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Suicide: signs, symptoms, and how you can help

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Depression and the intrusive thoughts of taking one's own life is always a topical discussion, but even more so right now following the deaths of singer Scott Hutchison, designer Kate Spade and chef Anthony Bourdain.

The topic has also been recently explored in a storyline on Coronation Street, where popular and cheerful Aidan takes his own life. It's a storyline that aimed to bring to light that the symptoms of suicide are not always obvious.

Suicidal thoughts can affect anyone, from any walk of life. Depression is a mental illness that does not correlate to popularity, wealth or success. Therefore, even the happiest appearing person can be suffering in silence - so it's important to know the subtle (and sometimes, not so subtle) signs to look out for.

Signs and symptoms

Those who are distressed and at risk of suicide can display a wide range of symptoms, in any combination, and some people may suffer from more than others. One of the clearest and most obvious signs to look out for is the expression of suicidal thoughts, such as "I don't want to live anymore" and "you'd be better off without me". These can sometimes be brushed off as colloquial terms of phrase, but in a suffering person, they are the biggest warning sign.

Another common symptom in people is a complete loss of interest in the world around them. This especially includes loss of interest in activities, music, television shows etc. that they once enjoyed. This detachment to their surroundings can often be in 'preparation' for taking one's own life - it's another alarm bell that should start ringing.

Has your friend starting saying goodbye more often, or in more depth? Did they give you a long hug after your weekly coffee, where they usually wouldn't? Have they reconnected recently with old family and friends, as if to say goodbye?

Other symptoms include (but are not limited to): the increased use of drugs and alcohol, risk-taking behaviour, agitation and dramatic mood swings, lack of self-care, weight loss, irregular sleeping patterns (sleeping too much or too little), giving away possessions and tidying up affairs.

The people most at risk of suicide are those who have attempted to take their own lives before, those who have self-harmed, and those who have lost someone to suicide.

How to help someone who is suffering

It is possible to help someone who is suffering from suicidal thoughts, and decrease the risk of them taking their own life. Simply talking to someone can save a life. Confidently and directly asking someone "are you having thoughts of suicide?" may seem brash, but can be a way to trigger a response as to how this person is feeling. It is a myth that talking about suicide and using the word itself can encourage it!

Tell this person that you care and want to help. It is important that you do not pass negative judgement, or appear worried. Remain calm and confident. Express empathy toward this person, but remind them that suicidal thoughts are the product of a treatable mental illness. You may also want to remind them that they do not need to follow through on suicidal thoughts.

If you can, encourage the person at risk to do most of the talking. You constantly talking at them may not help, but be sure to remain calm, confident and approachable at all times. Encourage them to chat with you about the specific things, if there are any, that have triggered these feelings. You could discuss ways that you could make these better, but do not try and outright solve the problems.

Someone who is feeling suicidal in the moment should not be left alone - stay with them. If you can't, find someone else who can. In addition to this (not in replacement), it may also help to give this person a number for a helpline, where they are able to speak to someone trained to help.

In the UK, some helplines are:

Samaritans - 116 123
CALM - 0800 58 58 58
Papyrus - 0800 068 41 41
Childline - 0800 1111
The Silver Line - 0800 4 70 80 90
NHS - 111 (this is not a helpline, but may be able to direct this person to support)

If it appears this person has attempted suicide or seriously harmed themselves, for example deeply cut themselves or taken a drug overdose, ring 999.

While staying with the person at risk, you can ring their GP or out of hours service for an emergency appointment, contact their Community Mental Health Team, encourage them to ring one of the above numbers, or go to the nearest A&E department where they can be seen by a professional.

What to do if you're suffering

If you feel like you're suffering from urges to take your own life or seriously harm yourself, Mind has some great tips on how to keep yourself safe both immediately and in the long run.

In the moment, where you need to help yourself immediately, try to focus on getting through the next five minutes. Reward yourself for every five minutes that pass. To distract yourself, try writing, drawing, listening to music, playing a game on your phone. One user on Mind suggests drawing on Weave Silk, while another suggests watching funny dog videos on YouTube. Hold an ice cube in your hand until it melts and focus on how cold it feels, tear something up into hundreds of pieces, or take a cold shower.

Focus on your senses - name five things you can see, hear, touch, smell or taste. Remove anything you could harm yourself with, or if you're around someone, you can ask them to do it for you. It's also important to tell someone how you are feeling if you can - whether it's someone close by or just through a phone call or text - even a support worker on the end of one of the above helplines.

Challenge your own thoughts. Make a pact with yourself that you won't follow through with these urges for today. Keep a diary and look forward to events you have planned with friends and family. Make more plans! If you feel able to, plan to get the support you need.

In the long-term, you can make a safety plan. A safety plan is something you create for yourself to use if you find yourself feeling suicidal again in the future. It could include the following:

- A list of your warning signs - what you need to look out for within yourself that suggests you're struggling

- A list of your coping strategies - what has worked in the past to help these feelings pass?

- The names and contact details of people you want to speak to while feeling like this - it could be family members, friends, a doctor or helpline.

- What you need to do to make your surrounding environment safe - what do you need to remove from where you are?

You can make this yourself (while in a calm state of mind) or find a template online.

Some people like to make 'happy boxes' full of comforting pictures and objects to look through when these feelings are high, while others have a very extensive list of activities they can do to keep distracted and allow time to pass.

Take each day at a time, allow yourself to feel what you're feeling (don't suppress!), learn what triggers these feelings but never blame yourself. Know you deserve the help and support you need and are worthy of a life. There is no shame in getting support.

Mental health issues affect 1 in 4 of us. Be kind, be aware and be supportive.

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