Deaths by suicide are mostly difficult to prevent. The signs and patterns of suicide are not always open for all to see, which makes it difficult to help someone who is suicidal. Dr. Chris Hart, a psychologist based in Nairobi, says that this is because it is extremely difficult to spot a person on his way to committing suicide.

“Someone looking to commit suicide is hard to identify. Everything about them will look right until the very last moments when they engage in illogical activities,” he says. This means that you may not always see the signs and patterns of suicide.

He adds that it is only an extremely few people who will commit suicide on impulse. “People who commit suicide usually have triggers that have been brewing for some time waiting to go off. These men will seem happy and lead seemingly normal and happy lives. But inside, they will be heavy laden with stress and depression,” he says.

This is echoed by a new study that was conducted by the National Institute of Mental Health (NIMH), US, and published in the journal JAMA Network. The study examined the signs and patterns of suicide.

Shockingly, it found out that people who deliberately harm themselves are more than twice as likely to commit suicide over the next twelve months. On the other hand, people who show suicidal ideation are 31 per cent more likely to end up omitting suicide after professional treatment over the next one year.

“Patients with bipolar disorder, depression, or alcohol disorder also have a remarkably high risk of suicide,” said Dr. Sidra Goldman-Mellor who led the study.

Alarmingly, according to the World Health Organization (WHO), Kenya has so far failed to come up with a reliable register for deaths by suicides.

A research report that was conducted by KEMRI and Wellcome Trust suggests that the criminalization of the act of suicide by the penal code and the social stigma that is associated with both actual deaths by suicide and attempted suicide are the primary reasons why accurate suicide reports are hard to come up with in Kenya. Globally, WHO estimates that one person dies from suicide every 40 seconds.

The signs and patterns of suicide

At the same time, an individual seeking to commit suicide will try to rationalize their resolution and means. “The pain of existence often becomes too much to bear and their state of depression warps their thinking into ideas such as ‘They’ll be better off without me,’ in order to rationalize their suicide,” says Dr. Alex Lickerman, the author of The Undefeated Mind.

In many given instances, someone who has gone suicidal will tend to lose their conscious and sub-conscious sense of self preservation. In its place, they will be imbued with self-hatred, shame and self-degradation. But all along, a suicidal person will have been crying out for help.

“These people don’t usually want to die but do want to alert those around them that something is seriously wrong. In some cases, they choose methods they think can’t cause death but which end up fatally, like swallowing poison or high doses of a drug,” says Lickerman.

The research by NIMH says that the time an individual turns suicidal, their state of depression will have spiraled into a severe and pervasive sense of suffering and belief that escape from suffering is hopeless. One of the fastest rising patterns of death by suicide includes suicide and homicide.

“We have cases of filicide-suicide or femicide-suicide, where a perpetrator commits suicide after committing murder,” says Dr. Boniface Chitayi, a consultant psychiatrist based in Nairobi. The study by NIMH also says that one of the most effective ways to avert death by suicide is by following up on high risk patients over the next one year, during which the probability of suicide is high.

This includes patients who talk or idealize suicide, patients who attempt suicide, or patients who deliberately inflict harm unto themselves including by means of drug overdose.

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How to help someone who is suicidal: What not to say

Suicide is selfish

Once you spot the signs and patterns of suicide, you will need to be careful about the way you react. The last thing a person who is suicidal wants to hear is how selfish they are by contemplating or going suicidal. According to psychologist Patrick Musau, this will come across as a condemnation and will trigger more feelings of guilt.

Many people have bigger problems but they aren’t suicidal

This form of comparison will usually worsen their self-condemnation, regardless of how true it is. “Your loved one will probably have felt the same way, but with shame. They will compare themselves with others and conclude that they are defective or broken,” says Fredenthal.

How could you think of hurting your family like that?

According to Ms. Fredenthal, the a person who is suicidal is already aware that their action will end up hurting those they leave behind. “Do not go for this sort of reaction when trying to help them or get them to open up on why they are suicidal. They have already been feeling awful about their intentions,” she says.

How to help someone who is suicidal: What to say

According to Ms. Fredenthal, your words must acknowledge your loved one’s feelings and show compassion after spotting the signs and patterns of suicide in them.

For example, she says that you can say, ‘I am concerned about you because I care, and I would like to help however I can!’ or ‘That sounds painful. I am so sorry. I appreciate that you have shared this with me. How can I be of help?’ Your support should not be temporary. You will need to keep reassuring your spouse from time to time that you are there for them.