Suicide or suicide: why do people kill themselves?

No matter how scary it may sound, most people experience thoughts of suicide at least once in their lives.

Most often, a statement about committing suicide is dictated by the desire to attract attention to oneself, but sometimes both the person himself and his loved ones behave incorrectly, which leads to a transition from words to deeds.

What to do if the thought of committing suicide creeps into your head more and more often and it seems that it will be better for everyone?

Suicide or suicide: why do people kill themselves?

Suicide is an attempt to harm oneself in order to die.

The reasons why people attempt to leave this world are varied and complex, and often involve severe emotional or physical pain that the person finds unbearable.

Suicide is not only about strange people with psychiatric diagnoses of varying complexity. Not at all. Every fifth person, who is completely normal or considers himself such, has at least once in his life thought about doing something irreparable. However, we will not deny the obvious: about 90% of those who did not stop with their thoughts and moved on, realizing their desire to say goodbye to this world, had at least one mental illness, and it was not always diagnosed during their lifetime. So if those same wrong thoughts persist in you, perhaps it’s time to see a specialist?..

Russia does not occupy a place of honor in the sad statistics of suicides - it is in the top three “leaders” of this dubious rating, and only South American Guyana and South African Lesotho are ahead of it. Moreover, according to the World Health Organization, our country is ahead of the rest in the number of suicides among men. With the world average, this figure is 13.9, and in the Russian Federation – 48.3 per 100 thousand population. According to the latest data, suicides in Russia are in second place on the list of external causes of death, right behind road traffic accidents. In 2019, 17.7 thousand people died in road accidents, and 17 thousand died from suicide. Following them are poisonings - 15.8 thousand, murders - 7.2 thousand, and accidental drownings - 4 thousand.

What do suicide statistics look like around the world?

Every year around the globe, about 800 thousand people die as a result of suicide.
This means that every 40 seconds someone voluntarily dies. Suicide is the second leading cause of death among people aged 15 to 24, and depression is the leading cause of disability worldwide. How does this happen in women and men?
Women experience depression at approximately 2 times the rate and attempt suicide at 3 times the rate of men, with poisoning being their most common method of suicide. Representatives of the stronger sex, of course, fall into depression much less often, but if they are planning to end their life, they almost certainly achieve their goal - they account for about 80% of all suicides.

The risk of early death in depressed women is 4 times higher!
December 5, 20201853 6 The role of orientation and gender identity
. Children of non-standard orientation attempt suicide 3 times more often than heterosexuals. Medically serious suicide attempts among these youth are 4 times more common than among ordinary youth. According to some studies, more than 40% of adults who believe they were born into a body of the wrong sex have attempted to voluntarily take their own lives. More than 60% of them wanted to do this after becoming victims of physical violence. Non-heterosexual young people whose families do not accept them attempt suicide more than 8 times more often than those who have normal relationships with loved ones. In case of physical or moral violence, the chance of such people to say goodbye to life is 2.5 times higher than that of ordinary people.

Need for love

In order to value ourselves and our lives, we all need to feel self-love. The need for love is: – the need to be loved; – the need to love; – the need to be part of something. If these three “needs” are present in our lives most of the time, we are able to cope with life and solve the problems that confront us. For teenagers who are not loved, who themselves do not feel sympathy for their classmates and teachers, who feel like strangers at home, at school, and in the yard, it is much more difficult to cope with troubles. Due to the fact that they study poorly, do not get along with parents, friends and teachers, their self-esteem decreases, they feel worthless, lonely, and “lack of involvement.” Hence the inability to solve many pressing problems. Because their self-esteem has decreased, even those problems that were previously solved casually now become insoluble for them. Some teenagers compare this anxious, restless state with the feeling of a drowning person who has choked and is going to the bottom, or a person whose heart is convulsively compressed from melancholy. What do you think is the most important thing for them in this difficult time? You guessed it - Friend. Think yourself. Suppose you are planning to commit suicide because “nobody loves you,” and suddenly you begin to feel someone’s affection, care, they talk to you, they listen to you - and you have a glimmer of hope. If you are haunted by thoughts of death, because you yourself do not love anyone, then warm feelings towards you can be contagious: under their influence, your cold heart can melt. If you want to commit suicide because you feel like you don’t “fit in,” it can take just one friendly handshake to feel like you’ve made a place in at least one person’s heart. A caring and affectionate friend is able to talk you out of suicide, because he satisfies your need for love, a need that is so characteristic of each of us. Sometimes just one kind word is enough to save a person. An environment is where you are “surrounded” by others. You have several such “environments”: home, school, yard. Being in the company of your friends, you are surrounded by peers. In principle, there can be even more “Environments”, for example: work, church or basketball court. In each of these places you interact and come into contact with others. You talk, laugh, argue. And sometimes you just remain silent. Self-esteem is how you evaluate yourself.

