Suicidal Behavior

Three definitions of self-directed violence:

Suicidal ideation – thoughts about or an unusual preoccupation with suicide. These thoughts can include planning or think suicide.

Suicide attempt – self-directed behavior with the intent to die. Please note that an attempt does not have to result in injury.

Suicide – death caused by self-directed behavior.  The goal of this behavior is the intent to die.

Factors that may increase a person’s risk for suicidal behavior include:

  • Access to weapons or other means
  • Family history of suicide
  • Previous suicide attempt or attempts
  • Alcohol, Drug or Substance abuse
  • Current or previous history of psychiatric diagnosis
  • Poor self-control or impulsivity issues
  • Hopelessness – presence, duration, severity
  • Loss– physical, financial, personal
  • Recent discharge from psychiatric facility
  • History of abuse (physical, sexual or emotional)
  • Additional health problems (especially a newly diagnosed problem or worsening symptoms)
  • Age, gender, race (elderly or young adult, unmarried, white, male, living alone)
  • Same- sex sexual orientation

The first three warning signs:

  • Making threats to hurt or kill self
  • Seeking access to pills, weapons or other means
  • Talking or writing about death, dying or suicide

The remaining list of warning signs should call attention that an evaluation needs to be conducted in the very near future. Precautions should be in place right away to ensure the safety, of the individual.

  • Hopelessness
  • Rage, anger, seeking revenge
  • Acting reckless or engaging in risky activities, seemingly without thinking
  • Feeling trapped – like there’s no way out
  • Increasing alcohol or drug abuse
  • Withdrawing from friends, family or society
  • Anxiety, agitation, unable to sleep or sleeping all the time
  • Dramatic changes in mood
  • No reason for living, no sense of purpose in life 

Suicide Ideation (thoughts of suicide)

In most cases, suicidal ideation is believed to be the start of suicidal planning and action.

Many individuals will initially deny these thoughts for a variety of reasons including:

  1. the shame that is associated with symptoms of a mental disorder;
  2. fear of being judged negatively;
  3. loss of control over the situation; and
  4. fear of overreaction and involuntary hospitalization

Some signs and symptoms include profound social withdrawal, irrational thinking, paranoia, insomnia, depression, agitation, anxiety, irritability, despair, shame, humiliation, disgrace, anger, and rage.Suicide and suicidal behavior

There is a myth that asking about suicidal ideation increases the likelihood of the person to engage in the behaviors  – not true. In fact, most patients report a sense of relief and support when a caring, person non-judgmentally expresses interest in their pain.

What to do

Here are some ways to be helpful to someone who is threatening suicide or engaging in suicidal behaviors:

  • Be aware – learn the risk factors and warning signs of suicide and where to get help
  • Be direct – talk openly and matter-of-factly about suicide
  • Be willing to listen – allow expression of feelings
  • Be non-judgmental – don’t debate whether suicide is right or wrong
  • Be available – show interest, understanding, and support
  • Don’t “dare” the person to engage in suicidal behaviors.
  • Don’t act shocked
  • Don’t ask “why”
  • Don’t be sworn to secrecy
  • Do – offer hope that alternatives are available
  • Take action – remove lethal means of self-harm such as pills, weapons, and alcohol
  • Get immediate help from others with more experience and expertise
  • Be actively involved in encouraging the person to see a mental health professional 

Suicide Information Web Sites:

American Association of Suicidology:

American Foundation of Suicide Prevention:

Suicide Prevention Action Network (SPAN):

Suicide Prevention Resource Center:

Why Do Teens Try to Kill Themselves?

This helpful information is provided by the non-profit site called Kid’s Health. This site has a wealth of information. It is in three sections: kids, teens, and parents. It’s worth a look.

Most teens interviewed after making a suicide attempt say that they did it because they were trying to escape from a situation that seemed impossible to deal with or to get relief from really bad thoughts or feelings. Like Ethan, they didn’t want to die as much as they wanted to escape from what was going on. And at that particular moment dying seemed like the only way out.

Some people who end their lives or attempt suicide might be trying to escape feelings of rejection, hurt, or loss. Others might feel angry, ashamed, or guilty about something. Some people may be worried about disappointing friends or family members. And some may feel unwanted, unloved, victimized, or like they’re a burden to others.

We all feel overwhelmed by difficult emotions or situations sometimes. But most people get through it or can put their problems in perspective and find a way to carry on with determination and hope. So why does one person try suicide when another person in the same tough situation does not? What makes some people more resilient (better able to deal with life’s setbacks and difficulties) than others? What makes a person unable to see another way out of a bad situation besides ending his or her life?

The answer to those questions lies in the fact that most people who commit suicide have depression.

Substance Abuse

Teens with alcohol and drug problems are also more at risk for suicidal thinking and behavior. Alcohol and some drugs have depressive effects on the brain. Misuse of these substances can bring on serious depression. That’s especially true for some teens who already have a tendency to depression because of their biology, family history, or other life stressors.

