Please Stop and Read This First ...

Suicide is not about wanting to die, but about a powerful need for pain to end.

If you are feeling suicidal now, please stop long enough to read this. It will only take a few minutes.

I don't know who you are, or why you are reading this page. I only kow that for the moment, you're reading it and you're in pain. I can only guess that you are here because you are troubled and are considering ending your life. I wish I could be there with you -- to sit with you and talk, face-to-face and heart-to-heart.

People close to me have killed themselves, so I have some idea of what you might be feeling. I know that you might not be up to a lot of reading, so let's keep this short. There are five practical things I would like to share with you. I'm not attempting to make the decision for or against suicide for you. But if you're thinking about it, you're feeling pretty bad.

Please stay with me. Maybe you're the least tiny bit unsure about whether or not you really want to end your life. People often feel this way, even in the deepest darkness of despair. Being unsure is okay. It's perfectly normal. Even though you want to die, some part of you still wants to live. Just hold on to that part of yourself!

Think about this statement:

"Suicide is not chosen;
It happens when pain
exceeds resources for coping with pain"

You are not a "bad person. Nor are you crazy, weak or flawed because you feel suicidal. It doesn't even mean that you really want to die. It only means that you have more pain than you can cope with right now. I know it's useless to say "cheer up" or "snap out of it"! Naturally you would ... if you could.

Don't listen if someone tells you "it's not enough to kill yourself over". There are so many kinds of pain that may lead to suicide. Whether or not pain is bearable differs from person to person. What may not affect one person might through you into despair.

When pain exceeds pain-coping, suicidal feelings are the result. Suicide is not a defect in character; it is an imbalance in pain versus coping. You can survive suicidal feelings if you do either of two things: (1) find a way to reduce your pain, or (2) find a way to increase your coping ablities. Both are possible!!!

Here are five things you need to think about:

1) You need to hear that people DO get through this -- even people who feel as badly as you are feeling now. Hang on to hope!

2) Give yourself some distance. Promise yourself that you will wait 24 hours before doing anything. Or a week even. Remember that feelings and actions are two different things - just because you "feel" like killing yourself, it doesn't mean that you have to actually DO it right thi sminute. Put some distance between your suicidal feelings and suicidal action. Even if it's just 24 hours. You've already done it for 5 mntues, just by reading this page. You can do it for another five minutes by continuing to read. Keep giong! And realize that while you still feel suicidal, you are not (at this moment) acting on it.

3) People often turn to suicide because they are seeking relief from pain. Remember that relief is a feeling. And you have to be alive to feel it. You will not feel the relief you so desperately seek if you are dead.

4) Some people will react boldly to your suicidal feelings, either because they are frightened or angry; they may actually increase your pain instead of helping you, despite their intentions, by saying or doing thoughtless things. you need to understand that their bad reactions are about THEIR fears, not about YOU!

But there ARE people out there who can be with you in this and will not judge you or argue with you or send you to a hospital opr try to talk y ou out of how bad you feel. They will sdimply care for you. Find one of them. It's okay to ask for help. Here are some suggestions:

* Call 1-800-SUICIDE in the U.S.
* Look in the front of your phone book for a crisis line
* Call a psychotherapist
* Carefully choose a friend or a minister/priest/rabbi, someone who will listen

But don't give yourself the additional burden of trying to deal with this alone. Just talkign about how you got to where you are releases a lot of the pressure, and it might be just the additional coping resource you ened to regain your balance.

5) Suicidal feelings are traumatic. After they subside, you need to continue caring for yourself. Therapy is a really good idea. So are the self-help groups available to you.

If you are actively suicidal, call 911 immediately. Your life is worth saving and you are here for a reason. You are a precious, wonderful, and beautiful human being. It is ok that you may not know that now. It is none the less true.

This page may have given you some small relief, but the best coping resource you can give yourself is another human being to talk with. If you find someone who wants to listen, and tell them how you are feeling and how you got to this point, you will have increased your cop[ing resources by one. Hopefully the first person you choose won't be the last. There are a lot of people out there who really want to hear from you. It's time to start looking around for one of them.

Call Someone NOW!

Why is it so hard to recover from being suicidal?

Combat veterans are vulnerable to PTSD. People with PTSD suffer from a range of symptoms that interfere with their capacities to enjoy normal life.

People who suffer from PTSD may suffer suicidal conditions that are chronic, recurrent or include one or more attempts. PTSD may result when a person suffers an event or situation that is outside the range of normal experience, exceeds the individual's perceived ability to meet its demands and poses a serious threat to the loss of life.

