Can suicide be stopped?

According to the World Health Organization, every 40 seconds someone in the world commits suicide. In Poland, 5,201 people took their own lives in 2021. During the same period, 2,245 people died in road accidents. How many suicide attempts are made? How many people think they would like to disappear and never come back? How many relatives and friends are forever affected by the tragedy? Although it is difficult to estimate it accurately, we are talking about significant numbers. Yet we do not want to deal with suicides. Perhaps they happen somewhere, we hear that some people do it, but not us, and not those around us. Because there would be no reason, because we know our relatives, friends, co-workers and we are sure that they would never do it, or even if they wanted to, we would notice and help in time. Sometimes yes, sometimes no. World Suicide Prevention Day provides an opportunity to talk about it.

Are you surprised? Most suicide victims want to end their suffering, not their life. They choose to end life because they see no other solution. They don't have the strength to endure the pain any longer, nor the hope that anything will change. They are lonely and convinced that their presence or absence does not matter to anyone. Or, on the contrary, they feel a burden to their loved ones. In their own eyes, compared to others, they are failures, outsiders, losers. They don't believe they have control over their fate. Some suffer loss or struggle with physical pain. Others are constantly hurt by those around them. Then a thought arises that it would be possible to stop the torment - and this thought brings some relief, then it comes back, so one gets used to it and finally resorts to it more and more. Although the very attempt to commit suicide may be impulse, usually such an intention takes a long time to form.

You probably would like to hear that it can. But the most honest answer I can give is that it depends on timing. Something that could have been prevented a few months in advance may become inevitable when there are just few days left. Things set in motion usually follow their own trajectory and it may be too late to change its course. People often associate suicide prevention with grabbing someone's hand while they are standing on the edge of a roof, although previously they may have missed plenty of opportunities to help the same person feel good about living. A last-minute intervention makes great sense, and many of those saved are grateful for another chance. What is much more important, is taking care of the people around you every day - being interested, spending time together, liking someone with their imperfections, creating a culture where talking about problems and asking for help is not a shame.

Most people who commit suicide communicate their intention clearly beforehand. At the beginning, we can hear "I can't go on like this", "no one cares about me", "nothing makes sense", we may notice social withdrawal, giving up on confronting difficulties, reluctance to create plans, or invest time and energy in someone’s own future, preference for songs or poems about death. Subsequent messages may become clearer - "soon I will not be a problem", "if we see each other again", "I won't need it anymore". A person may sum up her or his life, put things in order, visit someone to reconcile or symbolically say goodbye. They can "flirt with death" while driving a car, behave recklessly, or abuse substances. Some people say outright "I will take the pills and I won't wake up", they start preparations, write a farewell letter.

Most often, the intensity of warning messages gradually increases. Although persons who think about death do not find any other solution themselves, they still leave a margin for someone to support them. Suicides are accompanied by ambivalence. The end is enticing and regrettable at the same time. You can desire it and be scared of it. Against the background of this contradiction, misunderstandings arise – some people say "he just talks like that, if he really wanted to do something to himself he wouldn't talk that much about it", some don’t understand how you can take a handful of pills and then call an ambulance. You can hear that all this is just attention drawing, blackmailing, manipulation. This may also be the case, and such cases require a different approach. More often it is a cry for help, the volume of which was turned up to maximum, because earlier no one wanted to hear it. Then, amidst this contradiction of feelings, there is the greatest chance for the helpers, because there is a thread connecting a given person with life which we can grasp.

According to Freud, the death drive is one of the basic human drives. Sounds sinister. But although this theory has been criticised, it would be hard to deny that more or less overt manifestations of self-destruction are common among people. There are dozens of ways to destroy yourself - suicide, self-harm, addiction, starving yourself, taking risks, but also criticising yourself over and over again, letting others hurt you, sacrificing yourself, staying in toxic relationships, wasting time, neglecting your own body and emotions, sabotaging your plans. You can annihilate yourself both actively and passively. Such tendencies begin in childhood and get triggered later in life while experiencing emotional emptiness, abandonment, rejection, deprivation of something important to us. When you're tired and disappointed, and you just want to get drunk. When feeling angry and frustrated, you want to speed your car over the top. When you think "I just don't care anymore". Self-destruction is familiar to most, and perhaps to all of us. It would be good for this awareness to lead to attentiveness and empathy.

How to behave when we hear "I don't want to carry on anymore"? A lot of people avoid talking about suicide outright for fear that it will make the thoughts of taking their own life closer and more real. It doesn't work that way. The question "do you consider killing yourself?" is not equivalent to giving someone that idea. On the contrary - open conversation, without avoidance and vagueness, often brings relief because the person finally feels noticed and taken seriously. However, the answer to the question of "whether to talk" is not at all obvious. Talk when you are ready to listen without interrupting with your “yes, but…”. Talk if you want to see the world as the other person perceives it, not only to reassure yourself that your own perspective is so much better. If you don't feel up to it, you can still help. You can also show care by having a cup of tea together and offering the number to call for professional assistance.

"You must think positively", "there is so much life ahead of you", "see how beautiful the world is" - such truths may speak to the speaker himself, but not to the recipient. When the world seems like a nightmare place, one trivial sentence will not change it. The messages "don't say that," "you cannot be serious", "just don’t do anything stupid" are not helpful, either. "I'll kill myself" may sometimes seem like a joke, but we never know if it is - sometimes a light tone serves to entertain such a thought. Do not challenge anyone with "you won’t dare", or say in anger, "Here you go, do what you want". Do not threaten "your parents will break down", "you will destroy the lives of your children", because it only deepens the feeling that what a given person is going through means little. Do not ask in disbelief "and this is why you want to kill yourself?" The seemingly caring "why" is also not the best, because it forces one to give explanations.

