Depressed people with chronic disabilities are at higher risk of suicide, particularly if chronic pain is part of the disability. Social support also plays a role; divorced, widowed and single people are at greater risk of suicide than those in stable long-term relationships.
Caregivers should watch for expression of suicidal thoughts. Has your loved one suggested that you - or the world - would be better off without them, or that they are no good to anyone? Susan Dion, a woman with fibromyalgia, proposes that people with
chronic disabilities who are considering suicide should make a list of 25 reasons to avoid suicide. Read her own list in the powerful online article entitled “Suicide is not an Option.”
Sometimes individuals who have made the decision to commit suicide appear, on the surface, to have resolved their feelings of despair and come to terms with their situation. They suddenly seem calm or happy. This appearance of calm should be pursued rather than accepted at face value. Caregivers should initiate a conversation about their loved one’s apparent state and the reasons for it. Talking openly about suicidal thoughts can save a life. If you have any concerns, contact a professional or a suicide hotline immediately.
It should also be noted that some medications for depression may reduce feelings of lethargy and increase the user’s energy level before they begin to elevate mood. During that period, it is important to ensure that a person who had expressed suicidal thoughts does not have the means to act on them. Consult with the prescribing physician to ensure that your concerns are addressed.
- Talking about suicide
- Seeking out lethal means (e.g., stockpiling medications)
- Preoccupation with death
- No hope for the future
- Self-loathing or self-hatred (e.g., feelings of worthlessness, shame or guilt)
- Getting affairs in order (e.g., giving away prized possessions)
- Saying goodbye to friends and family
- Withdrawing from others
- Self-destructive behaviour (e.g., self-neglect, taking unnecessary risks)
- Sudden sense of calm
In addition to contacting a professional, caregivers can assess the level of suicide risk and be proactive in reducing that risk. Here are some suggestions from albertahealthservices.ca: https://albertahealthservices.ca/injprev/Page4875.aspx
Speak up if you are worried
Ways to start a conversation about suicide:
- I have been feeling concerned about you lately.
- Recently, I have noticed some differences in you and wondered how you are doing.
- I wanted to check in with you because you haven’t seemed yourself lately.
Questions you can ask:
- When did you begin feeling like this?
- How can I best support you right now?
- Have you thought about getting help?
What you can say that helps:
- I may not be able to understand exactly how you feel, but I care about you and want to help.
- When you want to give up, tell yourself you will hold off for just one more day, hour, minute - whatever you can manage.
Listen calmly and be non-judgemental. Do not act shocked, or argue or lecture on the value of life. Refuse to be sworn to secrecy; you need to be able to consult a professional.
Assess the immediate danger
There is a big difference between having thoughts about suicide and having a well-developed plan. The following questions can help you assess the immediate risk for suicide:
- Do you have a suicide plan? (PLAN)
- Do you have what you need to carry out your plan (pills, gun, etc.)? (MEANS)
- Do you know when you would do it? (TIME SET)
- Do you intend to commit suicide? (INTENTION)
If a suicide attempt seems imminent, call a local crisis center, dial 911 or take the person to an emergency room. Remove drugs, knives, guns and other potentially lethal objects from the area, but do not, under any circumstances, leave a suicidal person alone.
Offer help and support
If a loved one is suicidal, the best way to help is by offering an empathetic, listening ear. Let your loved one know they are not alone and that you care. Do everything in your power to get the professional help your loved one needs.
When you're helping a suicidal loved one, don't forget to take care of yourself. Find someone that you trust - a friend, family member, clergyman or counselor - to talk to about your feelings and get support of your own.
In Edmonton, call:
- Crisis Support Centre (780) 482-4357 or 1-800-232-7288 (24/7)
- Salvation Army Hope Line (780) 424-9223 (M-F 9:00 a.m. – 11:30 p.m.)
- Alberta Health Services, Crisis Response Team (780) 342-7777
The Canadian Association for Suicide Prevention has a variety of resources on their website at http://www.suicideprevention.ca including contact information for crisis centres throughout Alberta.