Why do people commit suicide?

There are many reasons why a person may think about leaving this life. Often this is the result of long-term experiences that simply cannot be dealt with. According to Mind, a UK-based charity, there is a whole list of scenarios that lead to the desire to commit suicide:

• loss of a loved one;
• bullying, so-called bullying, discrimination or violence - this applies to people of any gender, but also age;
• the end of a relationship that is important to a person;
• loss of work, which hits workaholic men the hardest, who, even without committing suicide, can literally burn out within a year or two after they have, in fact, lost the meaning of life;
• a major change in life circumstances, such as divorce, retirement, or homelessness;
• identification of a serious illness that will seriously change a person’s entire life - for example, oncology;
• pregnancy or its loss is a very traumatic event, especially for women who have not been able to become a mother for a long time;
• problems with finances, including debts - this applies more to men;
• a guilty verdict and even just the realization that the near future will have to be spent in prison - and this again is mainly about the stronger sex;
• doubts about one's own sexual orientation or gender identity in an environment that does not understand or accept such characteristics;
• cultural practices that force a person to actually commit violence against themselves: for example, forced marriage;
• any other severe traumatic event.

Of course, such events do not always push people to thoughts of suicide, and not everyone who experiences them takes their own life. Each person reacts differently to the blows of fate - this is normal. It’s just that some people have a more stable psyche, capable of adapting to the new realities of life, while others have less so.

Depression June 15, 2021925 4

How do future suicides feel?

How do people who decide to give up their lives feel?
Often, for those who have everything in order in life, and their body works correctly - that is, they are going to live happily ever after, the thought does not even occur to them that experiences can prompt someone to voluntarily move to another world. We will list the most, so to speak, popular emotions felt by people who consider suicide as an option to solve their problems:

• strong feelings of guilt;
• rage or a desire for revenge - often occurs in teenagers who decide to “freeze their ears to spite their grandmother”;
• feeling of worthlessness;
• sadness or grief so strong that a person simply does not see any other way out of the current situation;
• a feeling of complete meaninglessness of life;
• feeling cornered - physically or emotionally;
• thoughts that everything is bad and it will never get better;
• the realization that you are a burden to your loved ones, and, in the person’s opinion, a change in the situation is not expected;
• severe physical or emotional pain.

If you notice a loved one constantly “chewing” such sensations, this is a very alarming “bell” and cannot be ignored.

Who commits suicide most often?

According to the US National Institute of Mental Health, voluntary suicide is most common in certain groups of people:

• aged 15-24 years;
• and over 60 years of age;
• suffering from mental disorders;
• survivors of a concussion or any brain injury;
• those who abuse alcohol or psychoactive substances, or, more simply, drugs;
• in people whose relatives have a psychiatric diagnosis or use drugs;
• “inmates” serving their sentences in places not so remote;
• those who have experienced domestic violence or abuse, not only physical and sexual, but also psychological;
• among those whose relatives committed suicide;
• suffering from severe or chronic, that is, incurable illness or pain;
• and, of course, a US-specific point - people having access to firearms or other weapons.

Women attempt suicide more often than men, but they succeed less often. Researchers studying this issue believe that it all comes down to the methods that representatives of different sexes use for this not the wisest of actions. Accordingly, representatives of the stronger sex make fewer attempts to voluntarily bid farewell to the mortal world, but they more often end in death.

Suicide and mental health

As we have already written, a healthy body that works without serious disruptions is not going to die voluntarily. His task is survival, not the reverse process. According to SAVE, the non-profit organization “Voice of Suicide Education,” about 90% of people whose attempts to say goodbye to the mortal world on their own are crowned with “success” have mental disorders. Moreover, they are not necessarily identified during life, that is, these are not always those who died with a diagnosis established by doctors. According to statistics, the following conditions most often cause suicidal thoughts or attempts:

• substance abuse disorders. Moreover, these very substances are often a trigger - a sort of “trigger” that triggers the development of mental disorders in people predisposed to this;
• depressive states and disorders;
• borderline personality disorder – impulsivity, anxiety, emotional instability, low self-control and difficulties with socialization;
• bipolar disorder, also known as manic-depressive psychosis, is a mental illness that looks like inadequate mood swings, constant changes in energy levels and performance;
• anxiety disorders - constant worry about literally everything: work, school, appearance, money and relationships with others;
• psychosis is a condition in which a person perceives the world around him inadequately - often with delusions and hallucinations - and behaves inappropriately.