What to say then? It means a lot just to notice "you seem worried", to acknowledge "it looks difficult" to encourage a person to talk with a simple "tell me more". Hearing what someone is struggling with, but also helping them to find the bright sides. Asking "Is there anything that could help you a little?", "What comforted you when it was bad?", "How did you cope?". Broadening the perspective, "After the worse days, brighter ones did come too, right?". Recalling the events that you know about. Redirecting attention to what is good, "What would you feel sorry to leave?", "What are you warmly thinking about?", "What person, animal, place, activity?". Summoning good emotions, "And do you remember when...". Shifting perspective, "And if your best friend were in that position, what would you tell them?". Activating the imagination, "What if something could be changed?", "What if someone wanted to support you?", "What if you could still make one dream come true?". It is worth adding, "It’s good that you tell me that", "I understand better now". In addition to talking, you can take someone for a walk, send a text message, or help find a therapist or support group.

The sooner we act, the better. But sometimes it is very late, and then the approach has to be different, which above all means you have to make more firm and quick decisions based on your own assessment, not dialoguing or considering options. If you suspect something bad is going on, do not be offended by a missed call, but pay a visit, even if it is unannounced. In an imminent life-threatening situation, take someone to a doctor, no matter “what people will say" or "if he or she will hold it against me". If it is needed, call an ambulance, police, or municipal police. Notify the person's relatives and refuse to hide the threat. Under the law, failure to provide assistance is punishable - if you can provide help without endangering yourself. If you hesitate and really don't know what to do, contact one of the available emergency hotlines and ask for instructions there. After the threat is over, take care of yourself by talking to a specialist as well.

The risk of suicide is often associated with depression, but paradoxically, it is not the highest in its deepest phase. Severely depressed persons simply do not have the strength to carry out their intentions. But they can implement them when their condition starts to improve, just when the family loses their vigilance as they have managed to breathe a sigh of relief that it is better. Especially when the treatment is limited to pharmacology, we can have a situation where the person starts to have more energy physically, but the thoughts are still the same. Seeming improvement may also mask the soothing feeling of knowing that the decision is made and the end of suffering is close. Setting a date also removes one of the greatest uncertainties in human life - the fact that no one knows the date of their own death.

Pay attention to how realistic your intentions are. Does the longing for "non-existence" appear sometimes and then disappear, or has it begun to accompany you constantly? Do you sometimes consider death or does it seem to be the only way out? Regardless of what stage you are at, ask for help, but if your plans are concrete, do so immediately. Make a phone call, see a doctor, ask someone to accompany you. Do not resort to psychoactive substances and make it physically difficult for yourself to commit suicide, lest you act on impulse. Ask yourself the question: do you not want to live, or do you not want to live as you live? Think about how everything is changing around you - why shouldn't this apply to you? Think honestly about what your death is going to solve – are these really the solutions it will bring? If you want peace - will you feel it at all, after? If you see yourself as a burden, how sure can you be that someone will be grateful? Each day, think about one thing, however small, that it would be worth or nice to do tomorrow.

Suicide comes as a shock to those around. Guilt is inevitable. Those who remain get frustrated at the thought that they could have done more. This is a difficult issue and the assurances that "it's not your fault" will not make it disappear. However, "we are all to blame" is also blurring the picture. It is true that almost always other persons are involved in the suffering from which one seeks to escape, into death. However, I prefer to talk about responsibility rather than guilt. Guilt is often passive and destructive. Taking responsibility means recognising and accepting your own share. It cannot be exaggerated. No parent, partner, teacher, friend or therapist is solely responsible here, and the final decision always rests with the person who commits the act. It cannot be ignored. If we could really have done something differently, we need to learn this lesson because we are still part of the world. In the event of a failed suicide attempt, it matters particularly that we change what we have done wrong. But we should also be careful, so we do not endlessly keep acting out of fear and desire to make up for possible faults.

Can taking one's own life be a conscious, mature decision? Should we save someone who clearly tells us that he or she does not want it? There are no clear-cut answers to these questions. While it is true that many suicide victims would like to live if they could only live differently, for some, such opportunities are objectively very limited. While thoughts of death often emerge in a black-and-white state of mind, the decision is not always limited in perspective. While many people are grateful for being saved, there are those who would say that "they can't even kill themselves". Where is the line between the obligation to save life and respect for freedom? To what extent do we have the right and are able to judge what is a choice and what is a consequence of the sad circumstances? It is certainly good to be able to openly talk about this.

Meanwhile, religion and culture have left their mark on freedom of discussion. Suicide victims are not buried in sacred ground. Unless they are considered mentally ill, and therefore unable to make a conscious choice. The suicide victim's family is marked by tragedy and the suspicion that there was something wrong with it. People are afraid to be too close to the thought of death – as if they might be affected by it. It is better not to publicise suicides because the "Werther effect" may arise, i.e. a wave of followers. Distorted portraits of suicide, known from romantic readings or contemporary TV series, have nothing to do with real death. In reality, there is nothing sublime or poetic about it, and neither is there a position of an observer who can watch others remember him or her in beautiful words. A real conversation becomes difficult. Which is a pity, because it could change a lot.