If a suicide attempt has been made call 911 immediately. I you or someone you know has ongoing thoughts of death or suicide call 1-800-273-TALK (8255) or go to a hospital emergency room.
Recognizing Warning Signs in Others
Sometimes, even health care professionals have difficulty determining how close a person may be to attempting suicide. As a friend or family member, you can't know for certain either. If you sense there is a problem, ask your friend or loved one direct questions and point out behavior patterns that concern you. Remind them that you care about them and are concerned. Talking about suicide with someone will not plant the idea in his or her head. If necessary, suggest that they make appointment to see their doctor and offer to go with them if you sense they would have difficulty doing it on their own. If you believe that immediate self-harm is possible, take the person to a doctor or hospital emergency room immediately.
Feelings of despair and hopelessness
Often times, individuals with depression talk with those closest to them about extreme feelings of hopelessness, despair, and self-doubt. The more extreme these feelings become, and the more often they're described as "unbearable," the more likely it is that the idea of suicide may enter the person's mind.
Taking care of personal affairs
When a person is winding up his or her affairs and making preparations for the family's welfare after he or she is gone, there is a good chance the individual is considering self-harm or suicide.
Rehearsing suicide, or seriously discussing specific suicide methods, are also indications of a commitment to follow through. Even if the person's suicidal intention seems to come and go, such preparation makes it that much easier for the individual to give way to a momentary impulse.
Drug or alcohol abuse
Someone with worsening depression may abuse drugs or alcohol. These substances can worsen symptoms of depression or mania, decrease the effectiveness of medication, enhance impulsive behavior, and severely cloud judgment.
Beginning to feel better
It might sound strange, but someone dealing with depression may be most likely to attempt suicide just when he or she seems to have passed an episode's low point and be on the way to recovery.
Experts believe there's an association between early recovery and increased likelihood of suicide. As depression begins to lift, a person's energy and planning capabilities may return before the suicidal thoughts disappear, increasing the chances of an attempt. Studies show that the period 6 to 12 months after hospitalization is when patients are most likely to consider, or reconsider, suicide.
What You Can Do to Help Someone
Among the many things you can do to help someone who is depressed and may be considering suicide, simply talking and listening are the most important. Do not take on the role of therapist. Often, people just need someone to listen. Although this might be difficult, there are some approaches that have worked for others.
Express empathy and concern.
Severe depression is usually accompanied by a self-absorbed, uncommunicative, withdrawn state of mind. When you try to help, you may be met by your loved one's reluctance to discuss what he or she is feeling. At such times, it's important to acknowledge the reality of the pain and hopelessness he or she is experiencing. Resist the urge to function as a therapist. This can ultimately create more feelings of rejection for the person, who doesn't want to be told what to do. Remain a supportive friend and encourage continued treatment.
Talk about suicide.
Talking about suicide does not plant the idea in someone's head. Your ability to explore the feelings, thoughts, and reactions associated with depression can provide valuable perspective and reassurance to your friend or loved one who may be depressed. Not everyone who thinks of suicide attempts it. For many, it's a passing thought that lessens over time. For a significant number of people, however, the hopelessness and exaggerated anxiety brought on by untreated or under-treated depression may create suicidal thoughts that they can't easily manage on their own. For this reason, take any mention of suicide seriously.
If someone you know is very close to suicide, direct questions about how, when, and where he or she intends to commit suicide can provide valuable information that might help prevent the attempt. Don't promise confidentiality in these circumstances. It's important for you to share this information with the individual's doctor.
Describe specific behaviors and events that trouble you.
If you can explain to your loved one the particular ways his or her behavior has changed, this might help to get communication started. Compounding the lack of interest in communication may be guilt or shame for having suicidal thoughts. Try to help him or her overcome feelings of guilt. If there has already been a suicide attempt, guilt over both the attempt and its failure can make the problem worse. It's important to reassure the individual that there's nothing shameful about what they are thinking and feeling. Keep stressing that thoughts of hopelessness, guilt, and even suicide are all symptoms of a treatable, medical condition. Reinforce the good work they've done in keeping with their treatment plan.
Work with professionals.
Never promise confidentiality if you believe someone is very close to suicide. Keep the person's doctor or therapist informed of any thoughts of suicide. If possible, encourage them to discuss it with their doctor(s) themselves, but be ready to confirm that those discussions have taken place. This may involve making an appointment to visit the doctor together or calling the doctor on your own. Be aware that a doctor will not be able to discuss the person's condition with you. You should only call to inform the doctor of your concern.
Whenever possible, you should get permission from your loved one to call his or her doctor if you feel there's a problem. Otherwise, it could be seen as butting in and may worsen the symptoms or cause added stress. Of course, if you believe there is a serious risk of immediate self-harm, call his or her doctor. You can work out any feelings of anger the person has towards you later.
Stress that the person's life is important to you and to others.
Many people find it awkward to put into words how another person's life is important for their own well-being. Emphasize in specific terms to your friend or loved one how his or her suicide would devastate you and others. Share personal stories or pictures to help remind your loved one of the important events in life you've shared together.
Be prepared for anger.
The individual may express anger and feel betrayed by your attempt to prevent their suicide or help them get treatment. Be strong. Realize that these reactions are caused by the illness and should pass once the person receives proper treatment.
Always be supportive.
People who have thought about, or attempted, suicide will most likely have feelings of guilt and shame. Be supportive and assure them that their actions were caused by an illness that can be treated. Offer your continued support to help them recover.
Take care of yourself.
It's not uncommon for friends and family members to experience stress or symptoms of depression when trying to help someone who is suicidal. You can only help by encouraging and supporting people through their own treatment. You cannot get better for them. Don't focus all of your energy on the one person. Ask friends and family to join you in providing support and keep to your normal routine as much as possible. Pay attention to your own feelings and seek help if you need it.
Other Helplines & Resources
Includes many local 24-hour hotlines along with support for suicide survivors, suicide prevention, and suicide statistics.