Sunday, March 18, 2012

Signs of Suicide

When you love someone who has a severe mental illness, you worry occasionally ... at least ... about suicide.  Some types of mental illness, such borderline personality disorder, have a lot of focus on suicide, as threatening it regularly is one of the symptoms.  For others, including schizophrenia, bipolar disorder, post-traumatic stress (PTS) disorder and clinical depression ... it is a reality that death is sometimes the outcome. 

In fact, the military is now dealing with a rash of suicides, blamed on multiple deployments, PTS and depression.

The most important predictor of suicide is one or more previous attempts. Suicide also may happen more frequently among people who are younger, who are feeling hopeless, or who abuse drugs and alcohol.

For those with schizophrenia, suicide is more likely in the midst of a relapse when the voices are especially critical or are ordering the person to harm himself. For bipolar people, you not only have to worry about depression but also the manic period, especially if the person is delusional and thinks he is indestructible or has supernatural powers.

Asking a person about suicide does not generally put the idea into his head. In fact, letting the person know that you care about them will probably be a good thing. Here are some questions to ask:
  • Are you feeling sad?
  • Does it seem to you like it's not going to get better?
  • Have you been feeling so bad that you are thinking about hurting yourself? 
  • Have you thought about how you would do that? 
  • Have you made any plans to do it? What are your plans? 
The more concrete the answer ... in, other words does the person have a plan and the means to do it ... the more serious the issue.

If the person has a plan and the means, take steps immediately. Do not let the person out of your sight. Call the psychiatrist. Call the suicide hotline. Get the person to an emergency room or a public mental health intake center like Netcare. Remove lethal objects. You can't handle this alone, so don't try.

If things are not as serious, notify everybody ... case manager, psychiatrist, therapist ... anyway. Make sure you have the numbers for the psychiatrist, Netcare and suicide hotline in your cell phone. And take good notes about what is happening so you can see the pattern building in the future. 

The best way to prevent a crisis is to prepare for it in advance. Do everything you can. Because you will have to live with yourself no matter what happens.

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