THE loss of the will to live, withdrawing from family and friends, a lack of interest even in activities and things that once sparked joy, and sleeping too much or too little are the classic symptoms of a person who may be courting suicidal thoughts. And yet, as beloved celebrities like chef Anthony Bourdain, comedian Robin Williams, and others who have taken their own lives have shown us, a happy and successful exterior can mask struggles with hopelessness and despair.
While suicide rates in the Philippines are lower than global statistics (an estimate 3.2 to 3.5 deaths per 100,000 Filipinos are by suicide, according to the Department of Health), they remain a serious cause for concern. Thirty percent of suicide cases are by individuals between the ages of 15 and 24, men are four times more likely to commit suicide than women, and whether they push through with it or not, 1 in 5 youths have seriously thought of ending their lives.
What would drive someone to resort to such an irreversible and permanent act? ‘Mental illness or personality disorder affect a person’s ability to make sound judgement,’ says Carmina Charmaine G. Bernardo, MD, FPPA, FPCPsych, psychiatrist and Head of the Mood and Anxiety Resource and Referral Center, Institute of Neuroscience, from the country’s top hospital Makati Medical Center (MakatiMed, www.makatimed.net.ph).
‘But so can a traumatic life event like a bad breakup, death in the family, physical or emotional abuse, financial loss, or a ruined career. A person dealing with a painful illness or terminal disease may decide to end their suffering prematurely. Intense feelings of worthlessness, loneliness, and being a burden to others have also pushed people to take their own lives. ‘In other words, certain triggers or stressors compel people to take action and free themselves from what they perceive to be unbearable and unending physical or emotional pain.’
The challenge for anyone who knows of a friend or loved one thinking of taking their life is to be aware of their triggers and stressors, and observant of out-of-the-ordinary behavior.
‘Of course, this is not always easy, as a person thinking of committing suicide can pretend that all is well so as not to arouse suspicion,’ explains Bernardo. ‘Some even appear suddenly calm and happy after experiencing severe depression. This could mean that they are resolved with their decision to end their life.’
Looking out for a friend or family member with suicidal thoughts is a huge responsibility. Still, if you can prevent them from pushing through with it, you could actually save a life-and that is no mean feat.
Bernardo cites common triggers and warning signs:
Specific dates and occasions. Everybody gets a case of the birthday blues: Maybe the special day reminds us that we are getting older or have no one significant to celebrate it with. ‘Birthdays, anniversaries, and special holidays can be sensitive times for suicidals,’ reveals Bernardo. ‘In fact, an international team of researchers discovered that Monday has the highest risk of suicide mortality, as does New Year’s Day. Call a friend or loved one to check on how they’re doing or make plans to go out on that day. Your company will be a welcome distraction from their dark thoughts.’
Reckless behavior. Does your friend or family member drink too much, drive too fast, not watch where they are going, miss doctor appointments, or skip prescription medication? ‘A lack of regard for their safety, health, and well-being can mean they no longer value their life,’ shares Bernardo. ‘Offer to accompany them to their appointments or drive them home when they are under the influence.’
Seeing people. While suicidals tend to withdraw from the world, others will go out of their way to seek out certain friends or relatives. Perhaps they will forgive someone-or ask someone for their forgiveness. ‘It is likely a form of closure before they end things,’ says Bernardo. Giving away prized possessions is another sign of ‘saying goodbye’ by offering something to remember them by. ‘Simply accept the token and assure the person that it will be in your safekeeping for now. It’s a subtle way of saying you will give it back when things get better.’
Talking about suicide is never easy, both for the person contemplating it and the one who speculates a loved one is strongly considering taking their life.
‘But it has to be done,’ says Bernardo. ‘Ask them pointblank gently and coming from a place of concern and sincerity. And be prepared to listen-not judge, scold, or dismiss their feelings. Let them talk and express themselves as much as they want. Sometimes, venting provides them with much-needed relief from negative thoughts.’
For the emotionally vulnerable, knowing that someone genuinely cares for them and wants to help them get out of their black hole can be enough reason to live. ‘Offer hope and the prospect of better things ahead if they just give themselves and others a chance,’ says Bernardo.
Most importantly, evaluate if a suicidal friend or family member is in immediate danger. Those at the highest risk already have a specific suicide plan, the means to carry out the plan, the time set, and an intention.
‘If an attempt is imminent, make sure they don’t have access to lethal objects that they can use to harm themselves like drugs, guns, or knives. And never ever leave a suicidal person alone,’ stresses Bernardo. ‘The best that you can do is to call emergency services, or bring the person to the nearest hospital where they can get the necessary professional help.’