The Warning Signs of Suicide
Since founding Stop Suicide USA in 2012, I’ve conducted more than 2,000 successful suicide interventions. I can’t imagine doing anything else. But this passion can often be stressful. The painful part of what I do, and that which haunts me, are the losses. As an Army and Law Enforcement Chaplain, I have been on the scene of dozens of suicides, completed dozens of funerals and counseled hundreds of individuals and families in their time of loss.
Often, the most heartbreaking words I hear from those left behind are, “We didn’t see this coming.” As an interventionist, I just wish I had known. I wish someone had called me. Unfortunately, survivors often didn’t know what to look for when the risk was present. In some cases, the signs were noted but were interpreted as “a phase,” an attempt at attention or a manipulation maneuver. And a call was never made.
In some instances, there may be no signs at all. For example, it’s estimated that one in five teens will never tell anyone or show any signs that they are having suicidal thoughts. If no one knows, how can help be provided? I will address that shortly.
The Core Signs of Suicide
Signs of suicide typically have to do with the things that are said or done. Spoken words can be subdivided into two categories.
Negative Self-talk
These words are normally not in the presence of others, but sometimes they are. One evening, I was listening to a voicemail and realized it was an unintentional pocket call. The person was all alone, shredding himself with his words. He questioned his life and questioned God. It sounded like a desperate prayer to God, but I was listening too. That was a divine intervention. Like the scene from the movie Bruce Almighty, it was a sign I recognized and was able to act upon. I called him immediately. We had a wonderful talk, the situation was de-escalated and he is doing much better now.
I often tell people that self-talk is like a monkey on your back whispering in your ear. And what we listen to is what we tend to act upon. Spoken words are the drivers for action, positive or negative. When it comes to suicide it might be words such as “I am hopeless…The situation is hopeless…I’m just a burden…I have no friends….No one cares about me…I can’t deal with this anymore…No one would care if I died.” When such words are shared with or heard by others, it is a sign for the helper to act. This blog focuses on the signs; a future blog will deal with how to begin that conversation.
How People at Risk of Suicide Act: Behavior
People at risk do certain things and act in certain ways. For example, one of my Board members recently had to give up golf. I called to check on him because he was no longer doing what he loved. His behavior had changed. I asked him if he was having thoughts of suicide. He assured me that was not the case. His was due to health issues; he was simply unable to play the game anymore.
When people stop doing what they have always loved to do, I am quick to engage them in a caring conversation. My oldest son recognized this in me. He was a US Airman, and I was an Army Chaplain on temporary orders at Ft. Jackson. One day, as we were touring the USS Yorktown in Charleston, he said, “Dad you are not working out anymore. I am just wondering why.” All his life, he knew I was a fitness fanatic. But he recognized that something had changed; I was no longer doing what I loved. In fact, I was suicidal, and he asked me the suicide question too. That was the turning point that saved my life, and the reason I founded Stop Suicide USA a year later.
There are other signs of suicide, including:
Increased alcohol or drug use
Withdrawing from friends or smalls groups
Sleeping too much or too little
Giving away prized possessions
Abstaining from family outings or the Friday night football game —or any other type of self-isolating
A drop in grades
Not eating or losing weight
Behaving aggressively or being overly nice.
All can be potential signs, and there are many more. Any change in behavior from the typical behavior is a potential sign, and a reason to engage in a caring conversation.
I have thousands of friends on my social media account that I don’t really know. Many of them come from the more than 29,000 people who have taken my training. There was one, however, I will never forget. We attended the same high school, and he graduated three years before me. We had never been friends, nor do I recall ever engaging with him. When he friended me, I assumed it was because we had mutual friends. Shortly thereafter he sent me a simple message saying, “Thank you for what you do.” That’s all he said, but my “Spidey senses” were tingling. I reviewed his previous posts and sensed suicide was on his mind. I reached out to him with an internet phone call. We had an engaging conversation, the suicide question was asked, he said, “Yes” and together we worked out a plan for his safety. He tells others he is alive today because of that call.