Mental illness is a serious thing.
Most of those who have never experienced this with friends or loved ones do not even realize how common such conditions are. According to various sources, from 10 to 50% (!) of therapists’ patients have mental disorders.

Up to 50! Just think: almost half of those who have ever gone to a therapist - a doctor “about everything and nothing” who refers us to various specialized specialists - are potential patients of psychiatrists!

Not everyone who contemplates suicide has a diagnosed mental illness, according to the UK charity Samaritans. But this is understandable - most of us simply did not have time to identify it.

How can you tell if a loved one has decided to commit suicide?

Unfortunately, it is not always possible to understand that a loved one is on the verge of suicide - unless, of course, we are talking about demonstrative behavior and attempts at blackmail. For some people, it is still possible to understand that they are planning a voluntary departure from life. SAVE have listed signs that should not be ignored if your loved one:

• talks about suicide and the desire to die;
• reports, even periodically, a feeling of being cornered, hopeless, or intolerable pain;
• believes that he is a burden to others;
• plans or looks for ways to harm himself: hoards serious medications, is interested in this topic on the Internet, or suddenly, out of the blue, acquires a firearm or other weapon;
• leaves or becomes very distant from family and friends;
• Drinks alcohol more often or starts taking drugs;
• eats or sleeps more or less than usual;
• regularly acts in an anxious or reckless manner;
• experiences sudden mood swings.

Not all of these signs appear in every future suicide, and not everyone can notice them.
The best way to find out about the plans of a loved one is to simply talk to him. Pesticide ban reduces suicide rate December 19, 2020544 4

Learn to recognize warning signs

If you notice them on a friend in time, you can save his life. Here's what you need to pay attention to first.

Suicidal thoughts

They usually involve two or more types of the following thought patterns:

• Obsessive fixation on some thought.
• The belief that there is no hope, and the only way to get rid of pain is by dying.
• The belief that existence is meaningless or uncontrollable.
• Feeling like your brain is in a fog and it’s impossible to concentrate.

Suicidal emotions

Here are the most common:

• Sudden mood swings.
• Feeling lonely and isolated even in the presence of others.
• Feelings of guilt or worthlessness, shame, self-hatred, the feeling that no one cares.
• Sadness, isolation, fatigue, apathy, anxiety, irritability.

Trigger phrases

They are usually consonant with suicidal thoughts and moods:

• Life is not worth all this suffering.
• You (or another loved one) will be better off without me.
• Don't worry, I won't be there when you have to deal with this.
• You'll regret it when I'm gone.
• Soon I will stop getting in everyone's way.
• Soon I will stop being a burden to everyone.
• I just can't deal with it, and why should I?
• There is nothing I can do to change anything.
• I have no choice.
• It would be better for me to die.
• It would have been better for me not to have been born at all.

Sudden improvement in mood

Many who decide to commit suicide commit this act precisely when from the outside it seems that they feel better. The final decision brings them relief and they appear calm. If you notice such a sudden change in a friend's condition, immediately do everything to prevent a suicide attempt (more on this later).

Unusual behavior

Those who contemplate suicide usually experience behavioral changes. Be wary if you notice several of these signs:

• Decreased performance at school, work, and other activities.
• Social isolation.
• Lack of interest in sex, friends, and anything that used to bring pleasure.
• Indifference to one's health and appearance.
• Changing eating habits. First of all, pay attention to extremes: fasting, eating unhealthy foods, stopping taking medications (the latter is especially important for older people).
• Lethargy and isolation.

Signs of a ready-made plan

If a person already has a plan, then a suicide attempt may happen very soon. You should be concerned if, in addition to suicidal thoughts and phrases, you notice the following:

• A person sums things up, for example, says goodbye to relatives, distributes valuables, and makes a will.
• Your friend makes rash or passive decisions regarding important things. For example, selling a home, career and everything related to his future.

