Suicidal behavior - from the book “What do we know about suicide?”

Suicidal behavior includes thoughts of suicide, attempts to commit suicide, and suicide itself. This problem mainly occurs in adolescents and young people aged 15-25 years. Adults take their own lives mainly after 70 years of age.

Only a small percentage of suicide victims have serious mental disorders. Most often, such radical solutions to problems are resorted to by people with minor disorders caused by prolonged depression, or those of an impulsive nature. It is important to promptly identify symptoms of suicidal behavior in your loved one, especially a child, in order to prevent terrible consequences.

Types and types of suicidal behavior

There are 2 types of manifestations of suicidal behavior:

1. Internal.

• Passive thoughts. A person thinks about death, but not about suicide. He believes that he has no reason to live, his departure will not upset anyone. Fantasies appear that life will suddenly end, for example, in a dream.
• Intentions. Specific thoughts about suicide appear. The patient chooses a method of suicide, thinks about the place and time of action.
• Intentions. The final decision is made. A person begins to realize his plan.

These three stages can be completed in a few minutes or take months or even years.

2. External.

• True. Long thoughts about the meaning of life and existing problems lead to the desire to commit suicide. Suicide seems to be the only way out. The decision to commit suicide is thoughtful and conscious. The patient does not tell anyone directly about his thoughts, so his death often comes as a complete surprise to those around him. Although from his behavior one can suspect that something is wrong.
• Demonstrative. They consist of hints and open threats to commit suicide. In this case, the suicide usually does not intend to take his own life. He just wants to be heard by others or receive something from them. Such a person does not know how to engage in dialogue or build normal relationships. If attempts to attract attention end in death, it is usually a tragic accident.
• Hidden. Such behavioral manifestations are characteristic of those who do not dare to deliberately hurt themselves or understand that suicide is not a solution. Nevertheless, patients try to hasten death, often unconsciously. They engage in extreme sports, drive while intoxicated or at high speed, run across busy highways, and become addicted to drugs.

UZ "Mogilev City Emergency Hospital"

Suicide is a scary topic, it is not accepted and not very pleasant to discuss. Therefore, when faced with either direct threats from a loved one to commit suicide, or suspecting such a development of events, a person often finds himself at a loss and does not know how to react to this: either ignore the threats, not paying attention to them, considering them empty talk, or rush to save your loved one at any cost? Indeed, often his life may depend on the reaction of loved ones, on their ability to recognize a threat in time, on their actions, on their sincere desire to support a person.

In Soviet times, there was a belief that suicide was a clear sign of mental illness. That is, every suicide victim posthumously received the title of abnormal, and those who were rescued were registered with a psychiatrist for life (with all the ensuing consequences).

In general, thinking about suicide is most often a sign not of absence, but, if you like, of excess intelligence (that very “woe from mind” that has already been discussed more than once). Almost all people think about suicide at one time or another. 80% of people admit that they have “toyed with” ideas about suicide.

Suicide is never spontaneous, although sometimes it seems quite unexpected. Such suicide is always preceded by a depressed mood, a depressive state, or simply thoughts about leaving life. And those around you. Even the closest people. Often people do not notice this condition (especially if they frankly do not want it). And a kind of test for readiness for true suicide is a person’s thoughts about the meaning of life. Therefore, teenagers and old people are in a kind of “risk group” for suicide.

Who is at risk of suicide?

The risk of suicide is very high in patients who drink alcohol. This disease is responsible for 25 - 30% of suicides; among young people its contribution may be even higher - up to 50%. Long-term alcohol abuse contributes to increased depression, guilt and mental pain, which are known to often precede suicide.

Chronic use of drugs and toxic drugs.

Drugs and alcohol are a relatively lethal combination. They weaken motivational control over human behavior, exacerbate depression, or even cause psychosis.

Affective disorders, especially severe depression (psychopathological syndromes).

Chronic or fatal diseases.

Loneliness, bereavement, such as the death of a spouse (parent), especially during the first year after the loss.

Family problems: leaving the family or divorce, financial problems, etc.

Suicide risk assessment

People may be at risk, which does not mean they are prone to suicide. It must be emphasized that there is no single cause of suicide. However, all hints of suicide should be taken seriously. Particular vigilance should be taken into account the combination of dangerous signals if they persist for a certain period of time. There can be no doubt that the cry for help needs a response from someone uniquely positioned to intervene in a crisis of loneliness.

The main “tool” for assessing suicidal risk is a conversation with a person, observation of him, and information received from third parties.

Suicide can be prevented.

There is an opinion that if a teenager has decided to give up his life, then it is no longer possible to prevent him. It is also believed that if a teenager does not succeed in committing suicide the first time, he will make suicide attempts again and again until he achieves his goal.

In reality, young people usually try to commit suicide only once. Most of them pose a danger to themselves only for a short period of time - from 24 to 72 hours. If someone intervenes in their plans and provides help, then they will never make another attempt on their life.

Not all teenage suicides result from unhappy love. It’s just that “a young man pondering life” (or, accordingly, a girl) has not found an answer for himself what his purpose in this world is, and it is still very difficult for him to accept the answer “to live in order to live” due to teenage maximalism. And the main percentage of suicides “because of love” does not occur because the teenager is impatient to start an intimate life or his hormones are raging. It’s just that, most often, a child’s love is nothing more than a reflection of the need to be needed by at least someone: if not the parents, then He or She. And when reciprocity does not arise, you often get the feeling that NO ONE IN THE WHOLE WORLD NEEDS YOU.

