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Research by the charity Campaign Against Living Miserably (CALM) states that 115 people die by suicide in the UK every week, with 75% of those deaths being male. Their research has also found that every suicide directly affects 135 people, that is friends, family, colleagues and the communities in which they live.
On top of that, when somebody is bereaved by suicide, they are themselves at greater risk of taking their own life. These figures may only be the tip of the iceberg as they don’t show the number of people who may be contemplating suicide.
It can be very hard to understand why someone has reached the point where they are considering ending their life. The idea that someone is feeling suicidal and is considering or wants to end their life can be a very challenging and difficult concept for many people to fully understand.
What makes someone think of suicide?
Suicidal thoughts can range from creating a detailed plan of how to commit suicide to having a fleeting consideration of suicide. Anyone of any race, gender, age or socioeconomic status may feel suicidal at any point in their lives. Even someone who seems to be happy or appears to “have it all” can be vulnerable to suicidal thoughts.
Suicidal thoughts are a symptom of an underlying problem, and can occur when a person feels that they are no longer able to cope with an overwhelming situation. This could stem from, for example, financial problems, the death of a loved one, the end of a relationship, or a debilitating illness or health condition.
Some other common situations or life events that might cause suicidal thoughts include:
- A family history of child abuse, neglect, or trauma.
- A family history of violence or suicide.
- A feeling of being trapped or of hopelessness or helplessness.
- A feeling of intolerable emotional pain.
- A feeling of isolation or loneliness.
- A loss of work, friends, finances, or a loved one.
- Experiencing bullying or trauma.
- Experiencing legal problems or debt.
- Experiencing grief.
- Having attempted suicide before.
- No family or friends as support for issues such as identifying as LGBTQ+.
- Not being able to access care for mental health issues.
- Not seeking help due to fear or stigma.
- Stress due to discrimination and prejudice.
There are also a number of physical and mental health conditions that increase the risk factor of suicidal thoughts, including but not limited to:
Having any of the risk factors for suicidal thoughts does not mean that suicide is inevitable; however, they may indicate that you should be on the watch for warning signs.
What are the warning signs that someone feels suicidal?
Warning signs for suicidal thoughts are never easy to identify as there isn’t really any typical pattern of behaviour.
If someone is contemplating suicide you may see one or more of the following:
- Giving away personal items and wrapping up loose ends.
- Mentioning strong feelings of guilt and shame.
- Saying goodbye to friends and family.
- Social withdrawal and isolation.
- Talking about dying or wanting to die.
- Talking about feeling empty, hopeless, or seeing no way out of their problems.
- Talking about not having a reason to live or that others would be better off without them.
All the above may seem fairly obvious signs; however, there are some signs that are less obvious and are easy to miss even for people who are close to the person contemplating suicide.
These include but are not limited to:
- Unusual changes in behaviour – This can be common for someone who is having suicidal thoughts, but it is easy to miss. The changes may not seem to be related to depression or hopelessness. For example, someone you know who is usually kind may become angry and aggressive, or someone who has been sad and struggling with depression may suddenly become calm and seemingly happy and at peace. Other changes may include increased substance abuse or unusual mood swings.
- Changes in sleeping patterns – A change in how someone sleeps can be a sign of depression but also a sign of suicidal thoughts. Someone who is feeling suicidal may sleep more than normal, struggling to get out of bed at all. They may sleep less, experiencing insomnia and staying up until all hours and then struggling the next day from fatigue. Whether it is a symptom of being suicidal or not, these kinds of changes in sleeping habits are a cause for concern and should be treated.
- Physical conditions – Physical pain and discomfort are often overlooked as signs and symptoms of depression and also of suicidal thoughts. People with chronic pain from, for example, arthritis and other debilitating conditions may be at an increased risk of having suicidal thoughts. Living with chronic pain often means managing a huge emotional burden, as having chronic pain means you are living in a physical and psychological state that you can’t control, and there is a hopelessness to it. Be alert to other signs of depression or suicidal thoughts, as it is very easy to fall into poor mental health when dealing with pain day in and day out.
- Emotional distance – Someone who is feeling suicidal may become detached from life in general, from other people, and from typical activities. They may seem emotionally distant from people, whether or not they have isolated themselves socially. Acting indifferent in the face of emotional situations may not seem like a suicidal behaviour, so it is important to note this kind of behaviour and recognise it as a potential warning sign or a symptom of depression. Along the same lines, someone feeling suicidal may lose interest in normal activities, work and home, and things they once enjoyed.