Talking about suicide

Some people, for some unknown reason, believe that talking about suicide can cause suicidal thoughts in others. Scientific research has debunked this myth and proved that this is not so - conversations about voluntary death do not in any way increase the risk of such an event. Moreover, scientists insist that the effect can be completely opposite - allowing people to share their thoughts and feelings with which they are struggling can, on the contrary, reduce the chance that a person will decide on such a terrible act.

Even if the conversation about contemplating suicide is quite intrusive, do not refuse it. Remember - this can help save a life.

Starting it is not as difficult as it seems. The banal “how are you feeling?”, “have you ever felt so bad that you thought about suicide?”, or simply ask a question about thoughts about suicide directly and directly are enough. The same Samaritans in such situations advise simply listening to what the person says and not judging. There is also a special technique that can be used in such a situation, it is called “active listening”, and is used in psychological training and psychotherapy sessions. What it looks like:

• focus on the interlocutor and do not get distracted;
• ask honest, open, direct questions;
• give time for wording - don’t interrupt, let him say everything that the person wants to convey to you, even if it doesn’t take him minutes at all;
• repeat the phrases said by the interlocutor so that it is clear to him: you understand him, and are not just pretending and communicating “for show.”

Listen more - for many people it’s enough just to express what’s boiling over them. This could work as a good therapy session.

If someone is thinking about suicide, will they kill themselves?

Experiencing suicidal thoughts does not always mean that a person is truly ready to commit a terrible act.

According to Samaritans suicide statistics, approximately one in five people will consider suicide at some point in their lives - often in response to a specific situation or temporary feeling.

In most cases, people who have thoughts of voluntarily leaving life do not commit anything irreparable.

And here there is an important nuance - there is a huge gap between suicidal thoughts and intentions. Thoughts can leave the same way they came, but intentions mean that the decision has already been made, and the person has decided to act in accordance with his plans to take his own life. It is in such situations that immediate help is needed.

What is our self-esteem based on?

Our self-esteem is our sense of self. The way we perceive ourselves, our lives, our feelings towards our friends - all of this affects our self-esteem. – Our self-esteem is also how we appear to others. Our self-esteem depends on how our friends, teachers, parents or educators treat us, and what they say about us. Think about how your self-esteem will change depending on the following circumstances: your parents praise you; you failed the exam; your friends “stand by you”; the gym teacher yells at you; you are considered the prettiest girl in the class; someone called you “crazy”; you were elected to the class council; you let your friend down.

What to do if a loved one decides to commit suicide?

If someone is contemplating suicide, it is important to act quickly. SAVE recommend:

• Ask direct questions:
  ask the person if he has any plans to take his own life. If the answer is yes, then clarify how and when this is planned to be done.
• Ask for help
  .
  If a person is in immediate danger, call 112. Hotlines for suicides or those trying to prevent them are, to put it mildly, difficult in our country - what is available in all civilized states without exception is completely absent in ours. But there is a 24-hour helpline: 8-800-2000-122
  , where you can seek psychological help and support every day and at any time of the day or night.
  There is also an emergency psychological help line of the Russian Ministry of Emergency Situations for residents of the capital: 8-499-216-50-50
  , anonymous, 24/7 and free.

In fact, people who think about suicide do not always want to die. Often they reach the edge because they simply cannot think of a way out of the current situation. Intervention can not only support, but also restore hope and show another point of view that a cornered person simply would not think of.

• Take the reasons for suicide seriously:
  even if you understand that the reason that a person considers to be a reason for leaving life is not objectively such, do not try to convince the person who is planning the irreparable of this. It won’t help - it seems to him that he is 146% right, all your arguments will be smashed against the wall of misunderstanding, and they will simply stop talking to you. Instead, listen, assure that you understand and agree with everything, but that you can get help and at least try to change something. Don't argue! Remember, about 90% of suicidal people are people with mental problems, and a considerable part of them do not have an official lifetime diagnosis. Treat it that way—agree with everything, don’t disagree with anything.
• Don't keep your knowledge a secret:
  yes, trust is very important, but if you just keep everything to yourself, you will simply endanger the life of a person who may be in the process of exacerbating a mental disorder and cannot objectively assess what is happening. In the case of people being cared for, loved ones, carers and medical staff need to be aware of such thoughts in order to eliminate all possible sources of danger.

What if this is all just window dressing to attract attention?

It is a fairly common belief that those who talk about suicide or make a futile attempt are trying to do it for attention, and therefore are simply showing off and do not need help.

