What to Do If Someone Becomes Suicidal

Recently, I intervened to prevent a friend from committing suicide. My friend is alive and I have the satisfaction that I knew what to do and had the opportunity to do it. That means a great deal to me because I value my friend. Her decision to live redresses some of the loss I feel because I was unable to prevent my son's death by suicide.

Suicidal Behavior runs on a continuum -- a long process during which suicidal people try various ways to reduce their profound emotional pain. Ambivalent, they have contradictory desires to live and to die and the balance between the two shifts back and forth.

• Deepening Depression -- Stressful life events cause temporary depression in most people. But some people suffer from major depression and manic-depression, inheritable illness which may lead to suicide. Caused by chemical imbalances within the brain, episodes of depression may arise with or without apparent cause. Fortunately, mood illness can be treated with medications and therapy; unfortunately, they often go unrecognized, undiagnosed and untreated. A depressed, uncommunicative, withdrawn person is at risk for committing suicide. The risk increases when depression goes untreated or if it is combined with alcohol or drug abuse. Although stressful life events do not cause depressive discuses, people who have these illnesses are more vulnerable.

• Final Arrangements - A person puts their affairs in order, change a will, gives away possessions, talks vaguely of going away.

• Sudden Elevated Mood -- Paradoxically a depressed suicidal person may suddenly appear better after they made a decision to end life, as if a burden has been lifted.

• Risk Taking Or Self-Destructive Behavior -- may represent a death wish. The person isn't ready to take their own life but tempts fate by reckless diving for instance.

• Presuicidal Statements -- Direct or indirect statements about suicide, hopelessness or death. Suicidal people pick rescuers. Despite what they say, they want these people to help them. A rescuer who picks up on these signs will ask direct questions.

• Ask "Are you thinking of suicide?" -- Contrary to popular belief, you aren't putting ideas into this person's head. You need to assess how likely a suicide attempt may be. Ask more questions.

• "Do you have a plan? A method? A means?" -- Is it deadly? Is it available, such as a gun or enough pills for an overdose?

• "When?" Today, next week, a vague future time?

Do not think you can talk a person out of committing suicide. Be supportive by letting the person know you care. Listen to them with respect for their profound despair. Do not make moral judgments.

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