Helping Someone Who is Suicidal
If you want to help someone who is suffering from depression, who you think or know may be feeling suicidal, it's helpful to understand the facts about what you're facing.
Firstly, any depressed person might decide to kill themselves. They can be any age, any social class. And it's little realised that suicide is a very common way to die in Western society today. It's estimated that, in the UK and Republic of Ireland, at least 425 people attempt suicide every day, and 6,400 die by suicide each year - that's one every 82 minutes, making it the tenth most common way to die. In the US it's the 9th leading cause of death, killing over 32,000 people every year, an average of about one suicide every 15 minutes. An attempt is made about once a minute .The majority (three quarters) of all suicides are committed by white males, and somewhere in the region of 60% are committed with a gun.
Depression is quite simply an horrific state to be in. It's utter hopelessness; nothing seems good, everything loses it's value, everything loses it's meaning, and everything becomes an effort, which is to say very, very hard. And painful. And with all of this comes an overwhelming sense of worthlessness, which is only made worse by knowing what is going on, or having attention drawn to it. The longer a person is depressed, the less joy there is in their life, and the easier it becomes to lose more and more of the things that matter. There is less and less left to live for. If they often become depressed, then suicidal thoughts can even become familiar and easy, and it only takes one difficult situation, even seemingly small, to completely destroy them. Each time the depression returns, their worthlessness and hopelessness is confirmed. People who have never experienced deep depression often say that they can't understand how anyone could feel suicidal, and I think this shows just what an altered understanding of life depression brings - because suicide often becomes an almost positive alternative in the face of the utter pain that the depressed person feels.
So, ok, maybe you can't understand it. But what you can understand is that they are hurting, and hurting very badly. The most important thing you can do for them is to stay constant - constantly supportive and non-judgmental. They're judging themselves enough already. Remember that it's unlikely that you're going to be able to understand what they're feeling, so don't even pretend that you do (and they'll probably know anyway). You can't get them to pull themselves together and cheer up, and telling them to 'go ahead and do it', thinking the challenge might stop them, doesn't work either. There's a good chance that they won't really want help (remember they think they don't deserve it), and may even get very angry at any attempt to give them some (anger is very closely entwined with depression)
Encourage them to talk about how they feel, but only if you are able to put your own feelings aside completely. Get them to do some of the things I've suggested on other parts of this web site. Remind them that they should eat regularly, even just a little bit - you could use the rationale that they already feel crap, and it's unlikely to make them feel any worse. This kind of attitude might be useful generally, to encourage them to towards feeling more positive. Encourage them to remember that it will pass, just as it has before (though be careful how you present it).
The most help can really be offered when they are not depressed, by gently encouraging them to find new value, meaning and joy in their lives. Even very small things are important (lots of small things put together make a big thing!).
You should be aware that suicide risk increases as the person begins to recover from a depressive episode - depressed people don't have enough energy to kill themselves. However, they don't necessarily recognise that they're beginning to get better, and they can easily direct their new energy towards self-destruction rather than further recovery. Maybe you can find a way to get them to use the energy for something more positive, or even something that's not much more positive, but at least not more negative. If you can distract them at this point (get them to brush their shoes, or get a hair-cut; anything active) that will help them recover further.
If the person has a sudden change from depression to a kind of peacefullness of happines, but doesn't seem keen or able to explain it, beware! This can mean that they've decided to go ahead and kill themselves, and that by deciding this they have already lifted much of their pain (which of course makes them feel even more that they've made the right decision). It might be worth watching them carefully for a while.
You have to understand that the suicidal person is completely caught-up in whatever illusion it is that's making them think life is no longer worthwhile. It's not rational in any way, and is likely to be very intricate and self-absorbed, even self-protecting. Trying to get them to think clearly may be impossible, but finding something outside of the cycle that they still care about can break it. If they're religious ( and please note that I said 'they', not 'you') then ask them how everlasting hell or it's equivalent is going to feel, compared to the little bit of pain their in now, that's sure to pass very soon. Or ask them what kind of funeral they want to have. Have they made any preparations, have they made a will? What kind of flowers would they like? It's worth talking about things that will happen after they're dead because it brings them face to face with the reality that, while they may feel worthless or unimportant right now, once they're dead they'll become a lot less important, and life will go on without them, just as it always does. The reality is that while they think they feel 'worthless and unimportant', they are really just missing feeling valuable and important, because they want these things very much (and in fact overrate them). They certainly don't want to lose the little bit of value that still remains, even if they deny that it's there at all.
These things may sound harsh, but this is a tough situation and getting harsh and 'real' is helpful because you need to find something outside of their thought cycle. This is not the time to sympathise with them. They'll no doubt resist thinking about what you say, because on some level they don't want to give-in, but if you're persistent they might. Don't get them angry though!
A much more controversial technique to get them out of their destructive thought cycle, but one that can definitely work at least once, is to hurt them: and I mean physically. And I mean intense physical pain, that stays for a good few moments, and is preferably unexpected. It sounds harsh, but it's an extremely effective way to get their survival-instinct to kick-in, and their thoughts to move to something else! Of course they might never forgive you, but they will be alive. Obviously, this method is not at all suitable for people who are already in physical pain, or for whom physical pain plays a part in the causes of the depression.
Whatever you can do, if you get they to agree or decide to wait a little while before killing themselves, say twenty-four hours, then they'll probably survive. It's encouraging also to know that people who attempt suicide and fail are unlikely to try again (only about 10% do).
You should also be aware of this: no matter what happens, it's not your fault. A depressed person still has full responsibility for themselves, and if they choose to go ahead and kill themselves then they are responsible for that action, not you. Even if they kill themselves to hurt you or someone else close to them, which is the reason for many bitter suicides, or if it's in response to something you (or someone else) has done, it's still their choice to sort out their problems this way rather than find another solution. And who knows, a person who kills themselves might be making the best or only choice that they can - they are the only ones who really know how painful they find their lives, and if they choose to leave it they may have very good reason. So it's not fair or reasonable for you to take any blame on yourself - if you do, then you might want to ask yourself what it is that you gain by doing so.
Click here for further reading on suicide
Click here for further reading on helping someone who is depressed
Good luck.