What could drive an individual to take his or her own life? What goes on in the mind of a suicidal person? Fear, desperation, isolation, hopelessness, failure or what? Suicide is a desperate attempt to escape unbearable suffering. Most suicidal people are deeply conflicted about ending their own lives. They wish there was an alternative to suicide, but they just can’t see one. Research shows that persons that attempt suicide usually give some sort of clue and indirect references about their intentions. Suicidal talk or behaviour is not just a warning sign that the person is thinking about suicide—it’s a cry for help. But unfortunately, the cry for help is just a personal secret, which in most cases is never shared with anybody. It is not necessarily true that if a person is determined to kill himself or herself, nothing is going to stop him/her. Experts say even the most severely depressed person has mixed feelings about death, and wavers until the very last moment between wanting to live and wanting to die. The truth is that most suicidal people do not really want death; all they want is for the pain to stop. A suicidal mind frame could develop dramatic mood swings or sudden personality changes. Somebody that is outgoing and cheerful could become withdrawn or shift from being well-behaved to rebellious. A suicidal person may also lose interest in day-to-day activities, neglect his or her appearance, and show big changes in eating or sleeping habits. It is not true that people that commit suicide don’t try to seek help. The best way to prevent suicide is to recognize the warning signs and know how to respond. If you believe that a friend or family member is suicidal, you can play a role in suicide prevention by pointing out the alternatives, showing that you care, and getting a doctor or psychologist involved. Risk factors According to experts, at least 90 percent of all people who die by suicide suffer from one or more mental disorders such as depression, bipolar disorder, schizophrenia, or alcoholism. Depression in particular plays a large role in suicide. The difficulty suicidal people have imagining a solution to their suffering is due in part to the distorted thinking caused by depression. Common suicide risk factors include: Mental illness, alcoholism or drug abuse Previous suicide attempts, family history of suicide, or history of trauma or abuse;terminal illness or chronic pain, a recent loss or stressful life event, social isolation and loneliness. Common warning signs Most suicidal individuals give warning signs or signals of their intentions. A major warning sign for suicide is talking about killing or harming oneself, talking or writing a lot about death or dying, and seeking out things that could be used in a suicide attempt, such as weapons and drugs. The best way to prevent suicide is to recognize these warning signs and know how to respond if you spot them. Major warning signs for suicide include talking about killing or harming oneself, talking or writing a lot about death or dying, and seeking out things that could be used in a suicide attempt, such as weapons and drugs. These signals are even more dangerous if the person has a mood disorder such as depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide. Other warning signs to look out for include: *Talking about suicide—Any talk about suicide, dying, or self-harm, such as “I wish I hadn’t been born,” “If I see you again…” and “I’d be better off dead.” *Preoccupation with death—Unusual focus on death, dying, or violence. Writing poems or stories about death. *No hope for the future—Feelings of helplessness, hopelessness, and being trapped (“There’s no way out”). Belief that things will never get better or change. *Self-loathing, self-hatred—Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden (“Everyone would be better off without me”). *Getting affairs in order—Making out a will. Giving away prized possessions. Making arrangements for family members. *Saying goodbye—Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won’t be seen again. *Withdrawing from others—Withdrawing from friends and family. Increasing social isolation. Desire to be left alone. *Self-destructive behaviour—Increased alcohol or drug use, reckless driving, unsafe sex. Taking unnecessary risks as if they have a “death wish.” *Sudden sense of calm—A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to attempt suicide. Hopelessness is significant factor A more subtle but equally dangerous warning sign of suicide is hopelessness. Studies have found that hopelessness is a strong predictor of suicide. According to experts in psychiatric medicine, most suicidal persons are not psychotic or deranged, and while extreme distress and emotional pain are not necessarily symptoms of mental illness, hopelessness is a strong predictor of suicide. People who feel hopeless may talk about “unbearable” feelings, predict a bleak future, and state that they have nothing to look forward to. A suicidal person may also lose interest in day-to-day activities, neglect his or her appearance, and show big changes in eating or sleeping habits. What to do when talking to a suicidal person Talking to a friend or family member about their suicidal thoughts and feelings can be extremely difficult for anyone. But if one is unsure whether someone is suicidal, the best way to find out is to ask. You can’t make a person suicidal by showing that you care. In fact, giving a suicidal person the opportunity to express his or her feelings can provide relief from loneliness and pent-up negative feelings, and may prevent a suicide attempt. Here’s what you should do: *Be yourself. Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it. Begin conversation like this: “Recently, I have noticed some differences in you and wondered how you are doing. What can I do to be of help right now?” Ask questions and listen to answers. *Listen. Let the suicidal person unload despair, ventilate anger. No matter how negative the conversation seems, the fact that it exists is a positive sign. *Be sympathetic, non-judgmental, patient, calm, accepting. The suicidal person is doing the right thing by talking about his/her feelings. *Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important to you. Say something like this: “I may not be able to understand exactly how you feel, but I care about you and want to help.” *Take the person seriously. If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head, you are showing that you are concerned, that you take them seriously, and that it’s OK for them to share their pain with you. What not to do when talking to a suicidal person *Don’t argue with the suicidal person. Avoid saying things like: “You have so much to live for,” “Your suicide will hurt your family,” or “Look on the bright side.” Don’t act shocked, lecture on the value of life, or say that suicide is wrong. Promise confidentiality. Refuse to be sworn to secrecy. *Don’t offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your friend or loved one. *Don’t blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness, or lack thereof, is not your responsibility. Prompt action is vital If a friend or family member tells you that he or she is thinking about death or suicide, it’s important to evaluate the immediate danger the person is in. Those at the highest risk for suicide in the near future have a specific suicide plan, the means to carry out the plan, a time set for doing it, and an intention to do it. Helping a suicidal person It takes a lot of courage to help someone who is suicidal. If a friend or family member is suicidal, the best way to help is by offering an empathetic, listening ear. Be proactive. Don’t say: “Call me if you need anything.” Call the person. Don’t wait for the person to call you or even to return your calls. Drop by, call again, invite the person out. Prevention tips Suicide is preventable. One way is to take care of mental health. If you spot the warning signs of suicide in someone you care about, you may wonder if it’s a good idea to say anything. But anyone who talks about suicide or shows other warning signs needs immediate help. The sooner the better.