Suicidality

The Suicidality is a very serious topic, because in Germany alone more than 10,000 people take their own lives every year. The real figure will certainly be much higher. This means that the number of suicides significantly exceeds that of road deaths per year.

What is suicidality?

A typical symptom of suicidality is thinking or talking about death or dissatisfaction with life or problems. This should be taken very seriously and understood as an alarm signal.
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Suicidality, i.e. a suicide risk, describes a psychological state in which the thoughts, fantasies and actions of the person concerned are aimed at bringing about their own death. This state of affairs can persist, repeat itself or only exist in crisis situations.

In the case of suicidality, a distinction is made between suicidal thoughts (no actual desire to commit suicide) and urgent suicidal thoughts, behind which specific suicidal intentions and plans are hidden. Suicidality is not a disease, but a symptom of an underlying problem.

A psychological problem has become so acute that only despair and hopelessness prevail. Those affected find their life unbearable and therefore want to end it. One possibility to change the current life for the better cannot be recognized in the case of acute suicidality. Suicide appears to those affected as the only way out. Treating suicidality is one of the toughest health care challenges.

causes

There are many different causes for suicidality. This includes:

• Depressive disorder
• Alcohol or drug addiction
• Past suicide attempts
• Suicides in the family or in close proximity
• Personality disorders
• neurotic disorders
• schizophrenia
• Isolation and loneliness, for example in old age
• Workloads
• Unemployment or other reasons that lead to a high degree of hopelessness and a lack of prospects
• Violent environment
• Financial problems
• Insults
• Loss of self-esteem
• Dependence on other people
• Traumatic or stressful experiences such as the loss of a loved one, for example through death or divorce
• Serious or incurable illness

Suicidality can occur as a result of one event, but it can also result from a series of different events. How the loads are experienced individually is fundamentally very different.

Symptoms, ailments & signs

A typical symptom of suicidality is thinking or talking about death or dissatisfaction with life or problems. This should be taken very seriously and understood as an alarm signal. It is a common misconception that people who intend to commit suicide don't talk about it.

Most suicidal people talk about being tired of life or that their life seems pointless to them. In the history of suicidal acts, the mood and behavior of those affected often change fundamentally. It is often observed that they react more emotionally and are prone to strong emotional outbursts, for example fear, sadness, outbursts of anger, feelings of shame and guilt.

The affected person gets into a depressed state. He believes that he can only escape through suicide. A deep hopelessness has set in. Suicidal people often withdraw and communicate less. On the other hand, it is also often observed that people who have decided to commit suicide suddenly appear “relieved” so that they are more communicative and open-minded than before. Giving away property or arranging matters can be an indication of suicidality.

Diagnosis & course of disease

Various aspects play an important role in the diagnosis of suicidality. This includes:

• Constriction, reversal of aggression and suicidal fantasies
• Risk factors include mental illness and disorders, especially depression and schizophrenia (acute phase)
• Addiction
• Psychosocial crises such as separation or death of a loved one
• Hardly any social relationships
• Previous suicide attempts or suicides in the family
• Hopelessness, despair, fear, joylessness, insomnia
• resignation
• Discharge from a psychiatric institution

These factors must be taken very seriously, and with them suicidality. The following applies: the sooner the risk is recognized, the better, because the longer the condition persists, the more the desire to commit suicide can solidify.

Complications

Suicidality and its complications have to be considered in each individual case. It can also be seen as a complication of depression. Suicidality runs the risk of not being recognized or understood. It is not uncommon for depression, in particular, to be invisible to the environment and lead to an increase in psychological stress due to failure to provide help.

The same applies to suicidality, which in such cases often only becomes apparent after a (successful) suicide attempt. In addition, this form of psychological suffering can be very acute, which lowers the inhibition threshold for engaging in emotional acts - autodestructive and suicidal acts - and thus makes intervention by third parties or therapists de facto impossible.

Furthermore, suicidality leads to complications during medical treatment. For example, a reluctance to live can mean that they refuse medication or food. This results in higher risks (accepted by the suicidal), which have legal and emotional consequences for doctors and relatives. Complications can also arise from unsuccessful suicide attempts. Mutilations, brain damage and the like occur and often mean a prolongation of the perceived suffering for those affected.

