Suicide: Our Responses Can Make All The Difference

Myths & Realities of Suicide | Warning Signs of Suicide | Supporting Individuals Struggling with Suicide

“I want to kill myself,” your friend comes to you and says one day.

Your eyes widen slightly, at that very moment, you’re not sure how to respond. Should I take this seriously? Why is he suddenly bringing this up? He’s usually quite funny and outgoing. This is quite drastic behaviour – maybe he’s just feeling emotional. On the side, you also wonder — what could this person possibly be going through that would lead him to consider suicide? He’s been living such a good life — a caring family, a well-paying job, and the high regard of those around him.

You did not have much time to think about a response, though, given that it was a live conversation.

“Hey, are you serious? Come on, it’s not that bad,” or
“Hahaha me too 😛 ” or
“Um… Cheer up! You actually have many things that others don’t; think about everyone else who has it worse.”

Looking back, while you realised that those were probably not the best responses, you remember the discomfort you felt with that statement, and wonder what you could have said to help your friend better.

…

Perhaps you identify with the experience of uncertainty or fear when it comes to interacting with someone who confides in you about their suicidal thoughts. That person might have been someone who has been struggling with depression for a long time, or someone who seemed to “have it all”. More often than not, there’s more to their life than what meets the eyes. Everyone struggles in their own ways, even if they don’t show it.

Suicide in Singapore

Suicide is a serious problem that exists in every society, and it has become a growing concern with a total of 452 suicides reported in Singapore, the highest since 2012. In particular, the highest number of suicides were from the elderly – a jump of 26% from 2019, the highest since 1991. From 2019, there was a 7% increase in suicide deaths for middle-aged adults between 30 to 59 years old and youths aged 10 to 29 years old.

Of an equivalent concern is the finding from a survey conducted this year by Wunderman Thompson, a marketing communication agency, that 4 in 10 of the respondents had contemplated suicide at some point in 2020. Think about your friends, family, colleagues, or people you know — out of every 10 of them, approximately 4 of them could be contemplating suicide.

Unfortunately, while we see an alarming rate of suicide ideation and increase in suicide rates across all age groups in recent years, the stigma associated with suicide remains strong.

Despite its prevalence, however, many unhelpful misconceptions continue to surround suicide and suicidal ideation. Here are some of them:

Myth

Reality

People who talk about wanting to commit suicide simply want attention and will not act on it.

Most often, the articulation of suicidal intentions are a cry for help, and should not be dismissed as just someone who is seeking attention. Repeated ignorance of distress signals can further reinforce their maladaptive beliefs and thoughts, which may eventually culminate in a suicide attempt. Any life lost is one too many; it is important to take every and any suicide threat seriously.

Asking someone if they are thinking of suicide may plant the thought in their head.

Clarifying the intentions of someone in a state of emotional distress is most often helpful rather than harmful. With the stigma surrounding mental health today, talking about suicide can be difficult. Thus, first opening up the conversation tactfully signals a willingness to hear more of their most negative thoughts and emotions which they might be afraid of sharing with others. This space you hold for them to be honest about where they are at is most healing.

More often than not, the question about suicide does not plant the thought in a person’s mind; rather, it allows those who are struggling with it a space to talk about it.

Suicides are acts of impulse.

The act of ending one’s life goes against our innate survival instinct. Often, the gap between suicidal ideation and completion comprises stages of ideation, deliberation, and attempts. While there might be some instances of impulsive suicide attempts, in many cases, suicides occur after long seasons of making plans, along with feelings of continued despair.

At various points, timely and effective intervention would have been really helpful in preventing the suicide attempt.

Suicidal people all look moody and depressed.

Most of us conceptualize the “suicide look” as one of despair and sadness. However, people who seem to be happy and doing well on the outside might also be struggling with suicidal thoughts.

Suicidal people want to die.

Suicidal people do not necessarily want to die. It is often the last option in attempting to seek an end to the emotional pain that they are experiencing. Having people come alongside them to journey with them through their pain and explore alternative options can help prevent suicide attempts.

With these misconceptions cleared, how do we actually go about supporting our family, friends and loved ones better?

