Suicide is a major problem in American society. Approximately 30,000 people deliberately end their lives each year. Although 15-24 year-olds have a much lower suicide rate than other age groups, the number of suicides among young people has actually tripled in the last 3 decades.
Why do people become suicidal?
There are a number of life circumstances that may cause a person to consider taking his/her own life. During difficult times, people often feel overwhelmed, lonely, hopeless, helpless, worthless, or unloved. These feelings may result from the breakup of a significant relationship, poor academic performance, concerns about sexual orientation, traumatic experiences, or for any number of other reasons. If a person feels overwhelmed by painful feelings and cannot envision a way of obtaining relief, suicide might begin to appear to be a viable escape.
What are suicidal warning signs?
Many individuals who are suicidal express their intent prior to taking their life. It is estimated that 80% of the individuals who kill themselves have communicated their intentions in some way to someone close to them.
The warning signs can be divided into 4 categories (verbal, behavioral, situational, and depressive). None of the signs alone necessarily indicate suicidal potential but several indicators, particularly if it is a change from the person's usual mood or style of coping, may deserve serious attention. The following are some of the warning signs:
Verbal warnings
No verbal statement is too insignificant to let pass without a response. Verbal warnings refer to any verbal response that expresses directly or indirectly a desire not to live, such as:
- "I broke up with Bill today; life is no longer worth living."
- “They won't have me any more to kick around."
- "I am of no use to anyone anymore."
- "I can't go on any longer."
Behavioral warnings
- failed suicidal attempt
- giving away valued possessions
- putting affairs in order
- alcohol or other substance abuse
- withdrawing from activities that previously gave the student satisfaction
- crying with no apparent cause
- sudden changes in behavior and/or attitude
- erratic behavior which cannot be explained
- inability or refusal to trust in others
- neglect of school work
Situational warnings
Some students may not do or say anything to demonstrate suicide risk but their situations may provide adequate clues. Some of these situations include:
- continued family strife
- loss of a parent or loved one
- experiencing a disfiguring operation or accident
- failure to gain admission to a graduate or professional school or program
Depressive warnings
People who seriously consider suicide are very often clinically depressed. Therefore, many of the "warning signs" associated with suicide are also symptoms of clinical depression. These symptoms include:
- sleep disturbances (inability to sleep or excessive sleeping)
- low self esteem
- lack of energy
- changes in appetite (loss of or increase in appetite)
- evidence of crying
- deterioration of personal appearance
- withdrawn and preoccupied behavior
- difficulty concentrating
- feelings of excessive guilt
- excessive irritability or frustration
- feelings of hopelessness and helplessness
- tendency to dwell on problems
Depression in some students is marked by hyperactivity or acting out behavior. If this behavior is different from the way the student usually behaves and if it is combined with other suicidal warning signs, the student may be at risk for suicide.
Suicides sometimes occur after an abrupt lifting of depression. If a person has been depressed for a period of time and then suddenly shows signs of cheerfulness and expresses no signs of depression, it may be an indication that the person has decided to make a suicide attempt.
How can I help?
- Trust your instincts that the person may be in trouble
- If you suspect the person is suicidal, ask if they have thoughts of suicide.
- Ask if they have a plan (have thought about methods) or have the means at hand.
- Take all suicidal threats seriously.
- Remain calm and understanding.
- Be a willing listener.
- Ask concerned questions.
- Empathize with the student's expression of feelings.
- Be reassuring that problems can be solved.
- Do not counsel the person yourself. Encourage the student to seek professional help from Counseling and Psychological Services (CAPS) or some other counseling agency.
- Volunteer to accompany the student to CAPS or a referral agency.
- Seek counseling or consultative help for yourself.
- Do not leave the person alone.
- Do not swear to secrecy.
- Do not argue with the person, "You can't kill yourself because..."
- Do not offer false assurance or try to "cheer up" the person; many times this comes across as your needing assurances and may cause the other person to feel less accepted and understood.
- Do not challenge suicidal remarks "If you feel that bad, go ahead and do it" or "You'll never do anything like that."
If your concerns are immediate and serious, contact CAPS quickly. A CAPS representative can be reached Monday - Friday, 8:00 a.m. - 5:00 p.m. at (660-1000). In the event of an emergency after working hours, contact the Duke University Medical Center at (684-2413) and ask to be referred to the psychiatrist on call.