When should you go to the doctor?

People who are thinking about ending their lives on their own should seek medical or therapeutic help. Persistent listlessness towards life or a feeling of senselessness is worrying. If thoughts of your own uselessness or superfluity arise, these should be shared with other people.

If other people's emotions can no longer be felt, wishes and dreams disappear or hopelessness sets in, the perceptions should be discussed with a doctor. If the person concerned comes to a point in his life where he believes he is a burden for the immediate environment, he should openly address his concerns. If the person concerned is often concerned with ways of ending their own life, help is needed.

If there are concrete plans for how one's own death should take place, there is an urgent need for action. If self-harming acts take place, a suicide note is written or the person concerned begins to terminate existing contracts, should heightened vigilance prevail. If a person expresses clear procedures that lead to their own deliberate death, an ambulance service must be alerted. Otherwise there is failure to provide assistance, which is punishable according to the legal requirements. A compulsory order is issued in the case of a hardened suspicion of suicidality.

Treatment & Therapy

Only a specialist can research the reasons for suicidality and initiate appropriate treatment. The therapy depends on the trigger of the suicide attempt. Often the person concerned has to be treated in a closed psychiatric ward, which often happens against his will in order to protect him.

Antidepressants or mood-stabilizing substances are used in depression. Manic-depressive states are clinically mostly severe clinical pictures, so that a combination of different drugs is required. In the case of suicidality resulting from the life situation, psychotherapy or sociotherapeutic measures are useful. A good relationship between the doctor and patient is always important for successful therapy.

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➔ Medicines against depressive moods & to lighten the mood

prevention

There is basically no urge to commit suicide. Before people have such intentions, a lot has usually happened and this is where it is important to intervene and help. If there is an emergency, help must be obtained immediately and the emergency doctor called immediately. It is important to let them know that the victim is suicidal.

Those who recognize signs of suicidality and act can save lives. Basically, it is wrong to make reproaches or reproaches to the other person, to downplay or trivialize the situation. Instead, the other person's situation should be taken seriously, as it just seems hopeless to them. The person concerned should not be left alone in the situation, but receive support and sympathy.

Aftercare

Suicidality is a phenomenon that must be taken very seriously and for which the therapy should be accompanied by close follow-up care. Contact persons for this are psychiatrists or psychologists as well as the family doctor. The reason for suicidality plays an important role in aftercare. It is important to know whether a single traumatic event is the cause of suicidal intentions or whether depression is the cause of those thoughts.

It is important to have a social network that the person concerned can always turn to if problems arise or if there is any other need for discussion. Relatives and friends can also do this to a certain extent. It is often advisable to visit a self-help group. Here, those affected can share valuable experiences and provide helpful tips in a protected environment.

Hobbies and social contacts in leisure time are also well suited to accompany the suicidality follow-up. Anyone who feels fears and restlessness can also reduce this with relaxation methods. This is best learned in the course and then practiced regularly at home on your own. There is a wide range of options: Progressive muscle relaxation, autogenic training or imaginary journeys, for example, are available. Yoga can also help. Through the combination of body and breathing exercises, relaxation and meditation, it has a holistic effect on body, mind and soul.

You can do that yourself

Statements about the desire to commit suicidal acts can be extremely stressful for the social environment and lead to situations of excessive demands. For this reason, extreme caution should be exercised when dealing with this sensitive issue.

If you intend to commit suicide, you are well advised to seek professional help. Working with a psychotherapist is advisable. Often the person affected does not manage to overcome the emotional low on their own. It is always advisable to be open about your own thoughts and emotions with people you trust. If the desire to end one's own life becomes entrenched, however, professional help is needed.

As soon as concrete plans arise from the desire to commit suicide, action must be taken. Under no circumstances should the person be alone or be in areas or situations where the hopelessness seems to be increasing. In an emergency situation, the person concerned can alert the rescue service himself or establish contact with a pastoral care center.

In addition, it can be perceived as pleasant and helpful when there is an exchange with other people who were previously at risk of suicide. There is a maximum of empathy here, so that the person affected can find a good conversation partner who has experienced his stressful situation himself and can point out ways out.