The majority of people give warning signs in the last phase of the suicidal process that can alert us to suicidal intent. Warning signs usually appear a week before the suicidal act and can be subtle and sometimes difficult to recognise. Warning signs appear in different forms like statements about someone’s feelings (indirect verbal signs), intended suicide (direct verbal signs), or as a behaviour which indicates severe distress (behavioural warning signs).
Direct verbal signs
Some people show their suicidal intent very directly, with statements like: “I have decided to kill myself.”, ”I wish that I was dead.”, ”I will commit suicide.”, or ”I will end it all.”.
Indirect verbal signs
Frequently, suicidal intent is expressed indirectly and we can recognise it in statements like ”I’m tired of life.”, ”What is the meaning of going further?”, ”My family would be better off without me.”, ”Who even cares if I die?”, ”I can’t go on anymore.”, ”Soon, you won’t have to take care of me anymore.”, or ”Goodbye, when you come back, I will be gone.”.
Warning signs can also be apparent in different forms of behaviour like taking care of personal and professional issues, writing or changing wills, planning their own funeral, giving away money or valuable property, or saying goodbye to their loved ones.
In the time period before suicide, it is also possible to notice other changes in an individual. The individual may be more emotionally unstable (e.g. screaming, yelling, outbursts of anger), confused, unable to communicate with family, friends, and peers, has weaker memory, loss of physical strength, and poor judgment. They can also return to alcohol or drug abuse even after a period of improvement.
Suicidal tendencies are also common when someone is in a situation that they perceive as very stressful. This is especially true when their social support or ability to seek out help in times of crisis is limited. Among those are: sudden rejection from a loved one (e.g. a girlfriend or a boyfriend), an unwanted divorce or separation, death of a partner, death of a child or friend (especially due to suicide or accident), diagnosis of a fatal disease, arguing with friends or relatives without any particular reason, loss of financial safety, and loss of a therapist.
Asking about suicidal thoughts
When we suspect that an individual has suicidal thoughts, it is important that we are not afraid to ask about it. If you notice warning signs or other sudden changes, prolonged sadness, feelings of despair, or other signs of depression in your friend, acquaintance, or relative make sure to find out if they are thinking about suicide.
You can ask a less direct question like ”Do you feel so unhappy lately, that you wish you’d be dead?”, or you can also ask more directly, “Are you thinking about suicide?”. Everyone can ask in their own way, the important thing is, that we ask.
Regardless of which words you use when asking about suicidal thoughts, avoid asking it in a way as if you don’t want to hear an honest answer, but you are only seeking a confirmation that everything is fine (e.g. ”You aren’t thinking about suicide, are you?”).
It is also important that you don’t deny the importance of an individual’s distress, even though their troubles may not seem that severe to you (e.g. adolescent distress due to unfulfilled love). The objective situation is not as important as the individual’s perception of this situation and their feeling of distress from it. We can gain their confidence only by expressing honest interest about their emotions in the conversation.
We all prevent suicide
It’s not true that only a mental health professional can ask these types of questions. On the contrary, suicide prevention is everyone’s task. The majority of people feel some aversion to ask questions about suicidal thoughts. This is completely natural and understandable since these are difficult topics for conversation. In the case where we receive an affirmative response to these questions, we suddenly have a certain commitment that we didn’t have before. We still need to overcome this aversion, because this might be the way to save a life.
If you ask about suicidal intent, you have the potential to help someone. Some people mistakenly believe that questions about suicide will encourage someone to think about it. This certainly isn’t true because someone who doesn’t think about suicide will simply answer that they don’t. On the other hand, individuals who think about suicide want to express their distress to others and seek help.
If someone tells us that they are thinking about suicide, we have to give them enough time to talk about their distress. An honest and open talk can be a great relief for a person in distress.
In most cases individuals make a plan for a suicidal act. The more thought out the plan is, the greater the danger for suicide is and immediate action is needed. It is important for us to ask immediately when we sense that something is going on. If the individual is seriously considering suicide, we should ask them to promise that they won’t harm themselves until our next meeting. Sometimes this kind of promise looks very simple but it can be extremely important to a person in distress. On one hand it can mean a temporary relief for a person, while on the other it can mean a last glimpse of hope for improvement. Therefore, in that time we have to be very active in offering help to that person.
Make an agreement with the distressed individual that you will help them seek out solutions for their problems. In addition, you should also make an agreement to help them seek appropriate professional help by contacting appropriate institutions as soon as possible. If the individual feels discomfort about seeking help, accompany them to a mental health professional.
If the individual cannot promise you that they won’t harm themselves until your next meeting, do not leave them alone, but rather call help immediately.