People may give direct as well as indirect verbal cues about their suicidal thoughts. These typically communicate feelings of being trapped, helpless, and hopeless. Direct verbal cues are clear statements expressing suicidal thoughts, such as "I'm thinking about killing myself," while indirect verbal cues serve more as hints that an individual is thinking about suicide. These can be statements like "Things will be better when I'm gone," "The pain will never stop unless I do something," or "I want to go to sleep and never wake up." These individual's may express these verbal cues on social networking sites like Twitter and Facebook. No matter which medium your friend uses to express these verbal cues, they should always be taken seriously.
Warning signs include:
- Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself.
- Looking for ways to kill oneself by seeking access to firearms, pills, or other means.
- Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person.
- Feeling hopeless.
- Feeling rage or uncontrolled anger or seeking revenge.
- Acting reckless or engaging in risky activities — seemingly without thinking.
- Feeling trapped — like there's no way out.
- Increasing alcohol or drug use.
- Withdrawing from friends, family, and society.
- Feeling anxious, agitated, or unable to sleep or sleeping all the time.
- Experiencing dramatic mood changes.
- Seeing no reason for living or having no sense of purpose in life.
How You Can Help
Ask directly about suicide:
When you notice any warning signs, check in with your friend or family member. Tell them that you're concerned and mention the warning signs you've noticed. If you're not sure whether someone is thinking about suicide, ask. When asking your friend if they're thinking about suicide, be clear and direct. For example: "Are you having thoughts of suicide?" or "I'm concerned about you. I'm wondering if you're thinking about suicide." You will not increase their risk of suicide by asking them directly about it. On the contrary, if your friend or family member is feeling suicidal, being direct will help them recognize that there are people who care.
When someone is thinking of suicide, they typically welcome the chance to talk about the pain they're feeling. However, if your friend doesn't respond positively, continue to express support. Explain that it was out of concern for them that you brought it up. If you continue to notice warning signs, get additional support for them. It is important not to keep your concerns to yourself if you're worried about their safety.
Be there:
When approaching a friend or family member who is experiencing emotional distress, be patient and supportive. You may not be able to understand how they are feeling, and it may seem uncomfortable or awkward to discuss personal and emotional issues. That's ok. Allow them to express whatever they're feeling. Your role is not to counsel them through this crisis, but to be a good listener. Listen in a way that shows empathy and compassion.
Minimize all distractions:
Talk in a quiet, private place where you're unlikely to be interrupted.
Ask open-ended questions:
(questions that elicit a variety of answers) to learn more about what your friend or family member is going through. An example of an open-ended question is, "What's going on for you right now?" or "How does that make you feel?" Use close-ended questions (questions that elicit "yes" or "no" answers) when you need specific information. An example of a closed-ended questions is "Have you had thoughts of suicide?"
Don't rush to judgment:
or argue about moral or spiritual issues regarding suicide. Keep in mind that suicide isn't the problem. It's the perceived solution for what seems to be a unsolvable problem(s).
Let them know that you're concerned because you care about them:
Say something like, "You are important to me; I'm concerned that you seem really sad." Sometimes people see asking for help as a sign of weakness. Give the message that it's OK to ask for help:
- Share an example of a time you or someone you know struggled and needed support.
- Suggest that reaching out for support is the first step to feeling better. Mental health problems are treatable and manageable once identified. Sometimes we need a mental health check-up just as we do a physical exam.
- Think about why he/she might be reluctant to reach out for help. Our backgrounds, cultures and experiences can have a huge impact on how we view help seeking. Some people may come from families or ethnic groups where asking for help or seeking a mental health professional is shunned or thought of as weak.
- Be aware. Learn the warning signs.
- Get involved. Become available. Show interest and support.
- Ask if he/she is thinking about suicide.
- Be direct. Talk openly and freely about suicide.
- Be willing to listen. Allow for expression of feelings. Accept the feelings.
- Be non-judgmental. Don’t debate whether suicide is right or wrong, or feelings are good or bad. Don’t lecture on the value of life.
- Don’t dare him/her to do it.
- Don’t give advice by making decisions for someone else, or by telling them to behave differently.
- Don’t ask ‘why’. This encourages defensiveness.
- Offer empathy, not sympathy.
- Don’t act shocked. This creates distance.
- Don’t be sworn to secrecy. Seek support.
- Offer hope that alternatives are available, do not offer glib reassurance; it only proves you don’t understand.
- Take action! Remove means! Get help from individuals or agencies specializing in crisis intervention and suicide prevention.
- Be Aware of Feelings, Thoughts, and Behaviors
- Can’t stop the pain.
- Can’t think clearly.
- Can’t make decisions.
- Can’t see any way out.
- Can’t sleep, eat or work.
- an’t get out of the depression.
- Can’t make the sadness go away.
- Can’t see the possibility of change.
- Can’t see themselves as worthwhile.
- Can’t get someone’s attention.
- Can’t seem to get control.
Connect to Resources
Non-Emergencies:
- Connect your friend or family member to mental health resources. It is important that you are not alone in reaching out to your friend or family. This means connecting them to a mental health professional. Let them know that help is available, help is effective, and that seeking help is the courageous thing to do. Offer to accompany them to their first appointment with a doctor or counselor, or to assist in scheduling the appointment. Help your friend or family member access one of the many resources available in your local community.
- Do not allow yourself to be the only one who is helping. Recognize the limits of your expertise and responsibility. Get others involved who can help your friend or family member and be supportive to them. This may mean sharing your concerns as needed with your other partner's, family members or other friends.
- Always follow up. Most people in distress feel like a burden to others and are unlikely to bring up the issue again. So, it is important to let your friend or family member know that you are still thinking about them, let them know you care about them, and most importantly - emphasize how important it is to seek help.
Emergencies
While it is rare, there are some situations where emergency help is necessary for your friend or family.
You should take immediate action and call 911 if you notice your friend or family member:
- has a weapon and is threatening to use it. If this is the case, make sure you leave the area immediately for your own safety.
- is threatening immediate harm to him/herself (e.g., jumping out of a window, stepping in front of traffic)
- has engaged in a behavior that requires medical attention (e.g., has taken pills)
