Do suicidal people exhibit warning signs?
Every time Davis and his mother Marcia said good-bye to each other, they performed a simple ritual: it started with her saying “God be with you, son. Your mom loves you,” to which he would reply “me too.” They would smile with affection and part. But on that day, he did something different. Before leaving the car, Davis looked at her and, without waiting for his mom’s words, he said “Mom, I love you very much,” and left, hastily. The following day, Marta received the heartbreaking news of his suicide.
This is what suicidal people do. They behave out of tune. They scream at us - many times through silence - in an effort to express their internal pain. It may come in words, in gestures, in mood swings, in risky behavior, or isolation. Davis tried all of them. Marta told me about problems in school during his early teens, the excessive partying later on, the drugs most of his friends used, and the numerous girlfriends he had in his youth. Sounds like a normal young man trying to find his own identity, right? Not quite.
Apart from interviewing the mother, I also talked to his younger sister, Mayra. I often try to get more than one version of a story because it adds depth and gives a clearer sense of what happened. In this case, it provided insight into what was going on in his life. More importantly, it made it possible for me to trace the warning signs he had exhibited before his death.
According to Mayra, at the age of 14, Davis had a car accident right after his girlfriend ended the relationship. Later, they found a letter in which he had written: “I wish I could vanish from this world.” This made it clear to the family that crashing onto a tree had been an intentional act.
Being able to identify warning signs can be very hard, even when they are verbally communicated. Minutes before leaving the car and saying “I love you, mom,” Davis told his mother that the constant arguments he was having with his wife would sometimes make him wish to... (he completed the sentence by moving his hand across his neck as if he were cutting it open with a knife).
She asked him directly if he was contemplating suicide, and he said: “yes, at least I would stop causing problems to everyone.” Marcia asked him to be patient because, with time, the arguments would pass. Today, she plays this scene in her mind over and over again, asking herself what she could have done differently.
Research shows that most people who die by suicide express their wish one way or another, but we are unable to either notice these warning signs or to assess their risk level. Apart from the verbal ones, which are more easily identifiable, such as “I want to disappear/die,” “life has no meaning anymore,” or “I am a burden,” these messages are often expressed by changes in behavior, mood, and appearance. In a way, they are similar to symptoms of depression: isolation, lack of hygiene, sadness, substance use, sleep dysfunction, mood swings, irritation, lack of pleasure, and apathy.
When it comes to suicide, some specific warning signs represent red flags because when present, they usually mean that the individual has advanced from thoughts to effective planning. This happened with my father, but again, we were only able to see it in retrospect. The day before his death, he paid my sister a visit. She could tell that there was something wrong with him. Every time she mentioned that I would return from vacation in a few days, he would reminisce about a trip we had taken together a few years prior. When a person decides to take their own life, they stop making plans because they ‘know’ that there is no future ahead.
Suicidal people talk about the past because, for them, there will be no tomorrow.
Apart from reminiscing, they organize practical things, especially finances. They pay debts, open joined accounts so that someone else can access their money, discuss the will, etc. The idea is to leave no hurdles for the family. Saying good-bye is also common. They call old friends, family members, and pay unexpected visits to loved ones. I had this experience. One day, a friend called me and I could immediately tell that she wanted to talk to me for the last time. I asked her directly: “are you thinking about suicide?” She fell silent for a few seconds, then burst into tears. It turned out that she had everything planned for the following week.
Another red flag should be raised when the person starts to give away possessions, particularly those with sentimental value. By doing this, they are sending the message that nothing else has value anymore.
Finally, there is one warning sign that frequently baffles those who are left behind: the apparent improvement of symptoms. Time and time again, I have heard mourners say “but he/she seemed to be doing much better.” It may sound like a contradiction, but it actually makes sense. The reason behind the sudden change in mood - when depression seems to be in remission, for example - is the fact that there is no more internal conflict, the ambiguity is gone, therefore, the individual does feel better. The angst is lifted, and as a result, they convey the misleading impression of recovery.
The question is: what should you do in case you identify the signs in someone you know? I will explore this theme in more detail on a future post, but the basic thing to do do is to address it in a straight forward manner. Ask if they are thinking about killing themselves. Try to assess where they are in terms of planning. This is very important because it will define your course of action. Build a support system, in other words, don’t do it alone. Involve other people and, if possible, family members. Finding a doctor may be also important because many suicides are related to mental illnesses that are either undiagnosed or remain untreated.
Finally, one of the most important things to keep in mind is: don’t judge their thoughts and actions. You can’t possibly know what they are going through. Judgment feeds the shame they are likely already experiencing. By doing that, you will make them feel even worse. And remember:
Suicide is rarely associated with a wish to die; it is primarily a desire to put an end to unbearable pain.