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Suicide warning signs

When someone commits suicide, those left behind always ask if they should have seen it coming.

About 2,000 Australians commit suicide each year and Aussie men are four times more likely to die by suicide than women. In Australia most male suicides are by shooting (followed by hanging, gassing and poisoning), whereas females prefer using poison.

What puts people at risk of committing or attempting suicide and what can you do if you're worried about a loved one? Learn to recognise the warning signs - and act immediately.

The following are danger signals of suicide:

Previous suicide attempts
Between 20 and 50 percent of people who kill themselves have previously attempted suicide. Those who have made serious suicide attempts are at a much higher risk for actually taking their lives.

Talking about death or suicide
People who commit suicide often talk about it directly or indirectly. Be alert to such statements like, "My family would be better off without me”. Sometime those contemplating suicide talk as if they're saying goodbye or going away.

Planning for suicide
Suicidal individuals often put their affairs in order. They may give away articles they value, pay off debts or a mortgage on a house, or change a will.

Depression
Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can manifest itself as obvious sadness, but often it is expressed as a loss of pleasure or withdrawal from activities that had once been enjoyable.

Be particularly concerned about a depressed person if at least five of the following symptoms have been present nearly every day for at least two weeks:

• Depressed mood, change in sleeping patterns
• Change in appetite or weight
• Speaking and/or moving with unusual speed or slowness
• Loss of interest or pleasure in usual activities
• Decrease in sexual drive
• Fatigue or loss of energy
• Feelings of worthlessness, self-reproach, or guilt
• Diminished ability to think or concentrate, slowed thinking or indecisiveness
• Thoughts of death, suicide, or wishing to be dead

Additional factors that point to an increased risk for suicide in depressed individuals are:

• Extreme anxiety, agitation, or enraged behaviour
• Excessive drug and/or alcohol use or abuse
• History of physical or emotional illness
• Feelings of hopelessness or desperation

What can you do to help?

Take it seriously
75 percent of all suicides give some warning of their intentions to a friend or family member. All suicide threats and attempts must be taken seriously, even those of teenagers among whom such threats are more common.

Be willing to listen
Take the initiative to ask what is troubling them, and attempt to overcome any reluctance to talk about it. Even if professional help is indicated, the person you care for is more apt to follow such a recommendation if you have listened to him or her. If your friend or relative is depressed, don’t be afraid to ask whether he or she is considering suicide, or even if they have a particular plan or method in mind.

Don't attempt to argue anyone out of suicide. Rather, let the person know you care and understand, that he or she isn't alone, that suicidal feelings are temporary, that depression can be treated, and that problems can be solved. Avoid the temptation to say, "You have so much to live for", or "Your suicide will hurt your family".

Seek professional help
Be actively involved in encouraging the person to see a physician or mental health professional immediately. Since suicidal people often don’t believe they can be helped, you may have to do more. You can make a difference by helping those in need find a knowledgeable mental health professional or a reputable treatment facility.

In an acute crisis
Take the person to an emergency room or walk-in clinic at a psychiatric hospital. Don't leave them alone until help is available. Remove from the vicinity of the potentially suicidal person any firearms, drugs, razors or scissors that could be used in a suicide attempt.

Medication and/or hospitalisation may be indicated and may be necessary at least until the crisis abates. If a psychiatric facility is unavailable, call your local emergency number. Chances are the dispatcher can help you locate immediate psychiatric treatment.

What about follow-up treatment?
Suicidal patients are often hesitant to seek help and may run away after an initial contact unless there is support for continuation. If medication is prescribed, take an active role to make sure the patient follows their prescription, and be sure to notify the doctor about any unexpected side effects. Often alternative medications can be prescribed.

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