Suicidal people meet the formal criteria for PTSD. Severe and prolonged suicidal pain is not something that most people suffer. People in suicidal crises feel that they are at the breaking point of what they can cope with. Since 30,000 people die by suicide each year in the United States, it is a condition that poses a serious threat to the loss of lief.

Many of us are hautned by memories of acute crises, acts of self-injury or extended periods of severe depression. We suffer PTSD simply from having been suicidal, independently of whatever particular trauma may have contributed to our become suicidal. Our "suicide PTSD" is also distinct from whatever event may happen as a result of beign suicidal. Most of us suffer many types of traumatic events in our lives, and these events and their consequen es need to be addressed in recovery. But the suicidal crises themselves may be events that induce PTSD.

The PTSD literature for veterans lists conditions that are commonly found among survivors of that type of taruma. Survivors typically have only some of these symptoms, and the severity of a particular symptom may vary from individual to individual. A remarkably large number of these conditions are common among people with long-term histories of suicidal pain:

1) Problems with memory. Persisten, intrusive and vidid memories concerning the traumati csituation. Events of daily life may trigger distressing memories related to the trauma. Memory lapses for parts of the traumatic situation. Many suicidal people are troubled by strong images, such as the feeling that they have bombs inside their bodies or a knife over their heads, and in recover continue to be bothered by the memory of having had these images.

2) Avoidance of things associate with the traumatic experience.

3) Denial on the seriousness of the experience.

4) Persistent anxiety.

5) Fear that the traumatic situation will recur. The trauma is often an event that shatters the survivors' sense of invulnerability to hearm.

6) Disturbed by the intrusiveness of violent impulses and t houghts.

7) Engagement in risk-taking behavior to produce adrenaline.

8) A feeling of being powerless over the traumatic event. Anger and frustration over being powerless.

9) A feeling of being helpless about one's current condition.

10) Being dramatically and permanently changed by the experience.

11) A sense of unfairness. "Why did this happen to me?"

12) Holding oneself responsible for what happened. Feeling guilty.

13) The use of self-blame to provide an illusion of control.

14) An inability to experience the joys of life.

15) Feelings of being alienated from other people and society in general. "I'm different. I'm shameful. If they knew what I was like, they would reject me. I don't belong in this world. I'm a freak, an outcast".

16) When people with PTSD try to return to normal lfie, they are plagued by readjustmetn problems in the basic elements of lfie. They have difficulties in relationships, in employment and in having families.

17) A lack of caring attachments. A sense of a lack of purpose and meaning.

18) Some chronically traumatized people lose the sense that they have a self at all.

19) Veterans report the feelign that they never really made it back from the war.

20) One Viet Nam veteran with PTSD said, "I don't have any friends and I'm pretty particular about who I want as a friend".

21) PTSD was aggravated for Viet Nam veterans because they returend to a country that had negative attitudes toward them.

22) When Viet Nam veterans retrns hoome, people were angry at they. They had shamed the contry, the had done something wrong, they were potentially harmful to others, it was dangerous to be with them.

23) A deep distrust of co-workers, employers, authorities.

24) Left with unexpressed rage against those who were indifferent to their situation and who failed to help them.

25) In personal relationships, there were problems of dependency and trust. A fear of being abandoned, betrayed, let down. A belief that people will be hurtful if given a chance. Feelings of self-hatred and humiliation for being needy, weak and vulnerable. Alternating between isolation and anxious clinging.

26) Trauma often causes the victim to view the world as malevolent, rather than benign.

27) No sense of having a future, or the belief that one's future will be very limited.

28) Feel that they belong more to the dead than to the living.

29) The feeling of having a negative "Midas touch" -- "everything I get invovled with goes bad".

30) Loss of self-confidence, and loss of feelings of mastery and competence.

31) A resistance to efforts to change a maladaptive world view that results from the trauma.

32) A mistrust of counselors' ability to listen.

33) PTSD can be worse if the sufferer experiences the trauma as an individual rather than as a memer of a group of people who are suffering the same situation. Unlke earlier wars in which units went overseas together and returned together, in Viet Nam each soldier had an individual DEROS (Date of Expected Return from Overseas). This reduced unit cohesiveness; each soldier experienced the war from an individual point of view. Suicidal people experience their near-death situation with extreme isolation. They see their conditions as being completely unique - "terminal uniqueness". They have no sense of identification with others.

34) The severity of PTSD symptoms tends to increase with the severity and duration of the trauma.

35) The use of alcohol or drugs to cope wtih the PTSD symptoms.

