SPOTTING the warning signs that a loved one is contemplating suicide is difficult and often not possible.
Psychologists working in mental health have highlighted a number of behaviours and phrases that could indicate suicide intention.
Justin Baker, clinical director of The Suicide and Trauma Reduction Initiative for Veterans at The Ohio State University Wexner Medical Center, told CNN "it's not really your job to be able to predict the future”.
But he added: "You're not going to cause someone to be suicidal by asking directly about suicide.
"The worst thing they're going to say is 'no' and not get offended. If they are, still ask them. I'd rather have someone offended at me than dead."
Samaritans says: “By asking someone directly about suicide, you give them permission to tell you how they feel.
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“People who have felt suicidal will often say what a huge relief it was to be able to talk about what they were experiencing.
“Once someone starts talking they’ve got a better chance of discovering options that aren't suicide.”
The charity says 6,000 people in the UK and Ireland take their own lives each year, and one in 20 will make an attempt over their lifetime.
It's the reason The Sun launched it's suicide prevention campaign, You're Not Alone.
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Dr Baker said "we are no better able to predict who will die by suicide than who will be in a car accident”.
But “this does not help to alleviate the grief or pain for those who have lost loved ones to suicide, but hopefully it helps remove some of the guilt and responsibility”.
Dr Baker said someone can decide to end their life in as little as five minutes.
In situations where a person has been planning it for a while, behavioural changes may become apparent.
"But I would argue most people don't get that kind of warning”, Dr Baker added.
Behaviours to watch for
Michael Roeske, senior director of Newport Academy for the mental health treatment of young people, told CNN a person may just not seem their normal self in the days or weeks leading up to a suicide attempt.
They may do things that signal they are practising for suicide, such as searching online or self harm.
Dr Roeske said a person might behave recklessly, such as get really drunk and driving, to “test themselves to see if they can actually do it”.
Meanwhile, Samaritans say people came may become distant, failing to reply to messages. They may also sleep or eat more or less than usual.
Some behavioural signs to watch for, according to the Samaritans and the American Substance Abuse and Mental Health Services Administration (SAMHSA), are:
- Looking for a way to kill themselves
- Increasing the use of alcohol or drugs
- Acting anxious or agitated; behaving recklessly
- Sleeping too little or too much
- Withdrawing or isolating themselves
- Showing rage or talking about seeking revenge
- Being tired or lacking in energy
- Not wanting to do things they usually enjoy
- Not replying to messages or being distant
The things they say
If someone says they want to die, it’s a phrase that should always be taken seriously, Dr Roeske said.
Such comments are sometimes just expressions of discomfort, pain, boredom or desire for closeness – but that doesn't mean you don't monitor the person who's making them, he added.
People who commit suicide have often told someone that they do not think life is worth living, Samaritans says.
It added: “The majority of people who feel suicidal do not actually want to die; they do not want to live the life they have.
“The distinction may seem small but is very important. It's why talking through other options at the right time is so vital.”
Those contemplating suicide might talk about feeling like a burden, saying things like “I feel like it would be better if I wasn’t here”, Dr Roeske said.
Signs in communication, according to SAMHSA, include:
- Talking about wanting to die or to kill themselves
- Talking about feeling hopeless or having no reason to live
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
Signs in their mood
People with certain mental health conditions, such as schizophrenia, anxiety and personality disorders, are more at risk of suicide.
Extreme mood swings are listed by SAMHSA as a key early sign.
Dr Roeske said extreme mood swings aren’t just feeling down – it includes someone who suddenly seems calm or cheery after a depressed episode.
This could indicate a person might have decided to attempt suicide without telling anyone, and they feel relieved by it.
Hopelessness is a key mood symptom, as Dr Roeske said: "They don't have a sense of the future getting better, or they just feel really unable to imagine not being in the pain that they're in.”
He added that people with severe physical illnesses, including chronic pain, can become very hopeless and say things like “I don’t want to feel this anymore”.
According to the National Institute of Mental Health and the Samaritans, warning signs in mood include:
- Empty, hopeless, trapped, or having no reason to live
- Extremely sad, more anxious, agitated, or full of rage
- Unbearable emotional or physical pain
- Finding it hard to cope with everyday things
- Feeling tearful
What to do
The Samaritans says if someone starts opening up to you about how they feel, it’s important to listen patiently, without distractions, and use open questions.
It says: “If you’re worried someone is suicidal, it’s okay to ask them directly. Research shows that this helps – because it gives them permission to tell you how they feel, and shows that they are not a burden.
“You’ll soon be able to tell if the person you’re speaking to isn’t comfortable or doesn’t want to have that kind of conversation.
“If they don’t want to open up, you’ll still have let them know you’re there for them.”
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Read more on how to talk to someone that might be suicidal here.
If you think someone is in immediate danger, call an ambulance on 999.
You’re Not Alone: Where to seek help if you need it
If you, or anyone you know, needs help dealing with mental health problems, the following organisations provide support:
- CALM, www.thecalmzone.net, 0800 585 858
- Heads Together, www.headstogether.org.uk
- Mind, www.mind.org.uk, 0300 123 3393
- Papyrus, www.papyrus-uk.org, 0800 068 41 41
- Samaritans, www.samaritans.org, 116 123
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