SUICIDE!!!


Suicide is a significant cause of death in many western countries, in some cases exceeding deaths by motor vehicle accidents annually. Many countries spend vast amounts of money on safer roads, but very little on suicide awareness and prevention, or on educating people about how to make good life choices.
Attempts at suicide, and suicidal thoughts or feelings are usually a symptom indicating that a person isn't coping, often as a result of some event or series of events that they personally find overwhelmingly traumatic or distressing.
In many cases, the events in question will pass, their impact can be mitigated, or their overwhelming nature will gradually fade if the person is able to make constructive choices about dealing with the crisis when it is at its worst.
Since this can be extremely difficult, this article is an attempt to raise awareness about suicide, so that we may be better able to recognize and help other people in crisis, and also to find how to seek help or make better choices ourselves.
It is intended to be informative rather than authoritative, and readers are encouraged to offer feedback, suggestions and criticisms.
This posting is accompanied by a companion posting containing information primarily about crisis and suicide prevention resources available on the Internet, and other national resources available in various countries.


Here are a number of frequently asked questions to help raise awareness and dispel some of the common myths about suicide:1. Why do people attempt suicide? People usually attempt suicide to block unbearable emotional pain, which is caused by a wide variety of problems.
It is often a cry for help. A person attempting suicide is often so distressed that they are unable to see that they have other options: we can help prevent a tragedy by endeavoring to understand how they feel and helping them to look for better choices that they could make.
Suicidal people often feel terribly isolated; because of their distress, they may not think of anyone they can turn to, furthering this isolation. In the vast majority of cases a suicide attemptor would choose differently if they were not in great distress and were able to evaluate their options objectively.
Most suicidal people give warning signs in the hope that they will be rescued, because they are intent on stopping their emotional pain, not on dying.


2. Aren't all suicidal people crazy?
No, being suicidal does not imply that you are crazy. Acutely distressed perhaps, but not crazy.As Appleby and Condonis[1] write: The majority of individuals who commit suicide do not have a diag- nosable mental illness. They are people just like you and I who at a particular time are feeling isolated, desperately unhappy and alone. Suicidal thoughts and actions may be the result of life's stresses and losses that the individual feels they just can't cope with.
The idea that suicide is usually due to mental illness is a myth which unfortunately tends to perpetuate the problem, particularly in our society where there is much stigma and ignorance regarding mental illness. A person who feels suicidal may fear that other people will think they are "crazy" if they tell them how they feel, and be reluctant to reach out for help in acrisis. On the other hand, people who are suffering from a mental illness such as schizophrenia do have much higher suicide rates, although they are still in the minority of attemptors.
For these people, having their illness correctly diagnosed can mean that an appropriate treatment can begin to address their illness.


3. Doesn't talking about suicide encourage it? It depends what aspect you talk about. Talking about the feelings surrounding suicide promotes understanding and can greatly reduce the immediate distress of a suicidal person. In particular, it is OK to ask someone if they are considering suicide, if you suspect that they are not coping. If they are feeling suicidal, it can come as a great relief to see that someone else has some insight into how they feel. This can be a difficult question to ask, so here are some possible approaches: "Are you feeling so bad that you're considering suicide?" "That sounds like an awful lot for one person to take; has it made you think about killing yourself to escape?" "Has all that pain you're going through made you think about hurting yourself?" Talking exclusively about how to commit suicide can give ideas to people who feel suicidal, but haven't thought about how they'd do it yet. Media reports that concentrate solely on the method used and ignore the emotional backdrop behind it can tend to encourage copycat suicides.


4. So what sort of things can contribute to someone feeling suicidal? People can usually deal with isolated stressful or traumatic events and experiences reasonably well, but when there is an accumulation of such events over an extended period, our normal coping strategies can be pushed to thelimit. The stress or trauma generated by a given event will vary from person to person depending on their background and how they deal with that particular stressor. Some people are personally more or less vulnerable to particular stressful events, and some people may find certain events stressful which others would see as a positive experience. Furthermore, individuals deal with stress and trauma in different ways; the prescence of multiple risk factors does not necessarily imply that a person will become suicidal.


