It is well established that a diagnosis of bipolar disorder increases the risk of suicide…
After a Suicide Attempt: What Now?
If you’re in agony over the suicide attempt of your loved one, no doubt you’re perplexed as to the best course of action to take. What should you expect? What should you do? In fact, this is the most critical time – immediately after an attempted suicide. But, what, exactly should you do now?
The first thing to do is to ensure the person is stable. This will most likely require hospitalization, depending on the method of the attempted suicide and how life-threatening the situation is at the present. The suicidal person cannot be left alone during the days immediately following the attempt. They are not rational, and, contrary to popular belief that once they’ve tried to commit suicide and failed, they won’t attempt it again, the truth is that many times they are likely to try it again at some time in the future.
For some persons admitted to the hospital following a suicide attempt, the greatest risk is the first few hours after admission. If possible, stay with the person as long as possible during visiting hours while he or she is in the hospital. If you can’t be there for the duration, ask others to help spell you. The idea is to monitor what’s going on with your loved one. This means asking lots of questions of the doctors and nurses, helping to comfort your loved one, and getting help for him or her if needed.
Suicide prevention experts caution that the person who has already attempted suicide may try death by suicide while they’re in the hospital. For others, this risk is greatest when they return home from the hospital.
Again, make sure that the individual is not left alone nor has access to any means of making good on their intention to do themselves in. This means sweeping the house for any prescription and over-the-counter drugs, poisons, knives and sharp objects, ropes and cords and, especially, firearms. If your loved one has been living alone, it’s best if you take him or her into your own home – or move in with them – to ensure their immediate safety.
If medications are prescribed, make sure that the individual takes them as directed. Many of the medications will help to stabilize mood, especially depression.
Pay attention to your loved one’s diet. Make it a point that he or she takes vitamins and supplements as recommended by the doctor in order to build up strength that’s probably been depleted. Often times, the suicidal person has neglected themselves to the extent that they are seriously malnourished.
Let Them Talk
During the time after the suicide attempt is when you want to engage the person in conversation as much as possible. Let him or her talk – as long and as often as they wish. In your comments, it’s important not to be judgmental or critical of the person. That is counter-productive and will discourage any opening up. It’s also very important to show how much you love the person. He or she is most likely devastated, feeling incredibly lost, ashamed, guilty, fearful of the future, and afraid, most of all, that you will withdraw your love.
Therapy Should Be First on the List
Your loved one needs professional counseling by a licensed and certified therapist. This must be primary on the list of short- and long-term priorities. In addition to individual counseling, group therapy may be recommended. Make sure the person attends every counseling session. Don’t allow them to slack off, since therapy takes time to work – and it’s often difficult and painful for the individual. The tendency is to minimize the risk, saying “I’m okay now. I don’t need any more therapy.” Don’t buy into this. Push, gently, for continued therapy.
Regular medical checkups are also a good idea. Following the suicide attempt, physical and/or mental changes occur, and healing takes time. If drugs and alcohol were also part of the individual’s lifestyle, these conditions need treatment as well.
Make Important Lifestyle Changes
Obviously, things can’t go back to the way they were before. This often means a severe change of lifestyle, but not always. In any case, some things have to change. Where there was no counseling, there now has to be. The suicidal person will not “get better” on their own. The reason they got to the point of despair, enough to want to end their life, won’t just go away. The underlying causes may not even be known or acknowledged by your loved one. All this has to be dealt with, and the best person to help in the recovery is a professional therapist.
Through therapy, your loved one will begin to discover the reasons that led him or her to attempt suicide. Depression, anxiety, fear, shame, disgust and other emotions will surface that are very powerful and very difficult and painful to deal with. The therapist will suggest short- and long-term behavioral changes that will help your loved one to better adjust to life.
There is no miraculous pill that will quell suicidal thoughts. There isn’t any set time period during which the person will be healed. Every person heals on their own timetable. Healing can’t be forced, no matter how much you or your loved one wants it.
Exercise plays an important part in rebuilding a healthy physical body. You, and other family members and friends, can help by encouraging your loved one to engage in sports, running, hiking, swimming, working out, or any strenuous physical activity. Be sure that this vigorous exercise takes place a minimum of four days a week, and for 30 minutes to an hour each day. Exercise produces endorphins, the body’s natural feel-good chemicals, which help to reduce feelings of depression.
Be aware that many persons who attempted suicide become withdrawn. They don’t want to talk. They don’t want any contact with others, including anyone from the outside world. Respect that feeling, but do encourage your loved one to go out and participate in activities again as he or she is ready to. Make sure you’re not too pushy on this point, however, as that can be misconstrued and backfire. When they are ready, take them out to activities and events – but don’t go anywhere that’s too stressful. Your loved one won’t be ready for that for quite a while.