- Accessing harmful means – This sign can be obvious, but more often than not it can be missed, for example someone may start stockpiling pills without anyone noticing, as they are easy to hide. It’s important to be aware of any harmful means someone you are concerned about may have access to – with access to these, the risk of suicide goes up.
Suicidal thoughts don’t usually happen overnight, they normally build up. That is why it is important to tune into the outward signs that may indicate that someone is thinking about or contemplating suicide.
How can you help someone who is feeling suicidal?
Suicide and suicidal thoughts are still topics that most people fear broaching; talking about our mental wellbeing doesn’t always come naturally, but talking really can help. Suicidal thoughts typically fall into two categories, passive and active. A passive suicidal thought might be “I wonder if the world would be better off without me?” Even fleeting passive thoughts like this suggest that the person needs to talk to someone – it is a sign that they are really feeling overwhelmed.
Active suicidal thoughts involve starting to have a plan, thinking about how, when and where they will do it. That’s when they need professional care.
What do you do if someone you know is exhibiting these signs of suicidal thoughts? If someone is actually threatening suicide, talking about doing it, or has or is actively accessing harmful means then don’t leave them alone, call 999 immediately for professional help. Try to keep them safe in the short term while waiting for emergency services.
Remove any items that they can use to end their life with – sharp objects such as razor blades and knives, cleaning products, drugs or medication, and belts, cords, wires and rope.
You can help someone who is feeling suicidal by listening, without judging them. If the situation is not that immediate, but you suspect someone is suicidal or may be considering suicide, talk to them about it. Discussing how they are feeling is not going to push anyone over the edge and make them take action. Talk to this person privately, listen without judgement, and be compassionate. You can ask them directly if they are considering suicide.
It can be daunting when someone you care about shows suicidal signs. But it is essential to take action if you are in a position to help. Starting a conversation to try to help save a life is a risk worth taking. Listening and showing your support is the best way to help them. You can also encourage them to seek help from a professional.
Offer to help them find a healthcare or support provider, make a phone call, or go with them to their first appointment. The initial emotional support role that you play is similar to carrying out physical first aid. First aid is the immediate temporary care given before regular professional aid can be obtained.
What won’t help someone who is feeling suicidal?
It is human nature to want to solve someone’s problems for them; however, this will not help. Don’t be tempted to take over and try to find a solution to their problems. This will only serve to make the person feel patronised or controlled.
It is also unhelpful to say things such as, “Snap out of it, you have so much to be grateful for” or “I know how you feel, I’ve had a hard time recently and I got through it” or “You know what you should do is….” – you are not listening to them.
Distraction is also unsupportive. Trying to take someone’s mind off the situation may only make them feel that how they are feeling is trivial, and will only add to their hopelessness if they feel they are misunderstood.
Someone talking about suicide or suicidal thoughts can sometimes be a plea for help. However, it is not up to you to decide what help they need – let them tell you, give them reassurance, respect and support to find their own solutions.
How to talk to someone who is feeling suicidal?
When you are broaching the subject with someone who may be suicidal, choose a good time and place to have the conversation, ideally where you are both feeling calm and have plenty of time. Tell them what you have noticed that makes you worried about them. For example, “You haven’t seemed yourself lately, is everything OK?” or “Would you like to talk with me about what’s happened? I’m worried about you.” This shows that you care, and that you are there to help.
You can also ask how they are doing, but be prepared to follow up a “fine” or “ok” with something such as “How are you feeling really? I want to know because I care”. They may not want to talk about it yet, but at least they know you care and are willing to have the conversation when they are ready. You can assure them “OK, but you know you can talk to me if you ever need to”.
Once they begin to talk, listen to what they have to say. Encourage them to talk about what’s going on, how they feel, what they are thinking, “Just take your time, there is no rush. I know talking about this can be hard, but I am listening”. Take time to try to understand their experience of anxiety or depression. Everyone’s experience is unique, so identify and confirm how they are feeling. Reassure them that what they tell you is confidential.
How to support someone feeling suicidal?
When people get to the point of thinking about suicide, they may feel like they have explored every single option and there doesn’t seem to be an alternative; however, if someone is talking about suicide it does not make it more likely to happen. You may not be sure what to do to help, whether you should take talk of suicide seriously, or if your intervention might make the situation worse. Taking action is always the best choice.
The first step is to find out whether the person is in danger of acting on their suicidal feelings – be sensitive, but ask direct questions. Asking about suicidal thoughts or feelings won’t push someone into doing something self-destructive. By offering an opportunity to talk about their feelings may reduce the risk of them acting on their suicidal feelings. You may need to accept that they might not be ready to talk. Tell them you are someone they can talk to if they ever need to.
