Survivors of Suicide Attempt
- Individuals who have attempted suicide and survived can be at continued risk for suicide. The single strongest indicator of a future suicide attempt is a previous attempt. That is why it is important to develop a safety plan, seek help, and increase contact with someone who has attempted suicide. Someone who has attempted suicide may feel a sense of isolation and be reluctant to share their thoughts and feelings with someone else, especially if they have experienced past crises related to suicide, such as a hospitalization. They may benefit from someone who will listen and validate their feelings without rushing to judgment
- Those who are struggling with suicidal thoughts or have had a previous suicide attempt may have mental health concerns. Depression and other mood disorders are often associated with higher suicide risk, especially if the illness is inadequately treated or untreated. Substance use disorders and childhood trauma are associated with risk for suicide. Anger, loss or family situations can also play a part in why someone may have attempted or be considering suicide.
- There are steps to take to help reduce the level of suicide risk for someone who has previously attempted or considered suicide. Assisting them in developing a safety plan that includes practicing safe/no use of alcohol and drugs, identifying and utilizing past and current coping skills and personal resources, strengthening social contacts and informal/formal support systems, as well as recognizing and responding constructively and proactively to triggers or warning signs of distress are all ways that a safety net can be constructed to help support the person.
Frequently Asked Questions
1. Why do people attempt suicide?
People usually attempt suicide to block unbearable emotional pain, which is caused by a wide variety of problems. It is often a cry for help. A person attempting suicide is often so distressed that they are unable to see that they have other options: we can help prevent a tragedy by endeavoring to understand how they feel and helping them to look for better choices that they could make. Suicidal people often feel terribly isolated; because of their distress, they may not think of anyone they can turn to, furthering this isolation. In the vast majority of cases a suicide attempter would choose differently if they were not in great distress and were able to evaluate their options objectively. Most suicidal people give warning signs in the hope that they will be rescued, because they are intent on stopping their emotional pain, not on dying.
2. Aren’t all suicidal people crazy?
- No, having suicidal thoughts does not imply that you are crazy or mentally ill. People who attempt suicide are often acutely distressed and the vast majority are depressed to some extent.
- This depression may be either a reactive depression which is an entirely normal reaction to difficult circumstances, or may be an endogenous depression which is the result of a diagnosable mental illness with other underlying causes. It may also be a combination of the two.
- The question of mental illness is a difficult one because both these kinds of depression may have similar symptoms and effects. Furthermore, the exact definition of depression as a diagnosable mental illnesses (i.e. clinical depression) tends to be somewhat fluid and inexact, so whether a person who is distressed enough to attempt suicide would be diagnosed as suffering from clinical depression may vary in different peoples opinions, and may also vary between cultures.
- It’s probably more helpful to distinguish between these two types of depression and treat each accordingly than to simply diagnose all such depression as being a form of mental illness, even though a person suffering from a reactive depression might match the diagnostic criteria typically used to diagnose clinical depression. For example, Appleby and Condonis
- The majority of individuals who commit suicide do not have a diagnosable mental illness. They are people just like you and I who at a particular time are feeling isolated, desperately unhappy and alone.
- Suicidal thoughts and actions may be the result of life’s stresses and losses that the individual feels they just can’t cope with.
- In a society where there is much stigma and ignorance regarding mental illness, a person who feels suicidal may fear that other people will think they are “crazy” if they tell them how they feel, and so may be reluctant to reach out for help in a crisis.
- In any case, describing someone as “crazy”, which has strong negative connotations, isn’t helpful and is more likely to dissuade someone from seeking help which may be very beneficial, whether they have a diagnosable mental illness or not.
- People who are suffering from a mental illness such as schizophrenia or clinical depression do have significantly higher suicide rates than average, although they are still in the minority of attempters. For these people, having their illness correctly diagnosed can mean that an appropriate treatment can begin to address it.