Be Alert for Suicide Warning Signs
After the suicide attempt, it doesn’t mean you’re home free – no matter how much your loved one tells you not to worry. Although some individuals do not exhibit any warning signs prior to an attempted suicide, about 75 percent do show one or more signs. You do need to be alert for any of the following warning signs of suicide – as they can occur anytime during the days and weeks after the initial attempt:
- Depression or sadness all the time – Note that suicide prevention experts say untreated depression is the number one cause of suicide.
- Talking or writing about death or suicide
- Writing a will
- Giving away possessions, especially those the person holds most dear
- Dramatic mood changes
- Change in eating or sleeping habits
- Loss of interest in activities – especially those previously enjoyable
- Poor work or school performance
- Abuse of drugs or alcohol
- Change in personality
- Withdrawal from family members and friends
- Feelings of hopelessness, being helpless or feeling trapped
- Demonstrating strong feelings of anger or rage
- Acting impulsively or recklessly
- Feeling excessive shame and/or guilt
If your loved one is in immediate danger, call 911 without delay. Suicide prevention lifelines are available 24/7 – so make use of them if your loved one needs to talk with someone urgently. Call 1-800-SUICIDE (1-800-784-2433) or the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or in Spanish, 1-888-628-9454.
Here is a link to suicide prevention hotlines in the United States, as well as some International locations: //www.suicide.org/suicide-hotlines.html.
Resources and Help
Keep yourself informed about things to do for your loved one. Helpful books and literature are readily available from a number of sources. The Feeling Blue Suicide Prevention Council is a non-profit community service organization serving Pennsylvania and the Tri-State Area. Their website contains a lot of helpful information and links. Here is a link to their booklet, “After an Attempt: The Emotional Impact of a Suicide Attempt on Families.” The booklet covers important Do’s and Don’ts, dealing with a traumatic event, what to say to the attempt survivor, ways the family can communicate their feelings, how an attempt affects spouses, siblings and parents, and additional resources.
The U.S. Department of Health and Human Services (HHS) National Suicide Prevention Lifeline has a downloadable booklet, “After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department.” The booklet covers what happens in the emergency department. First, there’s an assessment. The doctors determine any psychiatric or medical conditions present, determines if they are or have been treated, and if the suicidal thoughts or actions are the result of recent change or longstanding behavior. Next, the doctors seek to find out what the person did to harm themselves, and if there were previous attempts. They also ask if there are any current stressors, and/or anger in relationships. Doctors need to know what support systems there are, and who is or will be providing treatment, and what treatment programs are a good match for the individual and the family. The booklet further covers how you can help the emergency department, next steps after the emergency visit, what you need to know following the emergency department visit – how to keep your loved one safe, reduce risks, creating a safety plan, self care, moving forward and phone numbers for support groups.
The National Suicide Prevention Lifeline website has links to various suicide prevention organizations and peer support organizations where you can find more resources and help. Many of them have online libraries with downloadable publications, booklets and information to help family members following a suicide attempt by their loved one.
The Depression and Bipolar Support Alliance (DBSA) is the leading patient-directed organization in the United States focusing on depression and bipolar disorder. They operate a toll-free referral line 1-800-826-3632 and have a grassroots network of more than 1,000 patient-run support groups across the country.
The National Alliance for the Mentally Ill (NAMI), a nonprofit, grassroots, self-help, support and advocacy organization of consumers, family and friends of people with mental illnesses, has information on mental illnesses, programs, support groups, medication and treatment, and more. There are more than a thousand local affiliates in 50 states.
The Center for Mental Health Services (CMHS), of the Substance Abuse and Mental Health Services Administration (SAMHSA), maintains a mental health services locator, which you can use to help find services, facilities and resources in your state.
Should You Worry?
It’s natural to worry that your loved one may try another suicide attempt. But you can’t let this worry define you or derail your efforts to get professional help for him or her. You may also wish to undergo counseling yourself, to be better able to deal with the situation and feel better about helping your loved one on his or her journey to healing.
It’s important that you have your own support system in place. You can’t always be watching over your loved one, fearful that another attempt is imminent. This will just add to your stress level and make it impossible to maintain a serene environment. Get help around the house – whether that entails a friend or other family member coming over to be present while you take some needed away time, or while you work, or to transport your loved one to and from treatment or group meetings, or some other reason.
Remember that one of the most powerful emotions is love. The more you can show how much you love your family member that you nearly lost to suicide, the better off you both will be. Encourage other family members to be understanding, nonjudgmental and patient as well. It won’t be easy, and sometimes it may seem next to impossible. But your love and understanding will go a long way toward helping your loved one on the road to recovery.