Suicide was defined by the sociologist Emile Durkheim as applying to ‘all cases of death resulting directly or indirectly from a positive or negative act of the victim himself, which he knows will produce this result’.
A person’s risk of committing suicide can be increased by a number of demographic and social risk factors. Demographic risk factors for suicide include being male; being relatively young; and being single, widowed, or separated or divorced. Social risk factors for suicide include being unemployed, insecurely employed, or retired; having a poor level of social support as is often the case for the elderly, prisoners, immigrants, refugees, and the bereaved; and having been through a recent life crisis such as losing a close friend or relative or being the victim of physical or sexual abuse.
If you are assailed by suicidal thoughts, the first thing to remember is that many people who have attempted suicide and survived ultimately feel relieved that they did not end their lives. At the time of attempting suicide they experienced intense feelings of despair and hopelessness because it seemed to them that they had lost control over their lives and that things could never get better. The only thing that they still had some control over was whether they lived or died, and committing suicide seemed like the only option left. This is never true.
Some of the thoughts that may accompany suicidal thoughts include:
• I want to escape my suffering.
• I have no other options.
• I am a horrible person and do not deserve to live.
• I have betrayed my loved ones.
• My loved ones would be better off without me.
• I want my loved ones to know how bad I am feeling.
• I want my loved ones to know how bad they have made me feel.
Whatever thoughts you are having, and however bad you are feeling, remember that you have not always felt this way, and that you will not always feel this way.
The risk of a person committing suicide is highest in the combined presence of (1) suicidal thoughts, (2) the means to commit suicide, and (3) the opportunity to commit suicide. If you are prone to suicidal thoughts, ensure that the means to commit suicide have been removed. For example, give tablets and sharp objects to someone for safekeeping, or put them in a locked or otherwise inaccessible place. At the same time, ensure that the opportunity to commit suicide is lacking. The surest way of doing this is by remaining in close contact with one or more people, for example, by inviting them to stay with you. Share your thoughts and feelings with these people, and don’t be reluctant to let them help you. If no one is available or no one seems suitable, there are a number of emergency telephone lines that you can ring at any time. You can even ring for an ambulance or take yourself to an Emergency Room. Do not use alcohol or drugs as these can make your behavior more impulsive and thereby significantly increase your likelihood of attempting suicide. In particular, do not drink or take drugs alone, or end up alone after drinking or taking drugs.
Make a list of all the positive things about yourself and a list of all the positive things about your life, including the things that have so far prevented you from committing suicide (you may need to get help with this). Keep the lists on you, and read them to yourself each time you are assailed by suicidal thoughts. On a separate sheet of paper, write a safety plan for the times when you feel like acting on your suicidal thoughts. Your safety plan could involve delaying any suicidal attempt by at least 48 hours, and then talking to someone about your thoughts and feelings as soon as possible. Discuss your safety plan with a healthcare professional and commit yourself to it. Sometimes even a single good night’s sleep can significantly alter your outlook, and it is important not to underestimate the importance of sleep. If you are having trouble sleeping, speak to a physician.
Example of a safety plan
1. Read through the list of positive things about myself.
2. Read through the list of positive things about my life and remind myself of the things that have so far prevented me from committing suicide.
3. Distract myself from suicidal thoughts by reading a book, listening to classical music, or watching my favorite film or comedy.
4. Get a good night’s sleep. Take a sleeping tablet if necessary.
5. Delay any suicidal attempt by at least 48 hours.
6. Call Stan on (phone number). If he is unreachable, call Julia on (phone number). Alternatively, call my healthcare professional on (phone number), or the crisis line on (phone number).
7. Go to a place where I feel safe such as the community centre or the sports centre.
8. Go to the Emergency Room.
9. Call for an ambulance.
Once things are a bit more settled, it is important that you address the cause or causes of your suicidal thoughts in as far as possible, for example, a mental disorder such as depression or alcohol dependence, a difficult life situation, or painful memories. Discuss this with your physician or another healthcare professional, who will help you to identify the most appropriate form of help available.
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