We talk to psychiatrists about suicide prevention and how to journey with a friend or family member who needs help.
We all have low points in our lives, when nothing seems to go our way and problems feel insurmountable. As extreme stress is exacerbated by physical, mental or emotional issues, it’s not unusual to have suicidal thoughts. Just know that you’re not alone.
A 2021 survey of 1,000 Singaporeans revealed that 24% felt anxious, 21% were depressed, and almost 40% said they had considered suicide before. However, suicide is preventable, and you can be of help to friends or family members in their time of need. We chat with two experts on the signs to watch out for and how you can support your loved ones.
How does depression become suicidal ideation – when is it too much?
Disturbed sleep. Low energy. Mood swings. Loss of interest in everything. Life becoming meaningless. Feeling useless, hopeless and helpless. According to Dr Joseph Leong, a senior consultant psychiatrist at Promises Healthcare, those who suffer from depression may experience these things and withdraw from their daily activities. “They lose interest in what they usually enjoy and can’t find joy,” he says. They may even talk about what life would be like when they’re no longer around.
When the distress starts to feel overwhelming, that’s when suicidal thoughts may make an entrance. Dr Joseph says it’s important to have open communication, as well as to show care and concern – especially if the person develops a change in their normal regular routine.
Be aware: Common causes for suicide in Singapore
It may look different for each person, but most cases see an underlying psychiatric condition, often not formally diagnosed, that’s aggravated by stress factors. Dr Adrian Loh, a senior consultant psychiatrist at Promises Healthcare, breaks it down for us based on various age groups.
For youths, the reasons can range from difficulties in relationships and broken friendships (for example: being bullied in school or online) to low self-esteem from perceived underachievement (for example: failing in classes). This can result in feelings of loneliness, which may be worsened by absent, busy or critical parents.
Adults may experience similar stressors, with the add-on of new factors like unemployment, financial difficulties, marital breakdown and caregiver distress. Meanwhile, the elderly may feel despair due to poor health, the fear of being a burden to loved ones, or a lack of meaningful engagement after retirement.
Keep an eye out for these signs of suicide
Watch out for the warning signs, which can be communicated verbally, in notes or on social media, says Dr Adrian. These include farewell messages to friends and family, words that convey hopelessness, and the expression of a lack of reason to live or desire to end their life.
There may also be changes in behaviour, such as giving away their possessions, tying up loose ends like loans or debts, and increased alcohol or substance use. Social withdrawal is another warning sign, amplified by a lack of self-care and a surge in aggression or impulsive acts.
If you’re the first to discover your loved one is struggling, Dr Adrian’s advice is to remain calm, be empathetic and avoid the tendency to scold or guilt-trip the person as that may cause them to clam up.
“Approach the person sensitively and find ways to check in on the person’s situation,” he explains. “The presence of suicidal thoughts and plans should be addressed – this has been shown to be helpful and it doesn’t increase the likelihood of a suicide attempt, contrary to what some people worry about.”
So, how can you support a loved one who has suicidal thoughts?
Empathy is essential! Dr Adrian suggests “expressing a willingness to try to see things from that person’s perspective.” Keep in mind – that doesn’t mean you agree with their wishes. Instead, ask questions and listen with your full attention and a genuine desire to understand them. Sometimes all they need is a compassionate friend to help them feel heard and understood, so beware of dismissing their problems with over-simplistic reassuring statements.
Practical support is another way you can alleviate your loved one’s burdens. These simple gestures can be as small as arranging food delivery, running errands, doing chores, cooking meals or driving someone to their appointments. It’ll show how much you love and care for them, too.
Suicidal feelings may come and go, according to Dr Adrian, so it’s important your loved one knows they should inform someone if their suicidal thoughts grow stronger. It can be handy to have the number of a suicide helpline on hand or identify the nearest hospital so you’re prepared for any situation. You can also encourage them to seek professional help and speak to a psychiatrist, psychologist, therapist or counsellor if needed.
Dr Joseph says the key is to avoid judging those who are struggling, ignoring the warning signs, or belittling mental health issues. He shares the L.I.F.E. model from Caring for Life, a four-hour training programme that equips you to respond to anyone in distress with immediate support. When dealing with suicidal ideation, it’s crucial to “Listen with empathy; Inquire directly about their feelings and suicidal thoughts; Find lifelines; and Engage professional help.”
Equip yourself with the proper skills to help
Anyone can be a community carer as long as you’re interested in gaining the necessary skills to help! Keen to learn more? Sign up for the free Zoom training webinars by Caring for Life on 12 May 2023, 6pm to 10pm, or 13 May 2023, 9am to 1pm. If you’d like to talk to a psychiatrist, psychologist or therapist, get in touch with the experts at Promises Healthcare.
This post is in partnership with Promises Healthcare.