Depression

12 June 2018

What to do and say when someone wants to commit suicide

Celebrity chef Anthony Bourdain's recent suicide sent shock waves through the world. Here are ways you can somebody who's contemplating suicide.

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A few days ago, 61-year-old celebrity chef and television host Anthony Bourdain took his own life. He hanged himself in his hotel bathroom in Kaysersberg, France, using the belt from his hotel bathrobe.

According to prosecutor Christian de Rocquigny, toxicology tests will be performed to see whether Bourdain took any medications, which may help his family understand what led him to kill himself.

He said, “There is no element that makes us suspect that someone came into the room at any moment.” 

The cold hard truth about suicide

The World Health Organization estimates that globally close to 800 000 people die from suicide every year – that’s one person every 40 seconds.

Suicide is a terrifying idea to explore – but before we go into how you can help, here are some of the worst things you can do: 

  • Don’t say anything and ignore their cry for help.
  • Mock them by saying they are just looking for attention.
  • Ask them why they want to kill themselves.
  • Turn it into a joke or encourage them to just do it.
  • Tell them they are a coward; that suicide is a cowardly act.

What to look out for

According to Dr Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention, you must look for changes in pattern. "People can only keep things hidden to a certain extent. If you think about it, our behaviour patterns are in a pretty tight and narrow range. Your radar will go off if someone you know is acting differently, because you know their patterns." 

She continues, "Even if your instincts are to avoid the person because you're afraid you don’t know enough or that you might offend the person, you may be the only one who is noticing and who will reach out. Everyone has a role to play in preventing suicide."

Remember, too, that someone who is contemplating suicide will not necessarily call a helpline – you may need to step in and help.

Take any suicide threat seriously 

Dr Moutier says the best thing you can do if you're unsure whether someone is suicidal is to start an honest, caring conversation where you listen more than you talk. If you notice any signs indicating that they feel hopeless, depressed or trapped, be direct and ask them if they are having suicidal thoughts.

"That’s not going to make them worse; it’s not going to plant a seed. If you’ve created a safe environment to have this conversation, they will feel a sense of relief that they’ve been able to share this experience with someone who’s not judging them," says Dr Moutier. 

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If someone says they want to die, don’t ignore them. The National Institute of Mental Health says "suicidal thoughts or actions are a sign of extreme distress and alert that someone needs help. Any warning sign or symptom of suicide should not be ignored. All talk of suicide should be taken seriously and requires attention. Threatening to die by suicide is not a normal response to stress and shout not be taken lightly."

It's also important to know that almost every single person who has attempted suicide has given some kind of warning. Take note of statements such as “You’ll be sorry when I’m gone” or “I can’t see any way out” – they may indicate suicidal feelings. 

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How to talk about suicide

Stacey Freedenthal, a Denver psychotherapist, consultant, and associate professor at the University of Denver Graduate School of Social Work, has had extensive experience in dealing with suicide prevention. She has also compiled a useful list of things to say should you find yourself in a difficult position with a loved one who is suicidal.

1. ‘I’m glad you told me you’re thinking of suicide’

It’s natural to react with anger or disbelief when someone tells you they are thinking of suicide but that will only cause the person to regret having told you, which may push them away. When you tell them you are glad they told you what they are thinking, you are letting them know you can handle the situation, and that you encourage honesty and disclosure.

2. ‘I’m sad to hear you’re hurting’

Empathy can go a long way, particularly towards validating the person's pain and helping soothe their loneliness. You cannot say, “It could be much worse” or “You don’t really mean that” or “But you have so much to live for.” Do not diminish the pain that they are feeling right now. 

3. 'What’s happening to you that makes you want to die?'

Asking them to tell their story of why they want to die shows them that you really care and want to understand. Make sure you really listen to their story. Follow up with more invitations to share, such as "Tell me more." You can show empathy or understanding by saying, “That sounds terrible” or “I can see why you're in pain."

4. 'When do you think you’ll act on your suicidal thoughts?'

Freedenthal says that even if you’re not a mental health professional, "you still can ask some basic questions to help understand the person’s risk for suicide. Asking about timing will make the difference between whether you need to call someone immediately for help, for example, if the person says, 'I have a gun in my backpack and I’m going to shoot myself during lunch', or whether you can continue to have leisurely conversation with the person."

5. 'What can I do to help?'

Sharing resources that may help them is good, but you also need to make them understand that you are available to help too. "That said, there’s only so much you can do, so if you are feeling solely responsible for keeping the person alive, it’s best to involve others, too," writes Freedenthal.

Never ignore the warning signs

Suicide warning signs can be subtle or obvious, and include:

  • Talking about suicide, dying or self-harm
  • Being preoccupied with death, for example, writing poems or stories about death
  • Having no hope for the future, feeling trapped and hopeless
  • Feelings of worthlessness, self-hatred, guilt, shame or saying they feel like a burden
  • Getting their affairs in order by drawing up a will or giving away valued possessions
  • Withdrawing from friends and family; no longer socialising because they prefer to be alone
  • Making unexpected visits or calls to friends and family, and saying goodbye

If a person has a sudden sense of calm and happiness after going through an extremely bad depressive episode, it could mean they have decided to attempt suicide.

Do you need help?

For a suicidal emergency call the South African Depression and Anxiety Group on 0800 567 567. Their 24-hour helpline is 0800 12 13 14.

Image credit: iStock

 

Ask the Expert

Depression expert

Michael Simpson has been a senior psychiatric academic, researcher, and Professor in several countries, having worked at London University in the UK; McMaster University in Canada; Temple University in Philadelphia, USA.; and the University of Natal in South Africa.

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