Survivors are often told, "It's in the past. Forget about it and get on with your life", ir "why can't you just forget about all that and enjoy life like a normal person?" If we could simply "get on with life", we would have done it! PTSD helps explain why it is so hard for the chronically suicidal to recover. Because we were suicidal, we subsequently suffered many of the conditions associated with PTSD. These conditions are serious problems in their own right; they are formidable barriers in the recovery process.

We can hel from the original trauma, and we can heal from the PTSD conditions that have plagued us. The basic steps of PTSD recover programs provide helpful guidelines:

1. an envinonment that is physically and emotionally safe
2. treatment for addictive behaviors
3. patience - PTSD recovery takes time
4. caring attachments
5. restore sense of mastery
6. rest and relaxation
7. recall the traumatic event(s) in small steps
8. radualoly assimilate painful feelings and memories
9. fully experience fear, anger, shame, guit, depression
10. grieve one's losses

In a support group, Veterans have a chance to talk about their suicidal histories without the fear that they will be taken to a hosptial for doing so. They can talk about the isolation, the fears, the pain, the confusion, the acts of self-injury, the behavior of thers that was stigmatizing, denying, abusive, the horrible sense of estrangemetn that exists when you are in a terrible situation and there is no one who understands what you are going through, the hatred and contempt for oneself and the world, the debilitating sense of personal weakness. They see that they are not alone. They do not have the seriousness of their condition minimized, denied or belitted. With tiome, the pain abates and the troublesome PTSD symptoms can diminish.

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Maybe you're reading this page because you know someone who is suicidal, and you would like to be able to help. If that's the case, please continue to read ...

How to Help a Suicidal Person

1) If someone threatens or makes statemetns referring to suicde, TAKE THEM SERIOUSLY! Many people have taken their lives when people said their statements were "manipulative" or the person was being "melodramatic".

Many people have died "accidentally". They may take some medication just to get others to hear them and feel they will be discovered and saved. Instead of calling attention to their needs, they in fact, died.

2) If the person is telling you either in person or over the phone that they are going to kill themselves, you call 911 RIGHT NOW! Law enforcement can come to the person's home and take them to be evaluated by medical personnel. Even if you feel in your heart that they will not take their life, go by what they are telling you. Don't wait to get to their home before you call 911. Call RIGHT NOW from wherever you are.

If the suicidal person forbids you to call, is angry about it or upset, CALL ANYWAY. If you need to go to a neighbor's home to call, do it. If it's in the middle of the night, wake up the neighbor and make that call.

If the person is calling from an unknown location and sicusses suicide, find out where they are. You can't send someone to them if you don't know where to find them.

What if the person has you in confidence and makes you swear that you will not tell anyone how they are feeling? Do you keep their confidence? Suicidal discussion automatically ends confidentiality.

A person in crisis may not be aware that they are in need of help or want to seek it on their own. They may also need to be reminded that treatment for depression is available, that many people experience relief from depressive symptoms.

What Do You Say to Someone Who is Suicidal?

Ask these questions first:

Plan - Do they have one?

Lethality - Is it lethal? Can they die?

Availability - Do they have the means to carry it out?

Illness - Do they have a mental or physical illness?

|Depression - Chronic or specific incident(s)?

What if the person does not "qualify" for the above statements? Do you take them seriously? YES! ALWAYS take people seriously when suicide is discussed. If they truly want to die, they may not tell you the truth about their plan.

All it takes is for someone to say "I'm going to kill myself" to call 911. Law enforcement comes; they will assess the person; they wll talk to the person. There are times where the person is not "taken", but it's helpful to have the situation checked out.

After you have taken emergency measures and the person is not in immediate risk, what do you say to them?

Do NOT:

Judge them
Show anger toward them
Provoke guilt
Discount their feelings
Tell them to "snap out of it"

DO:

1) Acknowledge and accept their feelings even if they appear distorted - "you sound like you are feeling abandoned...," "that must have hurt you terribly...," how does make you feel"? "are feeling like there is no hope"? etc.

2) Be an active listener- repeat some of their statements back to them to let them know you are listening. For example, "so what you are saying is..., "I’m hearing you saying you hate yourself...," so receiving that letter made you feel abandoned..." "I hear you saying you want to die," etc.

3) Try to give them hope and remind them what they are feeling is temporary, without provoking guilt. "I know you feel you cannot go on, but things will get better," "What you are feeling is temporary," "I believe in you and that you will get better," "There is a light at the end of the tunnel - it’s ok if you don’t see it now."