Of course, this is not uncommon. And, of course, such people need help. Even if a person is not actually going to go to another world, such conversations or actions always indicate that he is stressed and his psyche urgently needs support.

Suicide in people of different ages

A person can become suicidal at any age. But the most vulnerable are children and adolescents. Today, suicide is the second leading cause of death among adolescents aged 14-19. In most cases, suicide occurs after prolonged depression. Other causes of suicide among teenagers include:

• suicides among close relatives;
• drug use, especially psychostimulants, and alcohol;
• antisocial behavior;
• decreased self-esteem;
• failures at school;
• breaking up with a close friend;
• change of place of residence and loss of contact with friends;
• pressure from parents;
• dysfunctional and alcoholic family.

Most often, suicide occurs in adulthood. There is an opinion that suicide is committed by people with mental illness. But this is the tip of the iceberg.

What pushes

Most people who decide to voluntarily self-destruct are mentally healthy and mentally strong individuals. Often adults look back at the past and discover that most of the things they dreamed of in their youth never came true. Or suicide is committed at the peak of grief and loss, when a person forgets about past achievements and future prospects. In such situations, a person needs a qualified specialist: a psychotherapist who will help overcome grief and improve the quality of life, and also show ways to achieve the desired goals. But, in many cases, a person who wishes to die does not turn to a psychologist or psychiatrist. And he decides to get out of a difficult condition on his own and commits suicide.

Indirectly affect the suicide rate:

• political changes in the country;
• changing the moral principles of city residents;
• changes in the institution of family, church reforms.

Adults often commit suicide without much thought. Therefore, it is extremely important to recognize approaching grief and help the person in constructive ways. If a person has no appetite, is depressed, loses self-confidence, or neglects social contacts, one should be seriously concerned about the state of the adult personality. If you contact a specialist at the Transfiguration Clinic, you will be able to receive all the necessary recommendations on how to behave in this situation and how to help the person.

Lonely pensioners and elderly people are also susceptible to suicide. The reasons for this action may most often be:

• difficult financial situation;
• lack of social contacts;
• feeling of worthlessness, feeling of abandonment;
• an abundance of physical ailments.

Psychological assistance and treatment

Treatment of a person with suicidal tendencies takes place on a hospital basis. For a full recovery, it is necessary to conduct a diagnosis and identify the current state of a person’s health. Are there any abnormalities in the functioning of the brain and mental disorders, is the person taking medications, and the general condition of the body? These and other factors can affect the psychological state of an elderly person and provoke the emergence of suicidal tendencies. The specialists of the Transfiguration clinic know what can cause destructive behavior and what measures are necessary to prevent the violent death of an old man.

The client of our clinic does not need to prepare in advance for treatment. The specialists of the Preobrazhenie clinic will carry out all the necessary diagnostics and treatment independently. Throughout the entire treatment course, the patient will be supported by a psychologist, and experienced psychiatrists, neurologists and therapists will improve their health.

At the Transfiguration clinic, treatment is carried out based on an integrated approach and the most effective methods, which include:

• psychotherapeutic sessions;
• drug treatment: psychotropic drugs, neurometabolic therapy, vitamin and amino acid complexes;
• physiotherapeutic procedures;
• restorative treatment.

Anyone who contacts the Transfiguration clinic will receive the necessary assistance in full. Every person who suffers from suicidal tendencies will be able to return to a full life, improve their body and improve their mental health.

Myths and truth about suicide

Myth: People who talk about suicide are not serious and have no intention of committing it. Fact:
Suicidal people often told someone that their life had no meaning or they couldn't see their future. Some actually reported that they wanted to die. But in some cases, conversations about voluntary death are really not a story about a decision made, but a cry for help.

Myth:
If a person is serious about completing his life’s journey, then nothing can be done. Fact:
Often suicidal feelings are temporary, that is, having coped with certain circumstances and received support in time, the suicide may well change his mind.
Myth: Only mentally ill people think about suicide. Fact:
Every fifth person has thought about suicide at least once in their entire life, and not everyone who dies as a result of it has mental health problems at the time of death. However, it must be admitted that about 90% of them actually have a similar problem, and often the diagnosis is made only posthumously.

Myth:
Suicidal people want to die. Fact:
Most of those who say or are contemplating suicide do not actually want to say goodbye to this world - they simply do not want to live the life that they currently have. It may seem that the difference is not big, but in fact it is not - there is a whole abyss between these two concepts. After all, today everything may be bad, but tomorrow the sun will come out from behind the clouds and life will sparkle with new colors. True, it’s no longer for everyone.

