Have you ever considered what life might be like if you were not around anymore? What about having thoughts of dying after the loss of something important to you, such as a child, a spouse, a possession that meant a lot, or some kind of relationship that contributed positively to your life?
If so, that is absolutely okay, as many people have “flirted” with the idea of ending the emotional and psychological (and sometimes physical) pain that feels imprisoning. Thankfully, we are living in an educated culture that seems to be more understanding of the topic of suicide.
Sadly, for many years people have looked negatively upon those who bring up the topic of suicide and who have attempted it. But it is important to educate ourselves to what causes a person to feel so helpless that death appears to be the only remedy for the pain. Unfortunately, this topic is be far too entailed to write about here, but we will certainly discuss what signs and symptoms to look for, what six questions you should ask someone who is talking about suicide, and who to seek for help and why.
Suicide is a very difficult topic, especially for children and adolescents. Any mention of suicide can trigger a cascade of challenges in the social arena such as other people’s perceptions of weakness or vulnerability, feeling pressured to hide or ignore the thoughts, being judged (primarily if the individual is religious or holds high morals or values), etc. It is very sad that the word suicide triggers social, emotional, psychological, and even spiritual judgments by others. Sadly, even within the mental health system one mention of the word suicide can cause a staff member to “screen” the individual and ask a series of questions geared toward determining risk and legality. Of course, this is all done to protect the person who is discussing suicide. But sometimes all a client or individual wants is to express his or her thoughts and feelings, not be assessed, judged, or made to feel like a bad person.
One of the things I have learned to do with my adolescent clients is to normalize the discussion of suicidal thoughts and feelings without immediately going into “assessment mode.” The majority of my young clients just want to be heard, and only know how to express their pain by discussing their suicidal feelings and thoughts. Other kids, however, are dropping hints that they are thinking about it, have a plan, and may act on their plan. In these cases, the individual is lethal and needs help ASAP.
But for many teenagers and adults, they simply want to discuss what is bothering them, get it off their chest, and possibly explore a solution (short-term or long-term). For others, however, it will be important to truly listen to the individual, try to discern or sense if the suicidal comments are real, and engage the person in talking and expressing himself or herself.
The most important thing anyone can do to help individuals thinking of suicide is to empathize with them (show them that you can relate or that you understand how they must feel), get them talking (expressing why they feel as they do), and consider asking the following:
- How much do you think about suicide? This question is asked to gauge how often the individual thinks of suicide. Individuals who often think of suicide are often those who are frequently depressed, anxious, or unmotivated by life’s demands and challenges. Constantly “entertaining” the idea of death and dying or suicide can signal that the individual is either thinking about it (even subconsciously) for themselves or is extremely depressed. We should also consider the individual’s culture and cultural behaviors before assuming the individual is wanting to kill themselves. For example, many hard metal bands discuss death, dying, and suicide and will often appear to be “idealizing” death. Individuals who are religious might also discuss death, dying, and suicide. You certainly want to make sure that you are not making snap judgments.
- Have you ever thought of how you might kill yourself and if so, are you thinking about that now? The goal in asking this question is to normalize the thought/feeling/experience and empathize. We all have had to struggle (and if you haven’t you most likely will experience something painful) with realities that are painful or disappointing. None of us are exempt. That’s why it is important when asking this question that you present the question in a compassionate, kind, and loving way. Asking this question angrily or in a condescending manner will only lead the person to reject anything you have to say to them. The other goal in asking this question is to get the person talking so that they can reveal how they are feeling and why. If the person answers your question correctly, you will not only have information on whether or not the individual is currently considering suicide, but you will also know how many times in the past this person has thought about suicide. A history of thinking of suicide, making threats, or even attempting can lead to greater chances these things will happen in the future at some point.
- How strong is the feeling for you on a scale from 1 (being worst feeling ever) to 10 (being not strong at all)? Asking this question allows you to gauge how severe the thoughts are and if the person is in need of crisis intervention or therapy. The answer to this question will determine the next steps. Sadly, nothing in mental health ever works out the way we hope it would. There are individuals who are very savvy with what to tell you and what not to tell you. The person does not have to tell you the truth and most likely, they will not. In cases such as these you will need to reach out to someone else for help. Calling a local crisis line, calling a local mental health practice or facility, or taking the person to the hospital emergency room will be helpful. However, if the individual does not believe they need help or is refusing to get help, your next step might be to call the police with your concerns around safety. Nine times out of 10 they will not be able to do anything other than ask the person to go to the hospital. If you do call the police, this might intimidate the person in such a way that they agree to get help.
- Do you think you might hurt yourself and if so, how can I help you because I really care? This is a humble and honest question that most people will likely respond to. You are not judging, you are not condemning, you are not calling the person out, or making the person feel guilty. You are making “I” statements (which brings the attention to how you are personally feeling about the situation) and asking the person to help you help them. If the individual says something similar to “there is nothing you can do but leave me alone right now,” you can give them space but keep your eyes and ears open.
- Can you think of any reason for why you should remain alive? This question can help bring the individual back down to reality while focusing on the reasons why he or she should give life a second chance. Sometimes we are so discouraged, so hurt, and so confused with emotions and life that we cannot see the forest for the trees. But having someone to help you focus on the details can be very powerful.
- Can we go to a therapist or hospital for a check-up? Using the word “we” communicates that you see you and the other individual as a team. You are not pointing your finger and saying “You need help now!” You are being compassionate and inferring that you will walk hand and hand with the person.