Vitamodo School · Bundle 2: Suicide Recognition & Prevention · Brochure 1 of 10 · Version 1.0
Andris Saulitis, MD
If you are yourself currently considering suicide, this brochure is not the right place to start. Please reach out to a crisis line or emergency service now.
Latvia: 116123
European Union: 112
United States: 988 (Suicide & Crisis Lifeline)
United Kingdom: 116 123 (Samaritans)
For other countries: findahelpline.com
For those who: are worried that someone they care about may be considering suicide, and want to know what to look for and what to do.
Not for those who: are themselves at risk — see the crisis lines above and reach out before reading further.
What this is — the clinical reality
This brochure is for the family member, the friend, the colleague who is worried about someone they care about. Suicide is one of the leading causes of death in adults under fifty, and the people in immediate contact with someone at risk are, almost without exception, the first to notice. Knowing what to look for, and what to do when you see it, is the single most important thing a person in your position can carry.
Three things you need to know.
The first is what suicidal thinking actually is. Suicidal ideation, at the clinical level, is not weakness, not selfishness, not a manipulation, not attention-seeking. It is a state of mind in which intense psychic pain has narrowed the person's perception of available options to one. Researchers call this state cognitive constriction — the person can see no other way out. The brain in this state has been overwhelmed by some combination of unbearable pain, hopelessness about the future, and a sense of being a burden to others. It is a clinical state. It can lift. People recover.
The second is what warning signs usually look like. The popular image of the silent, unreachable person who dies suddenly with no warning is, in clinical practice, the exception rather than the rule. Most people who die by suicide have shown signs to someone in the weeks or months before. The signs are often missed because they are unspoken or oblique — a giving-away of possessions, a strange calm after a stretch of distress, a final visit to settle something. Some signs are direct: statements about wanting to die, about being a burden, about there being no other way. Direct statements should be taken seriously every time. They are not, in nearly all cases, dramatic attention-seeking. They are help-seeking.