Risk Factors and Warning Signs of Suicide

We all live with emotional distress. That is part of life. The question is how do we choose to deal with our distress? Why are some individuals able to live with distress for long periods of time while others find themselves contemplating suicide? How can we tell when someone is contemplating suicide and how can we intervene? There is no doubt that suicide is a complicated issue. With the help of Cobain’s book Dying to Be Free, this article will look at the risk factors and warning signs of suicide while offering practical tips for how to help others.

There is no single common denominator and no one way to determine exactly who is at risk for a suicide attempt. Although every situation looks a bit different, there are some common characteristics and circumstances found in those who contemplate and carry out suicide.

Common Traits Among Those Who Attempt Suicide

• Perfectionist
• High achievement
• Fear of failure
• Low self-esteem
• Hopelessness
• Childhood trauma
• Prior suicide attempts
• Family history of suicide
• Effects of father figure
• Talent or high intelligence
• Tendency to question life’s meaning

The following are warning signs and risk factors of suicide. Although they are sometimes subtle, each of these signs can be helpful in determining those who are at risk of suicide. It is important to keep in mind that suicidal people may display all, or few, or none of the below behaviors making in difficult to pinpoint those who will follow through on suicide.

Warning Signs and Risk Factors of a Potential Suicide Attempt

• Previous attempts
• Family history of suicide
• Conflicts
• Shift in behavior and/or substance use
• Withdrawal
• Recent meaningful loss
• Hopelessness and helplessness
• Anxiety
• Preoccupation with death
• Preparing for death
• Sudden lifting of mood

What can I do?

If you think someone you know is contemplating suicide, the simplest and best way to find out is to ask direct questions. Here are a few suggestions that Cobain suggests in her book:

• “I am wondering if you ever think about ending your life?”
• “Sometimes people who have experienced what you are going through consider taking their life. Are you thinking about suicide?”
• “Have you been having suicidal thoughts?”
• “Are you thinking about killing yourself?”

It is essential that you do not ask about suicide in a negative way. Some examples of questions that should be avoided are, “You aren’t thinking about suicide are you?” or “You aren’t thinking of doing anything stupid are you?” If you ask questions with this kind of tone you may cause shame and it may appear that you aren’t prepared to handle the difficult truth. That person will most likely avoid talking to you about their concerns. It is also important to avoiding beating around the bush and instead be very specific. Avoid asking questions about “hurting oneself” and instead ask specifically about “killing oneself”.

Some other important issues to consider:

What if the answer is “yes”?

• Do not panic
• Do not judge
• Listen calmly
• Silence is ok. Just listen and keep listening
• Do not argue
• Do not try to “fix”
• Do not be sworn to secrecy about anything
• Do not discount feelings
• Be caring and compassionate
• Ask if he/she has a plan

What if they have a plan?

If the suicidal person has a specific plan, you should ask further questions about that plan such as “How will it happen?” and “When will it happen?”

Don’t be afraid to ask specific questions about that plan. If this person has obtained the means to act upon the plan, you should be ready to take further steps immediately. For example, it is a good idea to ask that person to give the item or items they intend to use against themselves to you or to another person. Sometimes these items include a gun, pills, rope or a car. Offer your assistance to help them find other options such as a parent, sibling or friend. If there isn’t a person you may need to suggest calling 911, a local crisis line or an emergency room. Do not leave that suicidal person if he/she has a plan unless that person has someone to care for them. If for any reason you are unable to do these things you should immediately ask a trusted adult, family member or professional for assistance. It is essential that you help the person in crisis find help regardless.

We will never prevent all suicides but in understanding the warning signs and risk factors we can raise our own awareness. In understanding what to do and what questions to ask, perhaps we will increase our ability to intercede and save lives.

If you are struggling with suicidal thoughts or if you are concerned about someone who is, I encourage you to be courageous and take the first step and ask for help. If it is an emergency you need to call 911, the local crisis line, or the National Suicide Prevention Lifeline (1-800-273-8255). You may also consider reaching out to your doctor or psychiatrist.

Reference

Cobain, B. and Larch, J. (2006). Dying to Be Free: A Healing Guide For Families After a Suicide. Hazeldon Foundation: Center City, Minnesota.

Photos

Images are courtesy of MorgueFile.com and both by Pippalou: The photo of the dripping pine, DSCN0351.jpg and DSCN2024.jpg.