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  • Suicidal Thoughts: When Is It Time to Worry?

    If you are having a crisis call 1-800-273-8255, 1-800-SUICIDE National Suicide Prevention Lifeline & don’t stay alone. If you are having active suicidal ideations, you need to seek professional help immediately.

    When you’re in the business of trying to help mentally ill people, including those with depressive disorders return to a state of good mental health, it’s a tough task. A doctor treating a patient with appendicitis can surgically remove the appendix, the patient heals and all is well; not so with mental illness.

    Psychiatrists need more than just medical training, but enormous human insight to know when suicidal thoughts are simply part of the path in clinical depression, or when it is time to worry. The same applies to patients who experience suicidal thoughts. Are they real; does the concept instill fear or a sense of peace?

    The integral difference between thoughts of suicide and suicide is some form of action, including planning steps or making a list of conditions or supplies required. Taking action in whatever degree of seriousness may seem obvious, but it is a fine line. Many people who suffer from depression have a tendency to default to suicidal thoughts the moment a depressive episode is upon them; it’s simply how their brain reacts to clinical depression, but they never act on it.

    Signals That May Precipitate a Suicide Attempt

    There is probably no way that a depressed person at risk of contemplating or attempting suicide can be sufficiently objective to analyze their own situation. If you are experiencing dark thoughts and engage in precise suicide planning, and are able to visualize clearly a world without you in it, get professional help immediately. Don’t second-guess whether or not you might actually go through with it, get help.

    If your fear is that someone you know and/or love is on the verge of committing suicide, but you’ve heard them threaten that before and nothing came of it, there are things to look for that might indicate this time they are serious. The list that follows includes psychiatric observations and the direct experiences of people who wanted to end their lives, but survived. Here are some signs that suicidal thoughts have turned potentially lethal:

    • In a person who is not normally very orderly or organized, or does not otherwise have an illness, such as terminal cancer, that might warrant it, the preparation of a will can be a subtle hint. While the making of will seems sensible and we should all do it, if it seems out of the ordinary for the person in question, that’s a reason to be concerned.
    • A strangely calm demeanor or even euphoria in a person who generally exhibits neither emotion profoundly. The decision to end the misery of life, as perceived by a depressed individual, can give them a sense of relief and find a final moment of happiness in knowing what has hurt them will soon be over.
    • A need to set everything in order, to tidy the house, and put everything away; again, this applies more so to those who are normally not fastidious about housekeeping.
    • Stockpiling prescription drugs over a period of time. This is often accompanied by using less than the prescribed dose so that there are “leftovers”.
    • Using a computer or library to research methods of suicide, such as poisons, drugs, access to firearms, etc.
    • Purchasing a gun or other weapon; this is a clear indicator if the individual is normally anti-firearms.
    • Wrapping up loose ends by sending overdue letters or notes, paying bills to current, dividing personal items and money, and giving them away to family friends (as though executing a will in advance), and saying good-byes that have a final ring about them.
    • Increased risky behaviors, including sexual recklessness and experimenting with or heavier use of drugs and alcohol.
    • Withdrawing from society and personal relationships; psychiatrists assert that this helps the individual remove himself or herself from the daily workings of life, a way of separating from the life her or she knew and is about to leave.
    • A sudden and sometimes prolonged interest in violence, such as gratuitously violent films, and death or dying; this may manifest in things like solo walks frequenting graveyards, reading books on the subject, visiting palliate care wards in hospitals, even hanging around funeral homes.

    The Mayo Clinic warns that people who may be about to commit suicide will openly talk about it, perhaps as directly as stating, “I am going to kill myself.” Because we glibly use language in modern society, it’s easy to assume such talk may be a turn of phrase rather than a genuine suicide threat. Psychiatrists tend to agree that the more subtle statements about ending one’s life are likely serious. Be alert to comments such as, “I wish I had never been born,” and “I’d rather be dead.”

    Don’t Wait And Regret Inaction

    The reason that suicide is such a shock to the family, friends, colleagues and associates of the victim is more than the extreme sense of helplessness (I could have done something… if only I had known!) and sudden absence of an otherwise vital person. An often-cited issue is that they didn’t see it coming. This may have been because they either did not see the signs, partially thanks to the more ambiguous victim statements as noted above, or they did not recognize them as serious or related to a direct commitment to end one’s life.

    If you see one or any of these signs, get help. Talk to the individual and offer remedial assistance, or get them to a doctor. If you discover that a suicide is imminent, or worse, in progress, call 9-1-1. People who are considering suicide are not able to see hope. A psychiatrist, church minister or suicide prevention line may begin to help them see that there are other options than death. Knowing the signs and taking action can save a life that is, ultimately, worth living. Almost everyone has entertained, albeit briefly, suicidal thoughts at certain highly charged emotional times in their lives, but it’s time to worry when words translate into actions and a plan is put in place to carry out the act of suicide.