Myth:
Suicides are most likely to occur during the winter months. Fact:
Statistics show that it's not just about the seasons, cold or warm weather, or the amount of sunlight.
And yet, the largest number of suicides occurs in the spring and around the New Year. Myth: Talking about suicide is a bad idea because it may make someone think about trying it. Fact:
Suicide can be a taboo subject. Often people who are seriously thinking about leaving this life do not want to bother anyone or burden anyone with their problems, and do not discuss anything even with their loved ones. But! When you ask a direct question, you are essentially giving the person permission to talk about how they feel. Quite a few people who are suicidal report what a relief it is for them to be able to talk about their experiences.

New screening effectively identifies suicidal teenagers February 4, 2021937

How to overcome suicidal thoughts and feelings?

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Source: , David Miklowitz. Translation: tlgrm.ru/channels/@thenoondaydemon Editing: Freak Mist

Up to 15% of people with bipolar disorder die by suicide, and at least one in three attempts suicide at least once in their lifetime. Suicidal ideation is part of the disease, related to its biological and genetic mechanisms, it is not your moral failure or weakness. We can protect ourselves with medication, psychotherapy, support from friends and family, and self-organization.

“I became more and more depressed, thought about suicide and at some point decided to do it. I took lithium, tablet after tablet, all evening, then got into the shower, but by then I had diarrhea and vomited. In a semi-conscious state, I called my boyfriend, and the doctors took me to the hospital. Catheter, oxygen mask... I looked terrible and felt the same. Everyone told me how lucky I was to be alive, but that made me feel even worse. I definitely didn’t feel lucky” (from a 28-year-old woman with bipolar disorder describing her first suicide attempt).

Suicide can be a sudden, impulsive act or a carefully planned act. Up to 15% of people with bipolar disorder die by suicide, and at least one in three attempts suicide at least once in their lifetime (Novick, 2010). Unfortunately, suicidality is part of bipolar disorder and is related to its biological and genetic mechanisms. We know that serotonin levels are lower in the brain of the person who has attempted it. (Mann, 1999). In other words, suicidal impulses are related to the neurophysiology of your illness, it is not your moral failure or weakness. In fact, quite a few healthy people have thought about it, at least “in passing.” But among people with bipolar disorder, such thoughts are stronger, and they turn into a plan of action.

The desire to escape from problems

People with bipolar and other mood disorders often feel helpless and think that nothing will ever get better. They seek to get rid of “increasing, uncontrollable, endless mental pain, tinged with fear and rejection.” Some people really want to die. But from my observations, most people with bipolar disorder want relief from unbearable life circumstances and the emotional, mental or physical pain that accompanies depression and anxiety disorders. When depression sets in and you feel terrified, apprehensive, and desperate to live, suicide seems like the only way to get rid of the unbearable thoughts. However, even in severe cases, suicidal thoughts can be managed and controlled through medical means. Antidepressants, anticonvulsants, and antipsychotics reduce agitation and aggressiveness, which can lead to suicidal actions. We can protect ourselves with medication, psychotherapy, support from friends and family, and self-organization. Helplessness, pain and emptiness are temporary, even if you don't believe it right now.

Risk factors for suicide

You are at risk if you:

• have bipolar disorder and regularly use alcohol or drugs (alcohol and psychotropic substances are incompatible with medications and prevent you from seeking help from doctors or loved ones);
• you have panic attacks, anxiety attacks, or other indicators of an anxiety disorder;
• you are prone to reckless behavior, such as dangerous driving, or outbursts of rage;
• you have one or more people in your family who have committed suicide or a violent act against another;
• You have recently experienced a major life shock, including loss (for example, divorce or death of a family member);
• you are isolated from friends and family;
• you do not have access to a psychiatrist or psychotherapist, you feel hopeless about the future and/or you do not have strong reasons to prevent suicide (for example, a commitment to raise children);
• you have thought about a specific suicide plan and have the opportunity to do so (use pills or weapons).

If you are experiencing suicidal thoughts, you should inform your psychiatrist, family members and other important people in your close circle. This is appropriate if you have one or more risk factors. Do not remain silent because you are afraid of causing pain and problems to your loved ones. Many people have felt this way and did not get the help they needed when they needed it. But your suicide will be a much bigger blow for them.

How to protect yourself from suicidal actions?

