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Reacting properly is important when a close person admits that they are thinking about suicide.
But tackling it can prove to be challenging. Some individuals succumb to a stupor and disregard the problem, while others struggle to articulate themselves, and a few proffer unsuitable solutions.
We, along with psychotherapist Dmitry Frolov and psychiatrist Evgeny Kasyanov, have drafted guidelines on how to respond when a loved one reveals that they have lost their will to live.
TIP #1 – Evaluate the risks
Firstly, cope with your emotions and avoid panic. Having suicidal thoughts does not necessarily lead to committing suicide.
The concept of “suicidal risk” entails the likelihood of an individual purposefully ending their life and can be categorized as high, medium, or low.
High risk
A person is describing, in detail, their plan to commit suicide and has already acquired the necessary items and written a farewell note. This poses a high risk and requires immediate medical attention to involuntarily hospitalize the individual.
Average risk
An individual at an average risk exhibits persistent thoughts about suicide despite not having a concrete plan. They frequently express their desire to cease living and believe death is a preferable alternative.
Not always necessary is hospitalization in this case. However, the person with such thoughts requires assistance. Carefully monitoring and assistance are the responsibilities of the relatives. Additionally, it is advisable to remove sharp-cutting objects and everything else that can be used for suicide, just in case.
Low risk
The person has a low risk of suicide as they do not have formal suicidal thoughts. However, they occasionally express statements such as “I wish I had never been born” or send messages like “I’m so tired. I just want to drown.” Nevertheless, they do not seriously contemplate the option of taking their own life.
Even if someone says something about suicide as a joke, it’s worth taking their words seriously because there is a chance, although small, that they might contemplate taking their life seriously at some point.
TIP #2 – Avoid clichés and refrain from offering alcohol.
People often offer commonplace advice and use stereotypical encouraging phrases to someone who is considering suicide. However, it’s important to recognize that individuals who consider suicide experience immeasurable internal pain, and sharing these thoughts with loved ones can further amplify their pain. It is essential to approach the situation with empathy and active support rather than solely relying on phrases like “oh, stop it, everything will be fine,” “you’re thinking too much,” “better forget about it,” or “why commit suicide when you have everything in life?”
- We will make everything fine!
- You have youth on your side, everything will still work out for you.
- Do not even consider it!
- Just switch off and take walks more often or go on vacation.
Although people usually say all of this with the best intentions, these phrases diminish a person’s feelings and worsen their condition, intensifying their despair and loneliness, or making them angry.
Suggesting drinking to relax is also absolutely unacceptable because it impairs the inhibitory mechanism and reduces a person’s rationality, resulting in a significant number of suicide attempts that occur while intoxicated.
TIP #3 – Just listen
Many people believe that they can inspire a loved one with suicidal thoughts to live. When discussing suicide, individuals do not anticipate receiving an evaluation or advice from others. Instead, they desire to discuss their suffering, current situation, and be actively listened to.
Therefore, one should prioritize letting the person speak out in such a situation. To achieve this, one can ask simple questions to assist them.
What is bothering you? Tell me.
- How do you feel?
- How long have you been thinking these thoughts?
- How does your body feel?
A person in a critical state finds it challenging to formulate feelings rather than thoughts when asked about them.
The main rule is that you must focus all your attention on the person during the conversation, showing them that you hear and understand them. It also helps to establish tactile contact by holding their hand or embracing them. This way, they will feel your support and release their pain, fears, and despair, leading to temporary relief, calming down, and a decrease in negative emotions.
If having a dialogue is challenging, employ the scientific method known as reflection. This involves repeating, clarifying, summarizing, and paraphrasing the words of the other person during the conversation. Use phrases like ‘I understand correctly that you mean this and that’ or ‘So, you mean this’.
Psychotherapists use this method during conversations with patients for two reasons. Firstly, to establish a closer connection and demonstrate interest and understanding. Secondly, when patients hear their own words spoken by someone else, they automatically begin to rethink them.
For instance, when your loved one expresses, “This is unbearable, I cannot bear it anymore,” you rephrase it as, “You are going through a tough time, it is challenging to live presently.” Consequently, the person may reconsider and believe, “Perhaps it is hard and challenging, not entirely unbearable.”
TIP #4 – Offer help
During a conversation, a person can show someone possible ways out of the situation that causes suicidal thoughts by offering active assistance, rather than simply giving advice.
For instance, you could vow to ask your acquaintances for available suitable vacancies, edit their resume, or accompany them to a lawyer if their issue pertains to this field, if a person has been failing to secure a job for a lengthy period.
Thus, you offer a reminder to the person that their situation does not have to be hopeless, that they have power within themselves, and that they can depend on someone. Moreover, it is crucial to understand that there are alternative solutions to address their problems, even if it feels challenging to do so, and that voluntary withdrawal from life is not the only option.
Always fulfill promises made to someone struggling with suicidal thoughts, as failing to do so may intensify their negative thoughts and feelings. Avoid making promises that you cannot keep.
TIP #5 – Encourage the person to seek medical help
The first task is to listen to a person, and the main one is to take them to a doctor.
Various reasons can give rise to suicidal thoughts, one of which is the inability of a person to find a way out of difficult life situations. A psychotherapist or a psychologist can assist them to view the situation from a different perspective.
However, a symptom of disorder is often thoughts of suicide. Typically, it is depression. Taking control of the underlying illness is essential in this situation, and motivating the person to see a psychiatrist is significant. Several approaches can accomplish this.
Individual problem.
For example, if a person is concerned that their despair is preventing them from working properly or taking care of their children, you can suggest that seeking treatment can help with this. You could say something like: “Doctors can help you get back on track. Don’t be afraid, let’s try to seek help.
Medicalizing the condition.
Often, just realizing that despair is a symptom of a treatable mental disorder can bring significant relief. It removes the person’s sense of guilt for their perceived failures and gives them hope.
For example, you can find a list of depression symptoms on the internet, show it to the person, and say something like: “Look, there’s this item here – thoughts of suicide. Maybe we should seek consultation, perhaps you have a disorder.
Example from real life
Share your own experience of being in the toughest crisis, but seeking help from a specialist and how they helped you. It is important that the story is truthful and sincere. To make it easier for the person to decide to receive treatment, help them find a specialist, arrange an appointment, or arrange for a preliminary consultation over the phone.
The easiest way to get help is in a private clinic – where the patient queue is usually shorter. But if that is not possible, you can go to a psychiatric hospital where you can receive free services. A psychiatrist can diagnose the disorder, prescribe medication treatment, and refer the person to psychotherapy.
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