Recently, I’ve been reading about Kurt Cobain, including his final days. There are those who think Cobain was killed, but I’m convinced he killed himself without any help from anyone.

I know this because there were signs of his intent all over the place. He was constantly in physical pain, he had mountains of stress on his skinny shoulders, he did drugs and, most importantly, he’d tried again and again.

Knowing the signs that appear on the road to suicide is key to staying alive. I don’t know if Kurt knew the signs, but they are predictable and it’s essential that those of us living with mental disorders—and the people who love us—can recognize them.

Who is most at risk?

The National Institute for Mental Health (NIMH) lists these risk factors:

• Depression, other mental disorders, or substance abuse disorders.
• Family history of a mental disorder or substance abuse.
• Family history of suicide.
• Family violence, including physical or sexual abuse.
• Incarceration, being in prison or jail.
• Being exposed to others’ suicidal behavior, such as that of family members, peers, or media figures.
• Recent trauma or life crisis.

How to tell you are a danger to yourself

Some of the signs that you may be suicidal are fairly obvious, like wanting to end your life. Others may not be so easily identified. The NIMH lists these:

• Excessive sadness or moodiness: Long-lasting sadness, mood swings, and unexpected rage.
• Hopelessness: Feeling a deep sense of hopelessness about the future, with little expectation that circumstances can improve.
• Sleep problems.
• Withdrawal: Choosing to be alone and avoiding friends or social activities also are possible symptoms of depression, a leading cause of suicide. This includes the loss of interest or pleasure in activities the person previously enjoyed.
• Changes in personality and/or appearance: A person who is considering suicide might exhibit a change in attitude or behavior, such as speaking or moving with unusual speed or slowness. In addition, the person might suddenly become less concerned about his or her personal appearance.
• Dangerous or self-harmful behavior: Potentially dangerous behavior, such as reckless driving, engaging in unsafe sex, and increased use of drugs and/or alcohol might indicate that the person no longer values his or her life.
• Sudden calmness: Suddenly becoming calm after a period of depression or moodiness can be a sign that the person has made a decision to end his or her life.
• Making preparations: Often, a person considering suicide will begin to put his or her personal business in order. This might include visiting friends and family members, giving away personal possessions, making a will, and cleaning up his or her room or home. Some people will write a note before committing suicide. Some will buy a firearm or other means like poison.
• Threatening suicide: From 50% to 75% of those considering suicide will give someone — a friend or relative — a warning sign. However, not everyone who is considering suicide will say so, and not everyone who threatens suicide will follow through with it. Every threat of suicide should be taken seriously.

What to do when you recognize the signs.

It isn’t just threats of suicide that should be taken seriously; take every self-harming thought you have seriously.

• Talk to someone.

The United States has a national suicide hotline: the National Suicide Prevention Hotline 1-800-273-TALK (8255). It’s available 24/7 and all calls are confidential and toll free. Other countries maintain suicide hotlines as well.

• Talk to a friend.

At my most suicidal, I called a friend who talked me out of the crisis.

• Wait.

Decide to stay alive longer. Even if just for a minute, wait. Every minute gets you closer to staying alive.

• See a mental health professional.

The day after my crisis, though I felt better, I knew I needed help. I found a psychiatrist who helped me see why I thought my life was hopeless and put me on the road to making positive changes.

• Get rid of any possible means of harm, especially guns.

Absolutely have no guns or rifles accessible. Guns are a permanent solution to a temporary problem.

• Make a distraction box or reasons to live list.

Fill the box with things that lift your mood, like music and pictures. Write down all of the things you’d miss if you were gone, like laughing with your kids. Anything that you value should go in the box or on the list.

• Have a plan for staying alive.

Your distraction box and reasons to live are part of a larger plan. Before you act on harming yourself, decide what you’ll do instead. Write it down and keep it where you can access it easily. Make sure your loved ones know where it is.

Millions of people have suicidal thoughts and live through them. In fact, survivors of suicide attempts far outweigh those who commit suicide. From 1977 to 2001, the Center for Disease Control estimates 4.45 million Americans are survivors of suicide attempts; no one can know how many people think of killing themselves and never act on it.

Suicide is a choice and you can choose not to act on it. You can choose to stay alive.

 

Sources

The National Institute for Mental Health

Mind.org.uk

United States Census Bureau