Warning Signs of Suicidal Behaviour The best way to prevent suicide is through education and awareness. Most suicides are related to depression and, since we cannot always prevent depression, although we can frequently treat it successfully, we must learn to recognize these symptoms that may occur in ourselves or others: Symptoms of Depression Depressed mood Loss of interest and enjoyment Reduced energy, being easily fatigued, diminished activity Marked tiredness on slight effort Reduced concentration and attention on a task Reduced confidence and self-esteem Feeling of guilt and unworthiness Bleak and pessimistic views of the future Ideas of acts of self-destruction or suicide Disturbed sleep Diminished appetite and libido Unexplained physical symptoms (Source: International Classification of Disease, WHO (1992)) When should a person consult a doctor? If symptoms as stated above persist for at least two weeks If normal stresses of life do not explain the symptoms When rest and relaxation have not helped What a person that feels suicidal may say: Direct messages include statements such as “I am going to commit suicide,” or “I don’t want to live any more.” Indirect messages include statements such as “Life isn’t worth living,” “I want to go to sleep and never wake up,” “Soon it won’t matter anymore,” and “Do you think suicide is wrong?” These are subtler ways that people express their pain, hopelessness and possible suicidal thoughts. How a person that feels suicidal may behave: Each of the following behaviors by itself may not signal suicidal thinking or depression, yet if several are present, there could be cause for serious concern. Depression, moodiness, sadness, or lack of energy Talking directly or indirectly about dying or committing suicide Changes in sleeping habits (too much, too little) Changes in eating habits (sudden weight gain, weight loss) Discouragement about the future, self-criticism Recent lack of concern about physical appearance, hygiene Withdrawal from social contacts or communication difficulty Giving away prized possessions Drop in school grades or work performance Acquiring the means for suicide (guns, drugs, rope) Making final arrangements, writing a will Taking unusual risks Increased drug or alcohol use Preoccupation with death through poetry and/or artwork Previous suicide attempts (80% of those who kill themselves have attempted it before) What may have happened to a person that arises suicidal feelings: The following events frequently lead to crisis. For some people, internal and external resources are present in sufficient amounts to cope. For others, intense feelings coupled with a lack of external resources result in serious emotional crisis. End of a serious relationship Loss of a loved one to suicide Death of a loved one Divorce Loss of a job Financial difficulties Moving to a new location Isolation What can we do to help the person that feels suicidal? Show that you really care. Be non-judgmental (don’t act appalled or offended) Talk openly about suicide by asking questions such as: “Do you ever feel so bad that you think of suicide?” “Do you have a plan?”(the more specific, the higher the risk) “Do you know when you would do it (today, next week)?” “Do you have access to what you would use?” Never keep a plan for suicide a secret Ask if they have made prior attempts or are bereaved through suicide (again, this denotes higher risk). If risk seems high, stay with the suicidal person or ask someone else to stay with him or her until the crisis has passes or until help arrives. Help the suicidal to get help. It may be necessary to get the suicidal person to a GP or to a hospital as soon as possible. Other resources may include informed clergy, psychiatrists, clinical psychologists, counsellors, support groups, supportive family members and select friends. The importance of continuing care and concern: Just prior to suicide many depressed people continually apologise to anyone they think they have offended. They then take their own lives. Half the people who kill themselves do so within ninety days after the precipitating crisis. Hence the need for continued care and concern.>