Signs of Concern
Most people do not simply wake up one day with the idea of killing themselves. A plan for suicide usually develops over time as a response to life events and psychological pain so severe or intense that suicide seems to be the only reasonable alternative. Individuals who are experiencing “suicidal thoughts” or “suicidal behaviors” often exhibit changes in their usual behaviors that are identifiable signals of increased risk for suicide. The trouble is that, all too often, these signs and changes are seen as normal behaviors or reactions to problems, stress, etc.
The truth is many of the behaviors on the following list are just that: normal responses to life’s pressures. This is why they are referred to as “signs of concern” rather than “warning signs.” When these signs are exhibited individually, most of these give no cause for alarm. However, if an individual you know is exhibiting several of these changes or if the behavior seems to be out of character for that person, trust your instincts and start asking questions.
What Do the Signs Look Like?
Suicide threats may be subtle or direct. Examples of an indirect suicide threat you may hear someone say, “I’d be better off dead,” “No one would miss me if I weren’t here,” “Who cares if I’m gone,” etc. Sometimes, an individual will make a more direct statement, “I am going to kill myself.” Statements such as these may be made out of frustration or anger. However, if this type of comment is unusual or if these remarks are accompanied by other behaviors that concern you, don’t be afraid to ask. Don’t just ignore it and hope the feelings will pass. Ask the individual directly if these are references to suicide. We must take all statements or comments about suicide seriously.
Previous Suicide Attempts
Someone who has previously made suicide attempts is at a higher risk to attempt again. According to Mental Health America, 30% to 40% of people who complete suicide have made a previous attempt. If an individual has attempted suicide, the pain must be great, and action is needed. However, it may be difficult to recognize the attempt for what it is. Sometimes high-risk behavior, taking unnecessary risks, self-destructive behavior, or half-hearted attempts – such as superficial wounds or overdoses of readily available medications – can be signals the individual is seriously considering suicide to relieve the pain. Any instance of deliberate self-harm should be taken seriously and action should be taken.
Adults often use the word “depressed” to mean a passing sadness or lack of energy. We all have times when we feel down in the dumps. People of all races, ethnic groups, genders, and ages suffer from depression. More than 20 million adult Americans have depression, and additionally, 1 out of 33 children and 1 out of 8 adolescents experiences depression. Depression is treatable. Nearly 80% to 90% of depressed people will respond to treatment, and nearly all of those who receive treatment will at least see some relief from their symptoms. Some common symptoms are:
- Persistent sadness or anxiety
- Feelings of hopelessness, pessimism, or helplessness
- Loss of interest or pleasure in life
- Changes in sleep or eating patterns
- Decreased energy
- Alcohol or substance abuse
Out of Character Behaviors
Many times, signs of concern can be considered normal behaviors, unless they persist over a long period of time, if there are several signs at once, or if the behavior is “out of character” for the individual as you know them. These behaviors can include:
- Talking about suicide
- Being preoccupied with death or suicide
- Losing interest in things previously enjoyed
- Withdrawing from family, friends and activities
- Increasing their use of alcohol and drugs
- Displaying extreme mood swings
- Feeling anxious or agitated
- Neglecting personal welfare (i.e. deteriorating physical appearance)
- Expressing feelings of excessive guilt/shame
Any of these changes in behavior warrant at least some questions. Even if the individual is not experiencing a suicidal ideation, something is happening in their life. We need to ask some questions.
Sometimes, individuals who are considering suicide make “final arrangements.” They visit friends, give away prized possessions, and, in some instances, even talk about or write out funeral plans. They seem preoccupied with death and the way things will be after they’re gone.
If You’re Worried, Ask.
Any one of these signs alone may be perceived as normal for the person. However, if you have any doubt or concerns about an individual’s intentions or behaviors, ask. If several of these behaviors have been in place for more than two or three weeks, ask, and then get professional help, if needed.