Suicide Prevention

Don't be afraid to ask

There is no harm in asking a depressed person if he or she is thinking about suicide, says Dr. Stephen Younker, a psychologist in Yakima, Washington. "A common misperception is we think we're going to plant the idea," he said. "That's just not true. Anybody who's very [clinically] depressed probably has some suicidal thoughts or ideations. Ask them if they have a plan to take their own lives. When people commit suicide, it's not a random act. It's a planned-out situation."

Some people who are suicidal simply believe that there has to be something less painful than their current state.

"It's not so much a desire to die, but a desire to change how I'm feeling right now," he explained. "They're wanting relief. Some people may want to end the pain, and they end the pain with the only option they think there is. They take their life."

They might feel they have failed everybody, that a situation was their responsibility and they didn't perform to the level they should have. They may be high achievers who find themselves in circumstances they can't control.

Depressed people may not be able to think rationally or may believe that they can't be helped, and friends may need to step in and get them the help they need.

"I believe we're created to have relationships and connections with other people. In depression, you disconnect from other people, and you leave yourself isolated and lonely. If a person comes along and shows a genuine interest in that person who's depressed, there's the key to that person seeking help. If someone cares enough to ask how they are feeling, that's generally the first step for a person that possibly would not get treatment."

Suicidal people tend to pick out rescuers—people who care about them and can help them out, if they pick up on the signs and are assertive enough to ask direct questions, Younker said.

Ask questions, such as "Are you thinking about suicide?" Keep asking, he urges. Err on the side of overdoing it. Don't be inhibited by politeness.

Let the person know you care. Tell them, "I love you," or "I care," or "I want you to continue to live."

Don't judge. Don't call the person's bluff, and don't try to motivate them out of any kind of guilt, he cautioned.

"I would not tell them they can't do it. And don't tell them, "Well, go ahead and do it."

"Don't leave them to get help on their own. If they are intensely suicidal, don't leave them alone until the risk has been eased and the situation taken care of."

If all else fails, call the police, Younker suggested. "If you're desperate, call 911."

Part II

Everyone is vulnerable to depression, but some more so than others. People who are under tremendous amounts of stress become depressed, but at the other extreme, so do people who have no responsibilities in life and suffer feelings of worthlessness.

There is a genetic chemical imbalance that predisposes a person to depression, says Dr. Stephen Younker, a psychologist in Yakima, Washington. But it also has a lot to do with how a person thinks and perceives things—as in whether they consider a glass is half full or half empty.

"Our attitude has a whole lot to do with this," he said. "That's why it's treatable."

The people most at risk of suicide are not the most severely depressed, because they don't have the energy to do it, Younker said. It's the severely to moderately depressed people who are the greatest cause for concern.

"People who are either going into a deep depression or coming out of a deep depression—that's a very critical time," he said.

A person may be suicidal if he or she:

• Is depressed, doesn't want help, and doesn't communicate.
• Drinks too much because stresses seem overwhelming.
• Takes more risks than usual, such as reckless driving or behavior.
• Is making final arrangements, such as changing a will, giving things away, or talking vaguely about going away.
• Suddenly seems in high spirits (which could be because the person has made the decision to take his or her own life and the burden is lifted).

A depressed person will get over depression, but how quickly depends on how hard the person works at trying to change his or her thinking, as well as on the treatments sought. Almost 90 percent of people who have clinical depression respond to treatment, Younker said. Suicide is much more likely if the depression is not treated with medication and psychotherapy.

Help is available from the family doctor, clinics, mental health organizations and specialists, psychiatrists, social workers, or community health centers.

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