When life is smooth and things go well, the questions of life’s meaning and one’s future aren’t very troubling to most (cf. Eccl. 5:20, NIV).1 But when the inevitable pains of living in a sin-broken world wash over us, we may ask, “Why all this suffering? Is it worth it? Is there any way out?” Suicide is one way out. Death is an end to suffering. But it’s not a solution to the problems.
None of us want to suffer. Yet suffering comes to all of us. When it does, it may feel unbearable. When suffering dispels all sense of joy and purpose, we desperately seek solutions to the problems, to put an end to the suffering, and find a way out. Suicide is an escape option, but it’s seldom a genuine desire for death. Every cell in the body has the “breath of life” (Gen. 2:7) and fights against death. The better way out of suffering is not suicide, but to alleviate the suffering and find ways to manage and cope with it. As a psychiatrist I have yet to meet a patient I thought really wanted to die.
What Is Suicide?
Suicide occurs when people harm themselves with the intention of ending their life, and they die as a result. There is, on average, one suicide every 40 seconds, or more than 2,000 suicides per day. Suicide is a leading cause of death for teenagers and young adults around the world.
A suicide attempt occurs when people harm themselves with the intention of ending their life, but they do not die. Estimates are that for every suicide, there are about 20 to 40 suicide attempts. This means that someone, somewhere in the world, attempts suicide about every other second. Females are more likely than males to attempt suicide, while males are more likely to die from suicide, as they often resort to more lethal methods.
Who Is at Risk of Suicide?
Suicide does not discriminate. Anyone may become suicidal. People of all genders, ages, ethnicities, and religions may be at risk. Suicidal behavior is complex, and there is no single cause. The most common risk factors for suicide include:
depression, other mental disorders, or substance use disorders
chronic pain
family history of a mental disorder or substance use
exposure to family violence, including physical or sexual abuse
exposure, either directly or indirectly, to others’ suicidal behavior
Fortunately, most people who have risk factors will not attempt suicide. And many who have suicidal thoughts will not act on them. It is therefore difficult to predict the risk for suicide. Some important warning signs may indicate acute danger and a need for immediate attention:
talking about wanting to die or kill themselves
talking about feeling empty or hopeless or having no reason to live
talking about feeling trapped or feeling that there are no solutions
withdrawing from family and friends
giving away important possessions and putting affairs in order
saying goodbye to friends and family
taking great risks that could lead to death, such as driving recklessly
Other serious warning signs that someone may be at risk for attempting suicide include:
displaying extreme mood swings, suddenly changing from very sad to very calm or happy
planning or looking for ways to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun
talking about feeling great guilt or shame
using alcohol or drugs more often
acting anxious or agitated
Stressful life events (such as the loss of a loved one, legal troubles, or financial difficulties) and interpersonal stressors (such as shame, harassment, bullying, discrimination, or relationship troubles) may contribute to suicide risk, especially when they occur along with other suicide risk factors.
It is important to note that suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress and should not be ignored or dismissed. If these warning signs are evident, get help as soon as possible, particularly if the behavior is new or has increased recently.2
How to Help Someone Who Has Suicidal Thoughts and Plans
Whenever you have a suspicion that someone might be suicidal and you are not aware that someone else is taking care of the person, you should engage with the person about it, or make sure someone else does. You might help save a life. I have found that the best way to address such concerns is a straightforward approach, being direct, respectful, empathetic, and caring. Here are some recommendations on what to do:
Ask: “Are you thinking about killing yourself?” or something similar. It’s not an easy question, but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts. The more comfortable and direct you are able to be talking about it, the easier it may be for the person to be open and honest in return.
Be there: Listen carefully and learn what the individual is thinking and feeling. Research suggests that acknowledging and talking about suicide may reduce rather than increase suicidal thoughts.
Keep them safe: A person who is suicidal should never be left alone. Stay with them until someone else can take over. Ask them how they would kill themselves, and eliminate, if possible, a suicidal person’s access to lethal items or places. If in doubt about what you should do, reach out to a suicide hotline and ask for advice.
Help them connect: If someone is having suicidal thoughts and plans, they require social and professional support. Depending on what they want, who is available, and what seems appropriate, help them make a connection with a suicide hotline, or a trusted individual, such as a family member, friend, pastor, or mental health professional.Stay connected: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person.3
1 This article is an adaptation of an article written for Elder’s Digest: Torben Bergland, “Suicide: Ministering to Those in the Shadow of Death,” Elder’s Digest, October/December 2022, pp. 12-14.
2 National Institute of Mental Health, “Suicide Prevention,” www.nimh.nih.gov/health/topics/suicide-prevention, accessed July 28, 2022.
3 Ibid.