The problem can be made worse because many people who are depressed turn to alcohol or drugs as an escape. But they may not realize that the depressive effects alcohol and drugs have on the brain can actually intensify depression in the long run.

In addition to their depressive effects, alcohol and drugs alter a person’s judgment. They interfere with the ability to assess risk, make good choices, and think of solutions to problems. Many suicide attempts occur when someone is under the influence of alcohol or drugs.

This doesn’t mean that everyone who is depressed or who has an alcohol or drug problem will try to kill themselves, of course. But these conditions — especially both together — increase a person’s risk for suicide.

Suicide Is Not Always Planned

Sometimes a depressed person plans a suicide in advance. Many times, though, suicide attempts happen impulsively, in a moment of feeling desperately upset. A situation like a breakup, a big fight with a parent, an unintended pregnancy, being outed by someone else, or being victimized in any way can cause someone to feel desperately upset. Often, a situation like this, on top of an existing depression, acts like the final straw.

Some people who attempt suicide mean to die and some aren’t completely sure they want to die. For some, a suicide attempt is a way to express deep emotional pain. They can’t say how they feel, so, for them, attempting suicide feels like the only way to get their message across. Sadly, many people who really didn’t mean to kill themselves end up dead or critically ill.

Warning Signs

There are often signs that someone may be thinking about or planning a suicide attempt. Here are some of them:

What if This Is You?

If you have been thinking about suicide, get help now. Depression is powerful. You can’t wait and hope that your mood might improve. When a person has been feeling down for a long time, it’s hard to step back and be objective.

Talk to someone you trust as soon as you can. If you can’t talk to a parent, talk to a coach, a relative, a school counselor, a religious leader, or a teacher. Call a suicide crisis line (such as 1-800-SUICIDE) or your local emergency number (911).

These toll-free lines are staffed 24 hours a day, 7 days a week by trained professionals who can help you without ever knowing your name or seeing your face. All calls are confidential — no one you know will find out that you’ve called. They are there to help you figure out how to work through tough situations.

What if It’s Someone You Know?

It is always a good thing to start a conversation with someone you think may be considering suicide. It allows you to get help for the person, and just talking about it may help the person to feel less alone and more cared about and understood.

Talking things through also may give the person an opportunity to consider other solutions to problems. Most of the time, people who are considering suicide are willing to talk if someone asks them out of concern and care. Because people who are depressed are not as able to see answers as well as others, it can help to have someone work with them in coming up with at least one other way out of a bad situation.

Even if a friend or classmate swears you to secrecy, you must get help as soon as possible — your friend’s life could depend on it. Someone who is seriously thinking about suicide may have sunk so deeply into an emotional hole that the person could be unable to recognize that he or she needs help. Tell an adult you trust as soon as possible.

If necessary, you can also call a suicide crisis line (such as 1-800-SUICIDE) or your local emergency number (911).These are confidential resources and the people at any of these places are happy to talk to you to help you figure out what to do.

Sometimes, teens who make a suicide attempt — or who die as a result of suicide — seem to give no clue beforehand. This can leave loved ones feeling not only grief-stricken but guilty and wondering if they missed something. It is important for family members and friends of those who die by suicide to know that sometimes there is no warning and they should not blame themselves.

When someone dies by suicide, the people left behind can wrestle with a terrible emotional pain. Teens who have had a recent loss or crisis or who had a family member or classmate who committed suicide may be especially vulnerable to suicidal thinking and behavior themselves.

If you’ve been close to someone who has attempted or committed suicide, it can help to talk with a therapist or counselor — someone who is trained in dealing with this complex issue. Or, you could join a group of survivors where you can share your feelings and get the support of people who have been in the same situation as you.

Coping With Problems

Being a teen is not easy. There are many new social, academic, and personal pressures. And for teens who have additional problems to deal with, such as living in violent or abusive environments, life can feel even more difficult.

Some teens worry about sexuality and relationships, wondering if their feelings and attractions are normal, or if they will be loved and accepted. Others struggle with body image and eating problems; trying to reach an impossible ideal leaves them feeling bad about themselves.

Some teens have learning problems or attention problems that make it hard for them to succeed in school. They may feel disappointed in themselves or feel they are a disappointment to others.

These problems can be difficult and draining — and can lead to depression if they go on too long without relief or support. We all struggle with painful problems and events at times. How do people get through it without becoming depressed? Part of it is staying connected to family, friends, school, faith, and other support networks.

People are better able to deal with tough circumstances when they have at least one person who believes in them, wants the best for them, and in whom they can confide. People also cope better when they keep in mind that most problems are temporary and can be overcome.

When struggling with problems, it helps to:

Counselors and therapists can provide emotional support and can help teens build their own coping skills for dealing with problems. It can also help to join a support network for people who are going through the same problems — for example, anorexia and body image issues, living with an alcoholic family member, or sexuality and sexual health concerns. These groups can help provide a caring environment where you can talk through problems with people who share your concerns.

Check your phone book or look online to find local support groups, or ask a school counselor or a youth group leader to help you find what you need.