It’s easy to brush off those melancholic posts cluttering your newsfeed as emo, but what if your friend is having more than just the bout of the blues? What would you do if a friend starts talking about suicide? According to the World Health Organization, more than 800,000 people die of suicide every year—that’s about one suicide every 40 seconds. “There are hundreds of modest steps we can take to improve our response to the suicidal and to make it easier for them to seek help,” said Martha Ainsworth of Metanoia.org. Taking these steps can save many lives:
Don’t brush it off.
Whether said as a joke, a cryptic Tweet, or a direct cry for help, “always take suicide attempts and threats seriously.” [via US National Library of Medicine (NLM)]. Suicidal behaviors usually occur in people with one or more of the following: depression, bipolar disorder, post-traumatic stress disorder (PTSD), stressful life issues, and other mental health ailments. “Assuming that the [suicidal] person is only seeking attention is a very serious and potentially disastrous error,” warned Kevin Caruso of suicide.org.
Spot the signs.
Observe if your friend has been exhibiting these suicide warning signs for two weeks or more. According to the American Foundation for Suicide Prevention (AFSP), the more warning signs exhibited, the greater the risk for suicide.
1. Difficulty concentrating, remembering details, and making decisions
2. Constant fatigue and decreased energy
3. Feelings of guilt, worthlessness, hopelessness and/or helplessness
4. Insomnia (early-morning wakefulness, difficulty sleeping) or hypersomnia (sleeping too much)
5. Irritability and restlessness
6. Persistent sadness, anxiety, or “empty” feelings
7. Overeating or appetite loss
8. Persistent aches or pains, such as headaches, cramps, and digestive problems that do not ease with treatment
9. Thoughts of suicide or actual suicidal attempts
Talk and listen.
One of the biggest mistakes friends and family members of suicidal people make is lecturing and getting mad at the person. According to international volunteer group Befrienders, the last thing suicidal people need is to be interrogated, categorized, and criticized. “They want a safe place to express their fears and anxieties,” they said. “Stay calm, and talk with him or her in a matter-of-fact manner,” suggested Caruso. Avoid saying things like, “You have so much to live for,” or “Think about how this will hurt your family.” The suicidal person is most likely suffering from a chemical imbalance in the brain and is extremely sensitive, overwhelmed, and confused. Be careful of the statements that you make, because the wrong choice of words may make the person even more depressed. Instead of being judgmental and angry, show concern and compassion by saying, “Things must really be awful for you to be feeling that way.” Let them know you are there to listen and let them express emotion. “Allow the person to cry, yell, swear, and do what is necessary to release the emotion,” said Caruso. “However, do not allow the person to become violent or harm himself or herself.”
Keep triggers away.
It’s okay to talk to the suicidal person openly about suicide. You may ask, “Are you feeling so bad that you are thinking about suicide?” If the answer is yes, ask, “Have you thought about how you would do it?” If the answer is yes, ask, “Do you have what you need to do it?” If the answer is another yes, ask, “Have you thought about when you would do it?” Once you find out the planned method and timeline, make sure you keep that person away from guns, the edge of tall buildings, drugs, or other suicide methods mentioned. Keep your friend or loved one from seeing “triggers,” like movies or books that romanticize and sensationalize suicide.
When critical, go to the ER.
If the person is at a high risk of suicide (ex. on the edge of a tall building or with the methods ready nearby), do not leave him or her alone for even a second. Only after you get professional help for the person can you consider leaving him or her. In the Philippines, since we do not have a reliable emergency dispatch unit like 911, your best option is to take the suicidal person to the nearest hospital emergency room for intervention, potential treatments, and further evaluation. Contact a trusted family member or guardian immediately. “Because our country still believes in the fallacies about suicide, most suicidal people will initially refuse to be taken to the ER because they think they will be placed in a straight jacket and locked up like in the movies,” said Survivors of Suicide (SOS) Philippines, an online support group for Filipinos undergoing depression and other mental health issues. “As long as the person cooperates and is surrounded by supportive loved ones, suicide intervention with a qualified mental health professional is far from scary. Reassure the suicidal person that you will be there throughout the assessment.”
If the person is not critically suicidal, offer to take him/her to a psychiatrist, therapist, or counselor as soon as possible. If you must, make the appointment for the person. “Suicidal feelings need to be dealt with on a professional level. Only trained professionals should assume the care for the person,” advised Caruso. According to AFSP, suicidal feelings often come from having a mental illness, and it can be treated with professional help. Medication, talk therapy, or a combination of the two has been shown to save lives. The best way to help is to encourage and assist the suicidal person to get the help they need.
Contact the family.
“At the end of the day, you really need the suicidal person’s immediate family or guardian to take over.” [via SOS Philippines] “Most of the time, there is an underlying mental health ailment, which can be cured and is nothing to be ashamed of. Getting help for depression is no different from getting help for heart disease or cancer.”
Do not keep it a secret.
It’s natural to want to keep the trust of the friend who begged you to keep it a secret, but suicidality is critical. “Being a true friend means not letting the person who you care for die by suicide,” Caruso wrote in “Suicide Can Never Be a Secret.” The price for keeping the secret of someone’s suicidal thoughts could be the death of that person.
Do not handle the situation by yourself.
“There’s a natural impulse to want to fix the problems of people we love, but you can’t control a loved one’s depression.” [via helpguide.org] “It’s just as important for you to stay healthy as it is for the depressed person to get treatment. You are not betraying your depressed relative or friend by turning to others for support.”
“Because there is a dire lack of proper mental health facilities in the Philippines, it’s important to check if your suicidal or depressed friend is in the hands of a qualified mental health professional and that his/her guardians are educated about mental health." [via SOS Philippines] Even after the situation is diffused and the suicidal person has gotten help from a therapist or doctor, regularly check if your friend is progressing. Suicidal feelings can come and go, so follow up with continued support. Because mental health is still highly stigmatized, let your friend know that you care and are not ashamed of him/her. Be patient. “Even with optimal treatment, recovery from depression doesn’t happen overnight,” said Smith.
Crisis Line (for non-sectarian, non-judgmental telephone counseling):
Landline: (02) 893-7603
Globe Duo: 0917-8001123 / 0917-5067314
Sun Double Unlimited: 0922-8938944 / 0922-3468776
Center for Family Ministries (for spiritual counseling):
Landline: (02) 426-4289 to 92