Suicidal thoughtsIf you are thinking of ending your life, or you fear for someone you love

8If you are in danger right now

If you are reading this page because you are tired enough to think about an ending, thank you for still being here and searching. What you feel now is real and painful, but it is not the whole truth. This page was written for you, and for those who love you and fear for you.

1. Call now the mental health support line 16328, or ambulance (123), or go to the nearest emergency department.
2. Do not stay alone: call a friend or relative and ask them to come over or stay with you on the phone.
3. Move away from anything that could hurt you, and ask someone to keep it away from you.
4. Stay away from alcohol and drugs tonight, because they make decisions more impulsive.
5. Postpone any decision: suicidal thoughts intensify and then calm down, and what you feel now will change.

9What are suicidal thoughts?

Suicidal thoughts range from passing thoughts such as “I wish I wouldn’t wake up” or “everyone would be relieved without me,” to more specific thoughts about ending one’s life. They are a sign of psychological pain that has exceeded the person’s ability to bear it at that moment, and they have nothing to do with weakness, lack of faith or wanting attention. The World Health Organization estimates that suicide is one of the leading causes of death among young people worldwide, and that prevention is possible when a person finds someone who listens and connects them to help.

10Warning signs to watch for

The US National Institute of Mental Health lists signs that deserve immediate action, especially if they are new or increasing:

• Talking about wanting to die or being a burden to others.
• Talking about feeling hopeless or having no reason to live.
• Talking about unbearable pain or feeling trapped.
• Looking for ways to harm oneself.
• Increased use of alcohol or drugs.
• Withdrawing from people, saying goodbye, or giving away treasured belongings.
• Extreme mood swings, or sudden calm after a period of severe depression.
• Sleeping far too much or too little, and acting recklessly.

11What increases the risk?

There is no single cause, but the risk rises with depression, bipolar disorder and severe anxiety, with alcohol and drug use, with trauma and violence, with loss and acute financial or emotional crises, with isolation, with chronic illness, and with a previous attempt or suicides in the family or surroundings. Several factors combined with a sudden crisis is the most dangerous moment.

12How do you help someone you are worried about?

1. 1
   Ask directly

   “Are you thinking of hurting yourself or ending your life?” A clear question brings relief and does not plant the idea.

2. 2
   Listen without judgment

   Do not argue, lecture or minimize their pain. Say: “I hear you, and I’m here.”

3. 3
   Make the surroundings safer

   Keep extra medications and dangerous items out of their reach if you can.

4. 4
   Connect them to help

   Call 16328 together or a psychiatrist, or accompany them to the emergency room if the danger is urgent.

5. 5
   Follow up

   A call or message in the following days makes a real difference.

A study published in the journal Psychiatry reviewed the available evidence and found that asking people about suicide does not increase suicidal thoughts, and may even reduce them in some. So do not be afraid to ask.

13Safety plan: for yourself, before a crisis

A safety plan is a short sheet you write at a calmer time, with a therapist’s help if possible, and keep on your phone:

• My warning signs: the thoughts and situations that come before a crisis for me.
• What calms me on my own: walking, a shower, prayer, music, writing.
• Places and people that distract me.
• Who I call when I need help: three names and their numbers.
• Emergency numbers: 16328, 123, and my doctor.
• How I make my surroundings safer in hard times.
• At least one reason for me to keep going.

14Treatment works

Treating the underlying cause, such as depression, a mood disorder, trauma or addiction, clearly eases suicidal thoughts. Treatments that have proven helpful include suicide-focused cognitive behavioral therapy, dialectical behavior therapy, appropriate medication for the accompanying disorder, and close follow-up after any crisis. In severe cases a person may need a short stay in a psychiatric hospital that keeps them safe until the crisis settles and treatment begins.