How to respond when a loved one talks about suicide

It is the one month anniversary of Robin Williams’ death. While the initial shock may have lessened, many are still struggling to understand why this amazingly talented and popular actor would take his own life.

mentalhealthPublicly he seemed to have it all – fame, awards, money, family and friends. But in his private life, he fought battles of depression, substance abuse and the recent diagnosis of a debilitating illness.

I would like to think that in his death, there is some meaning — that his parting “gift” is opening the door for us to actually talk about depression and suicide even though it is difficult to do. Yes, suicide touches everyone.

Today is World Suicide Prevention Day. We can work collectively on prevention by dispelling myths about suicide, being knowledgeable about risk factors for suicide, paying attention to protective factors, and learning how to best respond when a friend or loved one has expressed suicidal thoughts.

Did you know:

  • Suicide in young people is a serious and prevalent problem.
  • Family and friends fear that talking to children and teens to see if they have suicidal thoughts will make them harm or kill themselves, but the opposite is true. It is a myth that talking about suicide causes an increased  risk for suicide.
  • Almost 20% of high school students think about suicide.
  • According to the Centers for Disease Control (CDC) in 2010, suicide was the second leading cause of death for 10- to 24-year-olds.
  • Four out of five teens who attempt suicide exhibited clear warning signs.
  • Youth who threaten suicide need to be taken seriously as they are not just looking for attention.
  • Some youth think about suicide before attempting to end their life but others are impulsive in their decision.

Unfortunately, there are no foolproof warning signs of suicide. But some factors put people at higher risk for attempting to end their lives.

One significant risk factor is depression and dramatic mood changes. Symptoms of major depression include:

  • Clinically significant and pervasive depressed mood for over 2 weeks.
  • Lost of interest and pleasure in most usual activities.
  • Significant weight disturbance.
  • Unable to sleep or sleeping all the time.
  • Psychomotor agitation or retardation.
  • Fatigue and  loss of energy.
  • Feelings of low self-worth and inappropriate guilt.
  • Inability to concentrate, think, make decisions.
  • Recurrent thoughts of death and suicide.

Other factors that put people at higher risk for suicide include:

  • Increased alcohol and drug use. People who abuse alcohol or drugs are six times more likely to attempt suicide.
  • Recent major losses or multiple losses (for example, death, divorce, health problems)
  • Prior suicide attempt(s).
  • Acting reckless or engaging in risky activities.
  • Bullying by peers or being a bully.
  • Child abuse and neglect.
  • Witnessing domestic violence in the home.

How should you talk to your child or teen about suicide?

  • Prioritize connecting with your child and communicating with them regularly.
  • Talk to them calmly and in a non-judgmental way.
  • Let them know that you care about them and love them unequivocally.
  • Convey how important they are to you and how concerned you are about them.
  • Empathize with their distress.
  • Most importantly, encourage them to get professional help. Let them know that depression is treatable and that you will help them in accessing treatment.

We can also pay attention to and build on protective mechanisms in families and in schools. These factors involve increasing children and teen involvement in positive experiences that will heighten their self-esteem, developing positive coping and teaching them how to problem solve more effectively.

Help kids foster a sense of purpose and meaning in life. Provide family support, connectedness and an extended ohana. Encourage peer support and social networks, and create a cultural environment that recognizes that the mind and body are closely intertwined. Talk about depression as a mental illness, rather than a moral weakness. And highlight the fact that depression is a treatable disease, recovery is possible, and with appropriate care, people who suffer from depression can have a fully functioning life.

Finally, know about resources in the community. If someone threatens to hurt or kill themselves, or talks about wanting to hurt or kill themselves, seek immediate help by contacting a mental health professional or calling 1-800-273-TALK (8255).

Here are some resources for teens, parents and teachers to recognize the danger signs of suicide and learn how to get help:

TeensHealth: Suicide

TeensHealth: My Friend is Talking About Suicide

National Institutes of Health: Suicide Prevention

For parents and teachers: Society for the Prevention of Teen Suicide

CDC guide: The Relationship Between Bullying and Suicide

ChingJune W. J. Ching, Ph.D., ABPP is a Board Certified clinical psychologist who practices in Honolulu. She specializes in the assessment and treatment of children, adolescents, adults, couples and families. She is past-president of the Hawaii Psychological Association and former chief psychologist at Kapiolani Medical Center for women and children. Ching received her master’s degree from Harvard University and her doctoral degree from Northwestern University. She holds a clinical affiliate faculty appointment at the University of Hawaii’s Clinical Studies Program.

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