Suicide ends your pain, but costs your life
If you or someone you know is in immediate danger:
Advice from IndoPsyCare clinician-scientists
What is suicide?
Suicide may be defined as “the act of intentionally causing one’s own death, often related to complex stressors and health issues leading individuals to experience hopelessness and despair.” (Center for Addiction and Mental Health, 2023). Suicide should be differentiated from suicide ideation.
Suicide ideation may be defined as “thoughts about or a preoccupation with killing oneself…” (APA Dictionary of Psychology, 2023)
These may range from passing ideas such as:
- Live is not worth living
- No one would care if I died
- The world would be better off without me
- I would be better off dead
Facts about suicide
The most significant predictor of suicide is a previous suicide attempt. Other factors that increase the likelihood of suicide include but are not limited to:
- Financial loss
- Having someone in one’s family who has attempted or committed suicide
- Acute emotional distress (this may include feeling helpless, hopeless, having low self-worth, experiencing guilt and shame)
- Experiencing other mental health or medical conditions
- Chronic pain
- Feeling lonely
- Experiencing physical, emotional, or mental abuse (including but not limited to domestic violence/bullying)
- Abusing drugs or alcohol
Get immediate help
If you think you may hurt yourself or attempt suicide, reach out. Do not be alone. Immediately do one or more of the following:
- Call a suicide hotline number: 112 (Emergency number), 119-8 (SEJIWA Counselling Service)
- If you can, get in touch with a mental health professional
- Visit the nearest emergency center
- Seek help from your doctor or other health care provider
- Reach out to a friend or loved one. Tell them you are experiencing suicidal thoughts and ask them to stay on the phone and distract you
- Acknowledge the way you feel is temporary. It might feel like the end of the world now, but things can and will get better. When you are at rock bottom, the only way to go is up.
- Create a list of reasons to live. Include the next episode of your TV show, your friends, family, or your pet. There are no rules regarding what you should and should not include on this list. Remind yourself you have things to live for.
- Immediately contacting your doctor or healthcare provider
- Call a family member who can stay on the line with you and distract you from your thoughts
- Engage in specific activities (such as watching your favorite movie, listening to your favorite song, or reading a chapter of your favorite book)
- Read the pre-written list of why your life is valuable and reasons to live
Reminder: You cannot continue to operate in crisis mode.
- Adhere to your treatment plan. Commit to attending psychotherapy and taking your medicine if your doctor prescribes it.
- Prepare a list of contacts and ensure they are readily available. Ensure this list includes your healthcare providers, including your mental health specialist and doctor. Moreover, include your friends and family who are aware of your condition and who can distract you if you feel suicidal.
- Remove any method of inflicting self-harm. Remove sharp objects or poisonous cleaning supplies or pesticides from reach. Where possible, ask someone to safeguard your medication, and only take it as prescribed.
- Schedule daily leisure activities. Include activities that have brought you pleasure in the past: such as watching your favorite movie, listening to your favorite song, or reading a chapter of your favorite book.
- Schedule daily exercise. There is a body of research that demonstrates physical activities can reduce symptoms of depression. Run, jog, walk, swim, or stretch. Engage in any physical movement.
- Spend time with loved ones. Create your own support network through reaching out to friends, family and people who care about you. Make a conscious effort to be social, and avoid isolating yourself.
- Avoid drug and alcohol use. You may believe that alcohol and drugs can numb your pain. Contrary to this belief, they may in turn make you more impulsive and increase the likelihood you will engage in destructive behaviors.
- Do not Google ways to end your life. Refrain from reading articles that may trigger suicidal ideations.
- Journal. Write about how you feel - the good and the bad.