Step 1: Recognise the warning signs of suicide so that we can provide timely support

There are 3 aspects we can take note of:

Speech

‍They talk about death and dying a lot
They express thoughts about feeling like a burden to others (e.g., “My family will be better off without me”)
They express thoughts of hopelessness or having no reason to live (e.g., “There’s no point to my life anymore”)
They frequently express feelings of emotional and/or physical pain

Actions

Giving away treasured possessions and saying goodbye
Researching suicide methods
Writing suicide notes (including emails/diaries/blogs)
Sudden social withdrawal
Sleeping too little or too much
Lack of regard for social commitments and obligations (eg. Not going to work, lack of care for personal hygiene, etc.)
Engaging in risky behaviour (e.g., reckless driving, increasing use of drugs and alcohol)
Becoming very quiet, spacing out a lot

Mood

Extreme emotional outbursts (anger, sadness, irritability, recklessness, uncharastically happy)
Sudden lifts in mood and sense of peace, after long seasons of sadness and pain (could signal that the individual has made peace with the thought of death)

Step 2: Responding to suicidal individuals with compassion and without judgement

Supporting suicidal individuals: Unhelpful responses

It takes courage for one to approach others to reveal their vulnerabilities and thoughts on suicide. If they say things like “my life is meaningless” or “living is so painful”, don’t dismiss them or make light of the situation. Very often, this is a cry for help and they may be near their breaking point, and have nothing or no one else to turn to.
There are some comments or questions that we may reflexively say or ask such as

- “There are bigger problems out there,” or “Other people have it worse than you”. However, these comments could hurt the recipient further as they invalidate their struggles and experiences.
- “Your family would be devastated if you took your own life!” This adds more pressure and causes more guilt and pain for the person you are trying to help.
- “I understand what you’re going through.” While we might have gone through similar experiences, we seldom really understand what another person is going through, as each person’s experience is different. In saying this, we also run the risk of making the conversation about us and our past experiences.

Supporting suicidal individuals: Helpful responses

Respond empathetically without judgement as they share their experience
- Rather than trying to “fix” their negative feelings by offering advice on what they can do to feel better, empathetic responses involve you placing yourself in their shoes and acknowledging their pain.
- Some examples of empathetic responses are: “That sounds so difficult.” or “you sound really disappointed with how life has turned out”.
Rather than saying that you understand how they feel, a more helpful approach is to ask open-ended questions that allow them to share their experiences from their point of view.
- Some examples of open-ended questions you could ask are, “You mentioned ___, tell me more about it” or “When you talk about feeling very down, what are some thoughts that usually cross your mind? What usually happens when you feel these strong negative emotions?”
Remind them that you care for them and you are with them
Ask them how you can help them
Encourage them to seek professional help
- At times, our loved ones need a level of support and guidance beyond what we can offer. Each person has their role in helping the suicidal individual recover; while you are a friend or colleague who provides a constant supportive presence, mental health professionals are trained to help them process, reframe, and correct deeply ingrained thoughts, beliefs, and experiences that would be key in helping them live well-adjusted lives in the long term.

It’s important to remember that anyone can have thoughts on suicide. No matter how strong a person seems or how good a person’s life appears to be, there are often underlying struggles that he or she may be dealing with that many of us are not aware of. Recognising and responding to suicidal individuals in an appropriate way with compassion and respect can make all the difference.

“Sometimes it takes only one act of kindness and caring to change a person’s life.” – Jackie Chan

References:

Afridi , M., & Nadilo, R. (n.d.). WELL-SERIES: Singapore. Wunderman Thompson. https://www.wundermanthompson.com/insight/well-series.

Gene, N. K. (2021, July 8). 452 suicides reported in Singapore in 2020 amid Covid-19, highest since 2012. The Straits Times. https://www.straitstimes.com/singapore/452-suicides-reported-in-singapore-in-2020-amid-covid-19-highest-since-2012#:~:text=SINGAPORE%20%2D%20A%20total%20of%20452,increase%20from%202019’s%20400%20cases.

Singapore Reported 452 Suicide Deaths in 2020, Number of Elderly Suicide Deaths Highest Recorded Since 1991. SOS. (2021, July). https://www.sos.org.sg/pressroom/singapore-reported-452-suicide-deaths-in-2020-number-of-elderly-suicide-deaths-highest-recorded-since-1991.

Tham, D. (2021, July). Suicide cases in Singapore highest in 8 years amid COVID-19 pandemic. CNA. https://www.channelnewsasia.com/singapore/suicide-highest-record-elderly-mental-health-isolation-covid-19-1984716.