4) Be there for them. If they are not there with you, go to them or have them come to you. It is better if you go to them, in case they change their mind and don’t show up where you are.

5) Show love and encouragement. Hold them, hug them, touch them. Allow them to show their feelings. Allow them to cry, to show anger, etc. Let them know you hear them and are there for them. Let them know it is ok to feel what they feel, even if it is distorted. Let them know you accept them right where they are now. If you love them, tell them.

6) Pamper them. Feed them if they are hungry. Let them shower if you feel that will help them. Rent a movie if they feel like it. Turn on their favorite music if it makes them feel better.

7) Help them get some help. If phone calls are needed for counseling, drug recovery, Dr. appointments, etc., encourage them to make these calls. It is better if they call, but it’s ok it you need to make these calls if their level of functioning is low. If they have a counselor, psychologist, psychiatrist, etc. this is a good time to call them if the person is still at risk. If it’s evening and the person is not at risk, calls should be made the next day to these people informing them of the person’s suicidal ideation. The mental health professional may make an adjust to the person’s medicine, admit them into a hospital, etc.

8) If you are at the person’s home, remove any item/items the person may use to hurt themselves with. Grab their medication or weapon. Make these items inaccessible to the suicidal person until they are safe.

9) Is there a child or children of the suicidal person witnessing their parent’s crisis? Try to get the child out of there (AFTER the person is safe) and into a friend or relative’s home. This situation is extremely traumatic for children. Many times we think they are asleep but they are fully aware of the situation at hand.

Signs to Look for if a Person is at Risk of Suicide

They may prepare for death by giving away prized possessions, making a will, or putting other affairs in order.

They may withdraw from those around them.

Change in Sleep Patterns - insomnia, often with early waking or oversleeping, nightmares

Change in Eating Habits - loss of appetite and weight, or overeating

They may lose interest in prior activities or relationships.

A sudden, intense lift in spirits may also be a danger signal, as it may indicate the person already feels a sense of relief knowing the problems will be ended.

One or more diagnosable mental or including physical or sexual abuse substance abuse disorder

Family history of mental or substance abuse disorder

Family history of suicide including family, peers, or in news or fiction stories

Family violence, including physical or sexual abuse

Prior suicide attempt/attempts Firearm in the home

Exposure to the suicidal behavior of others, including family, peers, or in the news or fiction stories

Recent suicide attempt by a friend/family member

Recent Loss - through death, divorce, separation, broken relationship, loss of job, money, status, self-confidence, self-esteem, loss of religious faith, loss of interest in friends, sex, hobbies, activities previously enjoyed

Change in Personality - sad, withdrawn, irritable, anxious, tired, indecisive, apathetic.

Change in Behavior - can't concentrate on work or routine tasks

Diminished Sexual Interest

Fear of losing control- going crazy, harming self or others

Low self esteem- feeling worthless, shame, overwhelming guilt, self-hatred, "everyone would be better off without me"

No hope for the future - believing things will never get better; that nothing will ever change

Suicidal impulses, statements, plans; favorite agitation, hyperactivity, restlessness or lethargy.

Strong wish to die, preoccupation with death,

Increased alcohol and/or other drug use

Inability to tolerate frustration

Inability or unwillingness to communicate

Sexual promiscuity

Neglecting personal appearance

Depression

Exaggerated &/or extended boredom

Carelessness &/or accident prone

Unusually long grief reaction

Hostile behavior

Family disruption, especially divorce

Abrupt ending of a romance

REMEMBER: The risk of suicide may be greatest as the depression lifts. They may now have the energy to commit the act.

Also remember, that you can only do what you are able to do. If your friend or loved one is intent upon ending their life, you can only do so much. You are NOT responsible for their behavior. None of us can control others. This is a myth that some of us hold on to.

If you witness some of the above signs, try to talk with the person and get them some help.

If you feel the person is at risk of ending their life, even if they deny it, call 911 so that they may be evaluated.

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For Suicide Survivors

If you have lost a friend or loved one through suicide, remember ... none of us are God. We cannot control another human being's behavior and though we may have missed the "signs," we are not to blame. We did the best we could.

There are many of us who did see the "signs," yet were unable to save another human being. We are all limited in our ability to control another person's behavior and decisions. We can only be responsible for ourselves. This is a feeling of powerlessness that we must accept.

It is common for survivors of suicide to carry guilt. We say to ourselves "What if I....," Had I have...,"If only..., and the list goes on. These feelings of guilt are normal for us to feel, but these feelings are not true.

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