When you fall into depression and it becomes more severe, suicidal thoughts come to you more often. They can be vague at first (for example, “I would like to know what it would be like to disappear”), then more serious (“I know that I want to kill myself, but I don’t know how; I have many suicide plans; I have chosen one , as well as time and place”). The feelings, thoughts and behaviors that lead you to this desperate decision are quite complex and not fully explained by scientists. However, we know what we can do to protect ourselves from these actions and impulses. First of all, you need to block your access to the means of committing it and seek support (from doctors, family members, friends). Think about your rescue plan when you feel better, and start implementing it at the first sign of suicidal thoughts. Don't wait until you feel desperate, don't let yourself get to that point. Step 1: Get rid of tools that can harm yourself

The first thing you can do is remove all objects that could potentially kill yourself, including weapons, sleeping pills, poisons, ropes and sharp objects from your reach. Give them to a close friend who lives separately from you, or even to your psychiatrist. To avoid overdosing on medications, keep a couple of days' worth of pills at home and ask a spouse or significant other (or even your doctor) to store your medications, dispensing them as needed. Although these measures may seem superficial (you're getting rid of the means, not the causes), this will greatly reduce the chances that you will harm yourself in any way in the heat of the moment. Not having access to things like a gun, knife, and razor will greatly reduce the chances of you using it against yourself or someone else.

Step 2: Meet with your psychiatrist immediately

If your next visit to a psychiatrist is not in the next few weeks, let them know what's going on with you, or ask someone in your close circle to do so. Your doctor will likely start by asking you about your suicidal intentions and your history of suicide attempts (if he doesn't already know). Be prepared to spend some time on these questions before you move on to the reasons that occupy your entire mind. Many people find it difficult to talk about such things publicly. They fear that the doctor will immediately admit them to the hospital or be deeply disappointed that the treatment plan has failed. The doctor may indeed admit you to the hospital if he understands that the risk to your life is great. And this may be the best solution for you. Hospitalization will give you a chance to get emergency treatment, talk to people who feel like you, and get the medications that are right for you right now. This will also allow you to isolate yourself from stimuli that may trigger suicidal thoughts (for example, conflicts with loved ones and colleagues, anxiety about your daily responsibilities, noise, the Internet, the telephone). Your psychiatrist will likely reconsider your treatment regimen, add or select an antidepressant, or increase the dose of your mood stabilizer. In emergency cases, he may recommend electroconvulsive therapy. If you have visible signs of anxiety, agitation, or psychosis, he may prescribe an atypical antipsychotic or benzodiazepines. When your condition is controlled by medication, suicidal thoughts gradually disappear. Try to be realistic and don't expect the pills to work immediately. This may take several weeks. One client with bipolar mixed disorder (48 years old) attempted to suffocate himself by locking himself in the garage and turning on the car engine. After a brief hospitalization, the doctor added paroxetine (Paxil, an antidepressant) to her mood stabilizer. Suicidal thoughts and intentions quickly subsided, and depression became easier, although not immediately. Most therapists use distraction techniques, relaxation techniques, or cognitive restructuring. Certain events, situations, images, memories can trigger your suicidal thoughts, so you need to know as much as possible about them and be prepared to confront them. Step 3: Supportive Communication with Loved Ones

“When I think about the future, I panic, and that’s when suicidal thoughts arise. But when I go out with friends, I get distracted and start thinking about the good things that are waiting for me, and this gives me energy, a sense of purpose. I can make people laugh or influence them, and that makes me alive again” (43-year-old man with bipolar I disorder). For this man, being with other people was an antidepressant of sorts, giving him a temporary sense of relief from painful emotions. When you feel like taking your own life, it is important to reach out to loved ones and get support from them. They can keep you from acting rashly. When you are at the height of depression and despair, you are more likely to reject help. Thoughts “they won’t be able to help me, I’ll be disappointed, I’ll feel even worse” increase the feeling of hopelessness. It's important to challenge these thoughts and force yourself to ask for support from others, even if it seems futile. Think about who will help you when you feel bad? When you're depressed or anxious, who do you rely on? Is this person able to help you think through your problems and possible solutions without upsetting you? Is there someone on the list who can listen to you without criticism or horror? Some people with bipolar disorder may not be able to discuss the topic with their parents, but may be open with a sibling, friend, partner, spouse, or minister. The main thing is that this person will listen calmly and carefully and understand your despair without judgment. Choose someone who combines optimism with realism, someone who understands what bipolar disorder is, or who has gone through periods of depression themselves. This person may offer a new perspective on how to deal with despair. If there are no such people around, try to choose a person (or several) who is most dear to you. It is better to include as many people as possible on the “rescue” list.

