When people are a danger to themselves or others, we have a moral obligation to take action. Professionals have a legal obligation to take action. For that reason, it is important to me that you not only know the warning signs of suicidal behavior but you also know what to do if you encounter this situation.
One of the first and foremost signs is depression. Even though a person who is suicidal is likely to be suffering from depression, the symptoms of depression should not be confused with warning signs of suicide. The symptoms of depression include the following: sadness, withdrawing from or lack of interest in any or all activities, inability to concentrate, decrease in appetite and weight loss, restlessness and fatigue but inability to sleep, feelings of worthlessness, guilt, hopelessness, and helplessness.
Along with depression, suicidal people may have health problems, chronic illness and/or severe pain.
They also talk about death, dying, and suicide. Their dialogue may be subtle in that they say, “I cannot take it anymore,” or “I would be better off dead,” or “He will miss me when I am gone.” They have worked out a specific plan of how they will commit the act and they have the means to do it. In other words, they decided how they will end their life, what method they will use, they thought about when and where they will do it, and they have what they need to carry out their plan.
There is often concern around the holidays of an increase in suicide rates, but people who are suicidal often have some special date, not necessarily a holiday that plays into their suicidal thoughts. For example, I once had a neighbor who was engaged to be married but her fiance called off the wedding and left the country. Sadly, her parents found her dead on the day the wedding was scheduled to take place. I also dealt with a young woman who was actively suicidal on the year-to-the-date that her sister committed suicide. So, pay particular attention to whether or not there is a history of suicide in the family and whether or not the person has made previous attempts.
People who are suicidal prepare for their death. We call this taking care of unfinished business and it can involve calling people to make amends, taking out an insurance policy, making a will, paying off bills, giving away valued items, and even preparing the death site.
Lastly, but probably most important of all is that their depression lifts. You see, people who are suicidal struggle with how they should handle their pain, their stress, their depression. The struggling is the hard part. Once they finally decided how to handle their pain, they feel at peace with themselves. Unfortunately, there is always a better way to handle pain, but again, once they decide, the depression lifts.
So often, the loved ones / the survivors, in their grief and guilt claim that there were no symptoms. They say, “If only there were some warning signs, we could have prevented this tragedy.” Yet, the ending of the depression was the warning sign. The family just did not know that!
In the case that you should ever encounter a client, co-worker, neighbor, family member, or acquaintance who might be Suicide Warning, please always take it seriously and find out if they have a plan. Talk openly with them about it. The more specific their plan, the more likely they are to carry out the plan. Never handle it alone and know what your resources are. Even if you value your excellent empathy skills, unless you are trained as a suicide counselor, you need to get them the professional help that they need. As a professional, you will have a legal obligation to take action. I cannot emphasize this enough. If you do not refer them to the help they need and they commit suicide, you could be held responsible for their death / for knowing and failing to take action.
Last of all, say to the suicidal person, “I cannot help you if you do that” and make a contract with them to not do anything until you can get them help. This will not only help protect you legally, but it comes in handy especially when you have to hang up your call with them to call for help or get them to the hospital. This may not sound like much, but by doing and saying this, you are communicating to the person that you want to help. It may be just what they need to hang on to and get them through their immediate crisis.
In conclusion, people suffer from depression and they get better. People make phone calls and say they are sorry. They make wills and buy life insurance and they even occasionally talk about dying. But if you come across a situation where a person you know recovers from depression, they give you their favorite leather jacket, and the day they were supposed to get married is approaching, put it all together and see and hear the warning signs. And most of all, I sincerely hope you never need to use this information.