What Can I Do To Help Someone Who May Be Suicidal?
1. TAKE IT SERIOUSLY
a. Myth: "The people who talk about it don't do it." Studies have found that more than 75% of all completed suicides did things in the few weeks or months prior to their deaths to indicate to others that they were in deep despair. Anyone expressing suicidal feelings needs immediate attention. b. Myth: "Anyone who tries to kill himself has got to be crazy." Perhaps 10% of all suicidal people are psychotic or have delusional beliefs about reality. Most suicidal people suffer from the recognized mental illness of depression; but many depressed people adequately manage their daily affairs. The absence of "craziness" does not mean the absence of suicide risk.
c. "Those problems weren't enough to commit suicide over," is often said by people who knew a completed suicide. You cannot assume that because you feel something is not worth being suicidal about, that the person you are with feels the same way. It is not how bad the problem is, but how badly it's hurting the person who has it.

2. REMEMBER: SUICIDAL BEHAVIOR IS A CRY FOR HELP
Myth: "If a someone is going to kill himself, nothing can stop him."
The fact that a person is still alive is sufficient proof that part of him wants to remain alive. The suicidal person is ambivalent - part of him wants to live and part of him wants not so much death as he wants the pain to end. It is the part that wants to live that tells another "I feel suicidal." If a suicidal person turns to you it is likely that he believes that you are more caring, more informed about coping with misfortune, and more willing to protect his confidentiality. No matter how negative the manner and content of his talk, he is doing a positive thing and has a positive view of you.

3. BE WILLING TO GIVE AND GET HELP SOONER RATHER THAN LATER
Suicide prevention is not a last minute activity. All textbooks on depression say it should be reached as soon as possible. Unfortunately, suicidal people are afraid that trying to get help may bring them more pain: being told they are stupid, foolish, sinful, or manipulative; rejection; punishment; suspension from school or job; written records of their condition; or involuntary commitment. You need to do everything you can to reduce pain, rather than increase or prolong it. Constructively involving yourself on the side of life as early as possible will reduce the risk of suicide.


4. LISTEN
Give the person every opportunity to unburden his troubles and ventilate his feelings. You don't need to say much and there are no magic words. If you are concerned, your voice and manner will show it. Give him relief from being alone with his pain; let him know you are glad he turned to you. Patience, sympathy, acceptance. Avoid arguments and advice giving.

5. ASK: "ARE YOU HAVING THOUGHTS OF SUICIDE?"
Myth: "Talking about it may give someone the idea."
People already have the idea; suicide is constantly in the news media. If you ask a despairing person this question you are doing a good thing for them: you are showing him that you care about him, that you take him seriously, and that you are willing to let him share his pain with you. You are giving him further opportunity to discharge pent up and painful feelings. If the person is having thoughts of suicide, find out how far along his ideation has progressed.

6. IF THE PERSON IS ACUTELY SUICIDAL, DO NOT LEAVE HIM ALONE
If the means are present, try to get rid of them. Detoxify the home.

7. URGE PROFESSIONAL HELP
Persistence and patience may be needed to seek, engage and continue with as many options as possible. In any referral situation, let the person know you care and want to maintain contact.

8. NO SECRETS
It is the part of the person that is afraid of more pain that says "Don't tell anyone." It is the part that wants to stay alive that tells you about it. Respond to that part of the person and persistently seek out a mature and compassionate person with whom you can review the situation. (You can get outside help and still protect the person from pain causing breaches of privacy.) Do not try to go it alone. Get help for the person and for yourself. Distributing the anxieties and responsibilities of suicide prevention makes it easier and much more effective.

9. FROM CRISIS TO RECOVERY
Most people have suicidal thoughts or feelings at some point in their lives; yet less than 2% of all deaths are suicides. Nearly all suicidal people suffer from conditions that will pass with time or with the assistance of a recovery program. There are hundreds of modest steps we can take to improve our response to the suicidal and to make it easier for them to seek help. Taking these modest steps can save many lives and reduce a great deal of human suffering.



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