Now think about how your loved ones can help you. Tell them that you don't expect him to solve your problems for you. You need to focus on what makes you want to end your life and why. A mental health professional is probably better at this, but if you have a friend or family member who is a good listener, give them a chance too. If you are unable to call your doctor, ask your friends to do so. Ask them to take your weapons and pills. If you need to go to hospital, ask for visits. If you don't want to or can't go to the hospital, have someone stay with you in your apartment until you feel safe. If you are unable to take care of your children and pets, find someone to do it for you. Use distraction. Many people with bipolar disorder focus on their painful emotions, which they view as a burden to others. Take your mind off them. Just spend more time with your loved ones and friends. Invite them to watch a movie with you, go for a walk, go for a drive, take them to lunch. Physical activity will also free your brain from suicidal thoughts. It is important to thank your loved ones for their help every time you are able to do so. Remember, they are trying to help, even if what they do doesn't always help. It's important for them to hear that talking to them or spending time together helps you. Step 4. Make your list of reasons to live

When people feel hopeless, they begin to weigh the pros and cons of suicide as a solution to all problems. Suicide begins to seem like a logical alternative when you are convinced that nothing you do is producing a positive result, or that depression and other life problems will haunt you forever. When people believe they can cope with problems and feel responsible for their family and children, they are less likely to attempt suicide. When you're feeling better, make a list of all the things that make life worth living or the reasons why you didn't commit suicide sooner when you started thinking about it. Later, in a moment of despair, you should re-read and think about this list. It can save you from self-destruction. Check the statements below that motivate you to keep going:

• I have responsibilities and obligations to my family;
• I believe that sooner or later I will be able to cope with my problems;
• I believe that I myself am the master of my life;
• I'm afraid of death;
• I want to see my children when they grow up;
• life is all we have, and a hard life is better than nothing;
• I have plans for the future that I hope to fulfill;
• I know depression won't last forever;
• I love my family too much and don’t want to leave them alone;
• I’m afraid that my method of suicide will fail and will only make things worse for myself;
• I want to experience everything that life has to offer, and there is still a lot left that I haven’t tried;
• it would be dishonest to the children to leave them in the care of strangers;
• There are people who love me;
• my religion forbids it;
• this will hurt my family and I don't want them to suffer;
• I worry that others will think badly of me and my family. They will think that I am weak and selfish;
• I think it is morally wrong;
• I still have a lot of unfinished business;
• I am strong and brave enough to fight for life;
• I am afraid of suicide (pain, blood, violence);
• suicide will not solve any problems;
• I would not want my family to live with a feeling of guilt for my actions.

Complete the list with your personal motivations.

Step 5: Resources for Life

Many people turn to religion when they feel alone, depressed, and suicidal. Some go to church, synagogue or temple, others prefer to pray alone. Prayer gives them a sense of purpose and belonging to something important. Relaxation brings relief when you choose a comfortable position, tense and relax all muscle groups, starting with your feet and moving towards your face, and imagine pleasant scenes from the past (for example, the sea, a garden, a date), and breathing practices. An interesting method is “decentering” (monitoring your emotions and physical sensations from the position of an observer). Some people respond better to mindfulness exercises that allow them to experience a specific moment. Others do relaxation exercises.

Try light exercise such as walking, stretching, or cycling. When you exercise, focus on your body and physical sensations, try not to think at all. It is important to make exercise part of your regular routine to enhance the benefits.

Suicide Prevention Plan

Collect all the information you know into a suicide prevention plan. List the signs of depression and any suicidal thoughts or impulses, even those that seem fleeting and insignificant to you. Then review your list of strategies and solutions—for example, what specific things your loved ones can help you with when you're feeling down. Circle the points that make the most sense to you. Share this list with your doctor and loved ones. If a friend or family member doesn't want to take responsibility for a specific item on the list (eg, taking care of the children, calling a psychiatrist), delegate the task to someone else. It's hard to see a way out when you seem to have hit rock bottom, so use as many premeditated strategies as possible as soon as you feel the first signs of depression or suicidal despair.

Source: , David Miklowitz. Translation: tlgrm.ru/channels/@thenoondaydemon Editing: Freak Mist

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