious school and had a lot of family resources, he said — but she had been chronically suicidal for 10 to 15 years, since she was a teenager. “Every time she went to her mom and told her that, her mom would say things like) ‘Oh, you’re so beautiful. Look how you are with the horses,” Roeske said. “And (the patient) said, ‘What she felt was that mom was afraid of what I was saying and she needed to distance herself from it.’ He said therapists would do the same thing — you know, “create a positive gratitude list or correct your cognitive distortions.” Finally, it was a psychiatrist who looked at her as she said, “I think I’m going to kill myself.” And the psychiatrist said, “I think you can too.” And she said it was the first time anyone was willing to be there with her.” When you talk to someone who’s suicidal, you might want to tell them all the wonderful reasons they should stay alive, Roeske said — but that can actually make them feel more alone. If you’re concerned about someone living in your home, mitigate opportunities for a suicide attempt by limiting or removing access to potentially lethal items such as firearms or pills, Roeske said. Simply concealing a weapon is not sufficient precaution, experts said. Unfortunately, “we are no better able to predict who will die by suicide than who will be in a car accident,” Baker said. “This doesn’t help ease the grief or pain for those who have lost loved ones to suicide, but hopefully it will help remove guilt and responsibility.” CNN’s Jacqueline Howard contributed to this story.