If and when they are ready to talk, believe what they are telling you; it is always safest to assume that the person means what they say. Try to understand what led them to feel that way. Saying things like, “That sounds really tough” can show that you are listening and trying to understand the emotions they are going through.
Check your understanding of the situation and what you might be able to do to help. Help them explore their options, but remember any decisions must be their own, not yours. Reassure them that they are not alone and that there is hope that things can get better.
As you continue with your support, be patient, help them to overcome any setbacks, and point out any improvements that you see. Spend time with the person and express your care and support. Encourage them to make an appointment with a GP or a trusted health professional.
Let them know that they can take someone along for support if it helps and that you are happy to go with them. Don’t assume that someone with suicidal thoughts will get better without help or that they will seek help on their own. They will continue to need support and reassurance.
Keep telling them that there are other options to explore rather than suicide. You may have assured the person that your conversations are confidential, and so they should be; however, don’t agree to keep their suicidal thoughts or plans a secret – you may need to divulge to safeguard them.
Nonetheless, try to work with them if possible, to dismantle any plans. Help them to recognise all the reasons for staying alive and to identify the people, activities and services they can connect with when they are struggling. There may come a time when you feel unable to continue supporting them – you can only do so much to help on your own.
So, encourage them to connect with other trusted friends, family members, healthcare providers, and others who can offer compassionate support.
It is important to recognise when the issue has passed the point where you can safely handle it alone. If you believe that someone is in real danger, don’t hesitate to call 999 or take them to A & E. They may get upset in the moment, but your action can help them stay safe.
What to do if they don’t want to talk to a professional?
Not everyone feeling suicidal or having suicidal thoughts will be ready to seek professional help. For any number of reasons, they may dismiss the idea out of hand. Don’t be put off giving your support and don’t make seeing a professional a condition of your support.
Try to understand that it can take time for people to be ready to talk to a professional. Without being pushy, try to establish what their barriers are to seeking professional help and whether there is any way you can help to overcome their barriers.
Supporting someone with suicidal thoughts might have an impact on you, so it might help you to get support for yourself. Even if the person you are supporting refuses professional help, you can get professional support for yourself as you may need to “off-load” and help to build your emotional reserve.
What support is available?
There are numerous sources of information and support for anyone who may be experiencing suicidal thoughts and for families, friends and colleagues who are concerned about someone who may be at risk of suicide.
Below are listed some contact details:
- Samaritans is a registered charity that provides confidential, non-judgemental emotional support, 24 hours a day, 7 days a week, for people who are experiencing feelings of distress or despair, including those which could lead to suicide. In the UK, the Samaritans helpline service can be contacted for free on 116 123 or by email email@example.com. They also provide a self-help app to download.
- CALM, the Campaign Against Living Miserably, is a charity focused on reducing suicide in men aged under 35. Their helpline is 0800 58 58 58 and they are open 5pm–midnight 365 days a year. Webchat opening hours are 5pm–midnight every day.
- SANE provides emotional support and specialist information to anyone affected by mental illness, including families, friends and carers. SANEline offers non-judgemental and compassionate emotional support. Telephone 07984 967 708.
- Childline telephone 0800 11 11 is a free and confidential helpline for children and young people in the UK, or login for a 1-2-1 chat.
- PAPYRUS is a suicide prevention service that offers support and advice to young people up to 35 years. Telephone 0800 068 4141 for support. Text on 07860 039967. Email at firstname.lastname@example.org. They are open every day of the year 9am–midnight. The service is confidential and provides a source of support, practical advice and information to anyone concerned that a young person they know may be at risk of suicide.
- YoungMinds Parents’ Helpline offers free confidential online and telephone support to any adult worried about the emotional problems, behaviour or mental health of a child or young person up to the age of 25. Call on 0808 802 5544 (Monday to Friday 9.30am–4pm), email email@example.com or chat online (Monday to Friday 11am–1pm).
- SHOUT offers text support any time, text SHOUT to 85258.
- Telephone NHS 111 by dialling 111.
- Contact your GP or Google out of hours GP in x (give your location) for contact details of out of hours services.
Thoughts of suicide, even if they seem vague, should always be taken seriously. You may struggle to know what to do, but you can never go wrong by showing compassion and support. However, it can be emotionally demanding to support someone who is having suicidal thoughts, so it’s important that you try to keep yourself healthy too.
Find someone to talk things over with, such as a helpline or a mental health professional; they are there to support friends and family too. Taking care of others involves taking care of yourself.