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Home » Help in a Crisis » Suicide Prevention » General Information

General Information About the Suicide Situation

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You Are Not Alone!

Everyone feels depressed and alone from time to time. One out of three people will experience a major depression and almost everyone will face a life crisis at some point in their lives. Feeling depressed, angry or suicidal can be a natural reaction to some of life’s challenges. These feelings do not mean that you are defective or weak. You do not have to struggle alone - there is help.
The first step to working through these uncomfortable feelings is to talk with someone who cares. It helps to talk someone rather than to keep these feelings and fears bottled up inside. Someone else can give you support, strength and hope.

Here Are Some Resources

Talk to Someone You Trust:
Sometimes talking to a friend or family member is the best source of help. Talk to someone in your life that feels safe.

Face-to-Face Counseling:
Try calling your Employee Assistance Program, your health insurance plan, county health department, mental health clinic, church, school counselor or your doctor to discuss your concerns.

Possible Warning Signs

Recognize the Signs of Depression and Possible Suicide Risk

  • Talking About Dying -- any mention of dying, disappearing, jumping, shooting oneself, or other types of self harm.
  • Recent Loss -- through death, divorce, separation, broken relationship, loss of job, money, status, self-confidence, self-esteem, loss of religious faith, loss of interest in friends, sex, hobbies, activities previously enjoyed
  • Change in Personality -- sad, withdrawn, irritable, anxious, tired, indecisive, apathetic
  • Change in Behavior -- can't concentrate on school, work, routine tasks
  • Change in Sleep Patterns -- insomnia, often with early waking or oversleeping, nightmares
  • Change in Eating Habits -- loss of appetite and weight, or overeating
  • Diminished Sexual Interest -- impotence, menstrual abnormalities (often missed periods)
  • Fear of losing control -- going crazy, harming self or others
  • Low self esteem -- feeling worthless, shame, overwhelming guilt, self-hatred, "everyone would be better off without me"
  • No hope for the future -- believing things will never get better; that nothing will ever change

Other things to watch for- Suicidal impulses, statements, plans; giving away favorite things; previous suicide attempts, substance abuse, making out wills, arranging for the care of pets, extravagant spending, agitation, hyperactivity, restlessness or lethargy.

REMEMBER: The risk of suicide may be greatest as the depression lifts.

How to tell a friend is hurting

Sometimes when friends are feeling depressed or suicidal, they don’t just come out and tell you that they are in emotional pain. Watch for these warning signs that your friend may need help.

  • She says things like, “I’m such a loser!” “I’m going away.” “I just want to die.”
  • He used to hang out with friends, now he spends a lot of time alone.
  • She’s lost interest in school, sports, or hobbies.
  • He’s extra moody and irritable.
  • She’s been drinking or using drugs.
  • He dropped out of school.
  • She’s been acting violent, picking fights.
  • He’s been taking a lot of risk­—driving drunk, playing around with a gun.
  • She ran away from home.
  • He’s tried to hurt himself (i.e. cutting, burning, reckless behavior, etc.).
  • She gave away a bunch of her favorite things.
  • She said goodbye to her close friends for no reason.

How to help a friend

1. Directly ask your friend if he’s feeling depressed. Ask if he has thought about hurting himself. Let your friend know that you won't freak out or judge what he has to say.

2. Don't promise to keep your friend’s secret. You could save her life by getting help. Ask if your friend will go with you to talk to an adult about her feelings. Get help together!

3. If your friend is in serious trouble, and refuses to get help, go to an adult yourself.  Suicide is serious, don’t keep this a secret.

4. If your friend has taken pills, poison, has a gun or is planning to kill herself NOW. Call 911. THIS IS AN EMERGENCY. You must take action to save her life.

5. If you you want to talk about a friend in trouble, call San Francisco Suicide Prevention at (415) 781-0500. They'll help you figure out what to do. You don't have to be suicidal yourself to call a Suicide Prevention hotline.

Do Not Be Afraid To Ask:
"Do you sometimes feel so bad you think of suicide?"
Just about everyone has considered suicide, however fleetingly, at one time or another. There is no danger of "giving someone the idea." In fact, it can be a great relief if you bring the questions of suicide into the open, and discuss it freely without showing shock or disapproval. Raising the question of suicide shows that you are taking the person seriously and responding to the potential of her or his distress.

If The Answer Is: "Yes. I do think of suicide."
You Must Take It Seriously And Follow It Through.

"Have you thought how you'd do it?" "Do you have the means?" "Have you decided when you would do it?" "Have you ever tried suicide before?" "What happened then?" If the person has a definite plan, if the means are easily available, if the method is a lethal one and the time is set, the risk of suicide is very high. Your responses will be geared to the urgency of the situation as you see it. Therefore, it is vital not to underestimate the danger by not asking for the details.

Remember: Always ask "How?" and "When?" before "Why?" These questions tell you the first signs of serious risk.  The degree of suicide risk can be determined further by applying the criteria outlined in: Evaluating Suicide Risk (PLAID PALS).

Making A Contract
If you ascertain that the risk of suicide is high try to make a verbal agreement with the person to contact you before he or she follows through with suicidal intentions.

Active Listening is a communication skill which involves both the sender and the receiver in the communication process.  In active listening, the receiver tries to understand what it is the sender is feeling or what his or her message means. The person puts their understanding into their own words and feeds it back for the sender's verification. The receiver does not send back a message of his or her own -- such as an evaluation, opinion, advice, logic, or question. He or she feeds back only what they feel the sender's message meant -- nothing more, nothing less.

Whenever a person decides to communicate with another person, they do so because they have a need. He or she wants something, feels discomfort, has a feeling or thought about something. Therefore, they decide to talk -- to communicate with another person. In deciding to talk, the person selects words which they believe will deliver the message that they wish to communicate. When the other person receives the coded message, they must then go through the process, translating the verbal symbols into understanding of meaning.

If the receiver translates accurately, they will understand the message of the sender. If the receiver does not translate accurately, they will misunderstand the message and the communication process will have broken down. Very often neither the sender nor the receiver is aware the communication process has worked improperly! It is for this reason that active listening is effective. If a misunderstanding has occurred, it will be known immediately and the communication can be clarified before any further misunderstanding occurs.

Things to watch for when assessing potential risk in the PLAID PALS method...

Plan -- Do they have one?

Lethality -- Is it lethal? Can they die?

Availability -- Do they have the means to carry it out?

Illness -- Do they have a mental or physical illness?

Depression -- Chronic or specific incident(s)?

Previous attempts -- How many? How recent?

Alone -- Are they alone? Do they have a support system? Partner? Are they alone right now?

Loss -- Have they suffered a loss? Death, job, relationship, self esteem?

Substance Abuse (or use) -- Drugs, alcohol, medicine? Current, chronic?

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