3. Doesn’t talking about suicide encourage it?
It depends what aspect you talk about. Talking about the feelings surrounding suicide promotes understanding and can greatly reduce the immediate distress of a suicidal person. In particular, it is OK to ask someone if they are considering suicide, if you suspect that they are not coping. If they are feeling suicidal, it can come as a great relief to see that someone else has some insight into how they feel. This can be a difficult question to ask, so here are some possible approaches:
- “Are you feeling so bad that you’re considering suicide?”
- “That sounds like an awful lot for one person to take; has it made you think about killing yourself to escape?”
- “Has all that pain you’re going through made you think about hurting yourself?”
- “Have you ever felt like just throwing it all away?”
- The most appropriate way to raise the subject will differ according to the situation, and what the people involved feel comfortable with. It’s also important to take the persons overall response into consideration when interpreting their answer, since a person in distress may initially say “no”, even if they mean “yes”.
- A person who isn’t feeling suicidal will usually be able to give a comfortable “no” answer, and will often continue by talking about a specific reason they have for living. It can also be helpful to ask what they would do if they ever were in a situation where they were seriously considering killing themselves, in case they become suicidal at some point in the future, or they are suicidal but don’t initially feel comfortable about telling you.
- Talking exclusively about how to commit suicide can give ideas to people who feel suicidal, but haven’t thought about how they’d do it yet.
- Media reports that concentrate solely on the method used and ignore the emotional backdrop behind it can tend to encourage copy-cat suicides.
4. So what sort of things can contribute to someone feeling suicidal?
People can usually deal with isolated stressful or traumatic events and experiences reasonably well, but when there is an accumulation of such events over an extended period, our normal coping strategies can be pushed to the limit.
The stress or trauma generated by a given event will vary from person to person depending on their background and how they deal with that particular stressor. Some people are personally more or less vulnerable to particular stressful events, and some people may find certain events stressful which others would see as a positive experience. Furthermore, individuals deal with stress and trauma in different ways; the presence of multiple risk factors does not necessarily imply that a person will become suicidal.
Depending on a person’s individual response, risk factors that may contribute to a person feeling suicidal include:
- Significant changes in Relationships.
- Well-being of self or family member.
- Body image.
- Job, school, university, house, locality.
- Financial situation.
- World environment.
- Significant losses:
Death of a loved one.
Loss of a valued relationship.
Loss of self esteem or personal expectations.
Loss of employment.
- Perceived abuse:
5. How would I know if someone I care about was contemplating suicide?
Often suicidal people will give warning signs, consciously or unconsciously, indicating that they need help and often in the hope that they will be rescued. These usually occur in clusters, so often several warning signs will be apparent. The presence of one or more of these warning signs is not intended as a guarantee that the person is suicidal: the only way to know for sure is to ask them. In other cases, a suicidal person may not want to be rescued, and may avoid giving warning signs.
Typical warning signs which are often exhibited by people who are feeling suicidal include:
- Withdrawing from friends and family.
Depression, broadly speaking; not necessarily a diagnosable mental illness such as clinical depression, but indicated by signs such as:
- Loss of interest in usual activities.
- Showing signs of sadness, hopelessness, irritability.
- Changes in appetite, weight, behavior, level of activity or sleep patterns.
- Loss of energy.
- Making negative comments about self.
- Recurring suicidal thoughts or fantasies.
- Sudden change from extreme depression to being `at peace’ (may indicate that they have decided to attempt suicide).
- Talking, Writing or Hinting about suicide.
- Previous attempts.
- Feelings of hopelessness and helplessness.
- Purposefully putting personal affairs in order:
Giving away possessions.
- Sudden intense interest in personal wills or life insurance.
- `Clearing the air’ over personal incidents from the past.
- This list is not definitive: some people may show no signs yet still feel suicidal, others may show many signs yet be coping OK; the only way to know for sure is to ask. In conjunction with the risk factors listed above, this list is intended to help people identify others who may be in need of support.
- If a person is highly perturbed, has formed a potentially lethal plan to kill themselves and has the means to carry it out immediately available, they would be considered likely to attempt suicide.
Information provided by The Circle