How People at Risk of Suicide Act: Mood
Mood can present itself in numerous ways, some more expected, such as:
Anxiety
Depression
Anger
But also:
Tranquility
Happiness
Friendliness beyond what is typical of the person
According to Lifeway Research, “35% of suicide victims attended church the month prior to death.” Why? Were they seeking to make peace with God about their decision, or was it one last effort to find hope? This is one reason I encourage the faith community to rally with us in hosting the Stop Suicide USA Intervene Challenge to train their members as part of their network of care.
Shame: Another Common Sign of Suicide
I’ve worked with many grieving parents who recognized too late that their child was overwhelmed by the shame of something he/she had done. Shame can be handled in a healthy way, or it can be toxic. Unfortunately, many people are uncertain how to deal with shame. As a child, when I would be out with friends, my dad would always say, “Remember who you are.” It was his healthy way of saying do not bring shame upon yourself or the family name. But most people don’t understand the healthy concept of shame. For some, when a catastrophizing event occurs, they don’t know what to do with the shame they are experiencing. Some use shame to destroy people, rather taking the opportunity to help each other learn and grow from the mistakes we make. More than ever before, the inability to go and grow through shame can be fatal.
Learning How to Engage With Those at Risk of Suicide
Recognizing the signs by what people say and do is the first step to reducing suicide. The next vital step gaining the skills to interact with those at risk. The Stop Suicide USA Intervene Challenge offers a world-class suicide intervention training model that’s trained thousands of people to help those at risk. The fifth of the five core values we teach in the class states, “It is not what you look at that matters. It is what you see.” Frankly, there are times when there are no signs. But contrary to what some may think, that does not mean suicide is inevitable.
Some might argue that if there is no sign, there is no way to know of the risk. But this is not true. While a psychology class might differentiate between signs and risk factors, I make no such distinction. Risk factors are typically thought of as the situation or environment in which person is. However, in my mind the risk factor is the sign when there are no other signs. In other words, it’s not what you look at that matters; it’s what you see. What do you see when others see no risk?
Seeing the Unseen: Beyond the Signs of Suicide
A person at risk of suicide may not show any signs by what they say and do. But if I know they are going through a divorce, they earned a Purple Heart in the desert serving their country, or they just got the pink slip from their job, it doesn’t matter how positive that person might seem. I will still try to engage them in a caring conversation, which will often lead to the question of suicide. I recently had a case with a First Sergeant who was suicidal. Several weeks after the intervention, he asked, “Chaplain, how did you know? I didn’t think I was putting out any signs.” I said, “Your circumstances are the only sign I needed.”
If a tornado has knocked down the signs at a four-way stop, I don’t need signs to tell me I should stop. In fact, awareness should be heightened and greater caution exercised because others may not know there should be a stop sign there. The circumstance or situation tells me I need to be aware there is a risk. The same is true when it comes to suicide. Don’t look for signs, then discount the risk when you find none. If circumstances for a loved one or friend have changed, or you know they are in a toxic situation at school at home or in the workplace, consider that a sign. Be the friend who is willing to ask the question most wouldn’t be willing to ask. Obviously, you want to take time to build rapport before popping off a direct question about suicide. We’ll talk about that in another blogpost.
Finding the Courage to Ask: The Suicide Question
Awareness is important, but having the courage to ask the suicide question is equally or more important. “Courage to Ask Power to Save” is the subtitle of my book, Listen Learn Lead. “We didn’t see this coming” is a phrase that haunts me, but there is another: “I knew something wasn’t right…I thought he might be in trouble…but I didn’t know what to do…if only I had asked…” I have heard such words from hundreds of grieving individuals. Several years ago, I was one of them.
Three years before my own battle with suicidal thoughts, and before I was trained in suicide intervention, one of my sons had a friend who took his own life. We all were caught by surprise. I was unaware of the statistics on the prevalence of such thought, and had no clue as to the signs for which to look in those at risk. I wish I had known then what I know today. Dealing with pain when we have experienced loss is another topic I will cover in a future discussion.
To summarize: Signs are important indicators that risk is present. But sometimes there are no signs. An awareness of circumstances has been the primary reason I’ve been involved in thousands of suicide interventions. Regardless of whether it’s signs or circumstances you’re aware of, please remember that circumstances are signs too. When you see the sign, trust that the sign was meant for you. And have the courage to act upon what others may not see.