- Bleeding from self-inflicted wounds
- Loss of consciousness
- Extreme lethargy
- Recognize pesticide poisoning: the smell of pesticide accompanied by pinpoint pupils, low blood pressure/a slow pulse and slow breathing
|What to do||What not to do|
|Check for a pulse||Do not leave the person alone|
|Remove access to means of self-harm||If you suspect the person has consumed pesticide, DO NOT force the person to vomit and do not ask the person to consume oral fluids (including water)|
|Place the person in a secure and supportive environment at a healthcare facility|
|Mobilize social support: encourage family or friends to monitor and support the person during the imminent risk period|
The intent to commit suicide is not always plain to see. Though not always the case, the following warning signs might be indicative that someone is planning to end their life*:
*Please note this list is not exhaustive
- Donating or giving away prized possessions
- A sudden change in emotional expression (extreme and unfounded happiness, or emotional detachment, moodiness or erratic mood swings)
- A sudden, unfounded, sense of calm
- Expressing feelings of misplaced or exaggerated guilt, (“Everything is my fault”)
- Expressing a sense of hopelessness about the future (”Things will always be this bad; everything will only get worse”)
- Talking or writing about dying, or a preoccupation with the topic of death
- Saying goodbye to loved ones or writing goodbye letters
- Demonstrating a loss of interest in things or activities they value
- Abandoning self-care, or making less effort with their appearance
- Social withdrawal
- Increased dependency on drugs or alcohol
- Seeking access to a means through which they may end their life (such as buying pesticides or pills)
- Evidence of self harm
- Conducting online searches for ways to take their own life
Helping someone who is suicidal: How to start a conversation about suicide
Remember: Treat people who have engaged in acts of self-harm with the same care, respect and privacy as anyone else. Whilst it is important to be sensitive to the emotional distress associated with self-harm, do not treat these individuals as though they are made of glass.
The notion that talking about suicide increases the probability of someone committing suicide is a myth. Conversely, talking about suicide can help you encourage individuals to get the help they need.
- Have you thought about ending your life?
- Have you ever thought about inflicting self-harm?
- If you have, what are the ways you would hurt yourself?
- What do you believe makes your life worth living?
- Why do you feel like life is not worth living?
- What specific thoughts have you had regarding suicide?
- How long have you been experiencing these thoughts?
- How long have these thoughts lasted?
- Do you often think about killing yourself? How frequently?
- How have you been doing these past few weeks? Have these thoughts occurred more or less frequently?
- Have you formulated a specific plan to end your life? How, when and where are you planning to do so?
- Have you acquired the means to end your life?
- Have you ever made a suicide attempt? What happened?
- When you felt the urge to hurt yourself in the past, what things made you feel better?
- Take every suicide threat seriously. It is better to over-react than under-react.
- Remember this is not about you. Set aside personal values for a while.
- Restrict access to a means of self-harm and suicide (take away items the person may use to hurt themselves).
- Don’t just hear them. Listen to them. Be in the present moment without letting your mind wander, looking for ways to respond.
- Ask them how they want you to help: do they want a solution or just a shoulder to cry on?
- Help them explore reasons and ways to stay alive.
- Focus on the person’s strengths by encouraging them to talk about how earlier problems have been resolved.
- Inform family, friends, concerned individuals regarding the situation. Ensure they closely monitor the individual as the risk of self-harm/suicide persists.
- Advise the person and carers to restrict the individual’s access to self-harm (e.g. hiding pesticides/toxic substances, prescription medications, weapons, etc.)
- Validate their feelings and struggles, regardless of whether you agree with their point of view.
- If you can offer practical help (e.g., cook for them, help clean their house)
- Emphasize the importance of seeking professional help. If you can, take them to the hospital or accompany them to a therapy session.
- Don’t offer someone advice if when they’re experiencing a crisis (they won't be listening)
- Don’t scold them or be judgmental
- Don’t make them feel as if they are making a selfish choice
- Don’t invalidate their struggles (e.g., comparing their issues to someone else's), at the same time, don’t justify or agree with their decision.
- Don’t divide your attention… put your phone down
- Don’t keep this knowledge to yourself, seek professional guidance