Depression is one of the biggest mental health issues today and it is growing rapidly. In extreme cases, it can lead to suicide. This is the leading cause of preventable death worldwide. It is caused by the complex interaction of biological, genetic, psychological, environmental, socio-cultural and other factors. More than 1 million people commit suicide worldwide each year. To look at it another way, 1 person somewhere in the world commits suicide every 40 seconds.


Suicide – The Warning Signs

Although suicide can be an impulsive action, in many cases people will contemplate it for days or even months before actually attempting it. Knowing the risk factors and warning signs can often help in getting a suicidal person the help he or she needs to resume a more positive attitude to life.

1. The risk factors: There are 2 main risk factors – biological and psychological.

  • The biological issues to watch for include depression, substance abuse, personality disorders in the form of mood changes, impulsive behaviour, aggression etc. and serious medical conditions like cancer or chronic unbearable pain.
  • The psychological factors include losing a job or other financial problems, interpersonal problems, rejection, bereavement, separation of a major forced change in lifestyle.

2. There are also clues you can look for. These include direct verbal statements like: “I am going to end it all,” ” I wish I were dead,” “The family would be better off without me,” “I am a burden to others,” “Living is useless” and so on. The behavioural clues include increased substance or alcohol abuse, becoming withdrawn or isolated from family and friends, mood changes, giving away cherished possessions, putting personal and business affairs in order, making a will and other signs of not wishing to continue to live.

Understand The State Of Mind

The state of mind of a person thinking of suicide can often give additional signs of what they are contemplating. These include:

  • Ambivalence: The wish to die and the wish to live wage a see-saw battle in the mind
  • Rigidity: The thinking, feelings and actions of a person thinking of suicide are often constricted and different from what existed earlier.
  • Impulsivity: Thoughts (and in the worst case the actual act) of suicide can be impulsive and transient. These may last from a few minutes to a few hours or more and are often triggered by negative events in the person’s life.

Communicating With A Suicidal Person

What You Can Do:

  • Talk about the feelings and their causes. Contrary to popular belief, talking about suicide does not plant or reinforce the idea. People who are thinking of taking their own lives are relieved to be able to talk about their feelings and thoughts.
  • Talk in privacy in surroundings where the person feels comfortable.
  • Do not rush the conversation. Give the person as much time as he or she needs to express themselves.
  • Ensure that the person appreciates that you are really listening and understanding what is being said.
  • Give emotional support. Work through the emotions and thoughts of suicide and focus on the positives. The more openly the person talks, the more the turmoil will reduce. The person will then become more reflective and open to more positive thoughts and feelings.
  • With the person’s consent contact family, friends, colleagues and others who can help and enlist their support.
  • Refer the person to a mental health professional.

What You Should Not Do:

  • Do not show any shock at what you hear.
  • Do not interrupt the flow of what is being said to you.
  • Do not try to trivialize the problems
  • Do not ask the person to conceal negative thoughts.
  • Do not challenge the person to overcome the thoughts and feelings on his or her own and say things like “Everything will be fine.” Platitudes are seen as a way of glossing over the issues.

The key factors to keep in mind when dealing with a person with suicidal thoughts is to remind them that it is fine to reach out to others, that help is available and that recovery is possible.

“When everything seems to be going against you remember that an airplane takes off against the wind, not with it.”

– Henry Ford

Article by Dr. Sujatha Velmurugan
Consultant Psychiatrist
Kauvery Hospital, Chennai