Thoughts about suicide as an option in human life are not uncommon.
Acting on suicidal thoughts is a different matter.
Helpful strategies
The emotionally stressed brain loses the ability think and decide rationally.
Beware of the suicide roller coaster. Get off before it is too late, and give life another chance.
Dangerous Thoughts
- I’m worthless, useless
- I have failed
- My life is hopeless
- I have no right to live
- I am a burden for others
- The others would be better off without me
- Nobody really cares about me
- Things will never get better
- Thoughts that suicide is the solution
- Thoughts about suicide methods
- Suicide planning
Body alarm symptoms
Stress related symptoms
Depressive symptoms
- Problems with sleep
- Loss of appetite
- Feeling hopeless
- Loss of interest in usual activities
- Loss of energy
- Trouble concentrating
- Irritability
Negative Emotions
Pain
- Feeling hurt
- Feeling humiliated
- Broken heart
- Can’t stand this pain any more
- The pain will never go away
Shame
- Having failed an exam and at home told otherwise
- Having dropped out of college
- Having stolen
- Having lied (or not said the truth)
- Having had an affair and worrying about HIV
- Having had a negative sexual experience
- Having unusual sexual desires
- Hating one’s body
- Being rejected by others
To feel alien in oneself
Warning: To feel alienated in oneself may be a sign of a beginning dissociation, in which we are no more able to act rationally. Get your control back with physical activity, loud music, und speak to someone by phone, etc.
Behavior
- Restlessness
- Withdrawing from others
- Increased alcohol use
About Pain
Mental, or psychological pain can be worse than physical pain. It is a deeply threatening sensation, a mental agony, with a sense of panic, terror, fear, rage against the self, emotional freezing, and shame. It is an assault on our personal sense of self. Pain leads to estrangement from our body. Pain increases when we experience it as unbearable, and when we lose hope that it will ever subside.
About Shame
Shame is a normal feeling. We don’t usually show it, we like to keep it to ourselves. Shame and pain belong together. It is quite normal to keep these painful feelings to oneself, to hide them, and to pretend that there is absolutely no problem. Yet, the longer we hide our secrets from others the bigger the barriers will be finally talk to someone. It needs a hell of a lot of courage!
Know the safety strategies
What I can do by myself to calm down
- Pause for a moment and consider your thoughts and feelings
- Physical activity (biking, jogging, etc.)
- Get out into the nature (even in the rain!)
- Take a bath (“winding down”)
- Watch a video
- Listen to music
- What are your own helpful activities?
Talk to a trusted person
- A friend
- Family member
- Teacher
- Counselor
- Priest
- Who are your trusted persons?
Get professional help
- Call the local health center
- Call your psychiatrist
- Call a mental health counseling service
- Call a crisis line
- Go to hospital emergency
Safety planning
Smartphone apps for suicide safety planning
- The Stanley-Brown Safety Plan (https://apps.apple.com/us/app/safety-plan/id695122998)
- Beyond Now suicide safety planning app (https://www.beyondblue.org.au/get-support/beyondnow-suicide-safety-planning)
- ReMinder Suicide Safety Plan app (https://www.suicidecallbackservice.org.au/feeling-suicidal/reminder-suicide-safety-plan-updated/)
- BackUp app in Dutch (https://www.113.nl/backup)
- Sicherheitsplan in German (https://www.suizidpraevention-zh.ch/ich-bin-in-der-krise/erwachsene/wie-kann-ich-mir-helfen/sicherheitsplan-machen/)
Please note:
Applications targeting safety planning are best used in combination with treatments for suicidality. The apps allow users to save their personal lists of suicide warning signs, create coping strategies, identify positive contacts and social settings to distract from the crisis, identify family members and friends available to help, find professional help and resources, and make their environment safe from lethal means that may be used in a suicide attempt.
Know what to do
when you are concerned about someone in your family, among colleagues, peers
How to talk to a person who may be suicidal
What to say
I am concerned about you. I have recently felt that you may not be well. Would you like to talk about it? Are there reasons for me to think that suicide might be an issue for you?
I care about you. I’ll be there for you if you would like to talk. Suicidal people need someone who takes time to listen. Be open-minded and let yourself be surprised by whatever the person will tell you. Avoid asking “why”, because the immediate triggering event may be banal (for instance a remark made by someone else) and does not help to understand the history of a person’s vulnerability. Allow tears, sadness, anger, frustration. When the person mentions suicide as a solution, say that you don’t think that suicide is a good decision, but that you want to find out together what could help the person to be safe.
Is there someone else who knows about your situation? Would you like to tell me who? (Family member, friend, counselor, family doc?)
What not to say
“Think of your beloved ones”, “think of what it would mean for your family, friends, etc.”. Or: “I know how you feel”.
Hold back with giving advice. The first thoughts that cross your mind may not be helpful to the person in crisis.
If you want to offer help avoid being directive (you should…) but talk in the first person (listening to you makes me think that …). You will be most helpful if you respect the person’s need for autonomy.
Offer to be available, but be aware of your limits
Know your limits
You cannot be responsible for another person when it may be a matter of life and death. If you are not a health professional, you cannot be the therapist of a family member, friend, colleague, neighbor. But small outreach gestures like text messages, neighborly home calls, etc., can be very important for suicidal persons.
Try to find out the person’s attitude toward get professional help. What are the past experiences? Who helped in the past? A family doctor, counselor, psychiatrist, crisis line worker, hospital admission? Has medication helped in the past? What are the barriers to seek professional help?
Try to collaboratively develop a possible plan to get help. Again: Respect the person’s need for autonomy.
Ask what helped in the past to calm down in a crisis. It can be anything from self-soothing with a hot water bottle on the abdomen, cuddling with the cat, to Sudoku, outdoors activities, connecting with others, etc.
Together with the person at risk you may explore online support. Offer help in tackling the mental health care system, how to make an appointment. You may offer to accompany the person to a first appointment.
If your involvement continues, seek professional advice for yourself. You may call a crisis line or contact a mental health center, without disclosing the person’s name. Be open to the suicidal person about this. Tell the person what advice you got, where to turn to, and why it is necessary to get a professional mental health assessment. Again: when the person’s suicidal condition is serious, the situation requires professional involvement. You cannot be responsible for another person’s life.