Old people die if they suddenly realize that they have lived their entire lives in vain. Yes, if an elderly person is sure that he has done at least something significant along his path (at least for himself), then he begins to love life. But those who are convinced that their entire existence has been wasted can commit suicide even in old age.

The most common mental illness in adulthood is depression. Midlife depression is often associated with suicide. Along with physical changes, mental changes also occur. Parents who used to support their children now become dependent on them. Children leave their parents' home forever. The suicide rate among aging people is higher than at any other age.

The loss of the meaning of life can look like anything - it all depends on who sees this meaning in what. Lack of money can push someone for whom all life comes down to wealth to take a fatal step; unhappy love can cause suicide if the lover cannot imagine a future without his beloved; and a woman, convinced that her destiny lies only in motherhood, can commit suicide due to discovered infertility. Although, of course, in any of these cases you can find another way out.

The majority of suicides are nothing more than an attempt to conduct a dialogue: only in this unique and completely unsuitable method.

Most suicides, as a rule, did not want to die at all - but only to reach someone, draw attention to their problems, call for help.

Signs of suicidal behavior

1. Conversations on the topics of suicide, death, dreams with a disaster plot, dreams with the death of people or one’s own death, increased interest in instruments of taking one’s own life, discussions about the loss of the meaning of life, letters or conversations of a farewell nature.
2. Having experience of suicide in the past, having an example of suicide in close circle, especially parents and friends; maximalist character traits, a tendency to uncompromising decisions and actions, dividing the world into white and black.
3. Objective severity of life circumstances: childhood spent in a dysfunctional family, poor relationships with loved ones during this period, loss of a loved one, social rejection, serious illness, etc.
4. Reduced personal resources to withstand difficulties: depression, stress, helplessness, illness, violence in close circles, physical or mental exhaustion, the need and inability to overcome difficulties.

What to do if you suspect someone is suicidal

If you suspect that one of your acquaintances, friends or relatives may have a desire to commit suicide, you need to talk to them about it.

Do not be afraid that such a conversation will lead to his “idea of ​​suicide.” If such a thought already exists, it exists regardless of your conversations. By questioning him, you will give him the opportunity to talk about his feelings and intentions. People are often ambivalent in their desire for death. Even if someone denies such intentions, but you still suspect, you can gently return to the conversation after some time.

How to help

LISTEN - “I hear you.” Don’t try to console with general words like “Well, it’s not that bad,” “You’ll get better,” “You shouldn’t do that.” Give him a chance to speak. Ask questions and listen carefully.

DISCUSS - open discussion of plans and problems relieves anxiety. Don't be afraid to talk about it - most people feel uncomfortable talking about suicide, and this manifests itself in denial or avoidance of the topic. Conversations cannot provoke suicide, while avoiding this topic increases anxiety and suspicion.

BE CAREFUL for indirect indicators in cases of suspected suicide.

Every humorous reference or threat should be taken seriously. Teenagers often deny that they spoke seriously, try to ridicule you for being excessively anxious, and may feign anger. Tell them you take them seriously.

ASK QUESTIONS – generalize, reframe – “It sounds like what you’re really saying is...”, “Most people have thought about suicide...”,

“Have you ever thought about how to accomplish it?” If you get an answer, get specific. Gun? Have you ever shot? Where will you get it? What will happen then? What if you miss? Who will find you? Have you thought about your funeral? Who will come to them? You must make the unsaid, the hidden, obvious.

Help them talk and think openly about their plans.

EMPHASIZE THE TEMPORARY NATURE of the problems - acknowledge that his feelings are very strong, the problems are complex - find out how you can help, since he already trusts you. Find out who else could help in this situation.

Listen carefully to what they tell you. Try at all costs to remain calm and not give out moral assessments: “abnormal”, “terrible person” and the like. This will not help, but will only turn the other person against you. You cannot advise a person how he should feel. You can work through his problems with him and “break them down” into more specific issues that can be solved step by step. Emphasize that there are other ways to solve problems other than suicide. Offer to go to a psychologist or psychotherapist and talk about your problems.

DO NOT AGREE TO KEEP SUICIDAL THOUGHTS AND PLANS OF YOUR INTERLOCUTOR A SECRET! Even if you agreed, there is no sin in breaking your word. It will be much worse if your interlocutor dies and you will execute yourself for the rest of your life. Teenagers especially often fall for this “bait.” What is it like for them after their friend commits suicide, and they knew about their friends’ intentions and did not prevent it! Don't be afraid of losing a friend, but be afraid of losing a person!

Do not let your interlocutor out of your sight and try to select and hide the means with which he wanted to commit suicide.

What to do if you are feeling suicidal

Remember that some people with whom you shared your thoughts do not know what to do and, in their temper and inability, they can say a lot of offensive things to you, and it will hurt you even more. Don’t be offended by them for this, but try to seek support from those who will help you.

Do not think that your crisis is just your problem, which you need to cope with alone. Seek help from a psychotherapist, doctor, friend who will listen to you carefully and help with advice.

Give yourself time. What you feel right now is a feeling that may subside in a day or a week. The feeling of pain is just a feeling. Death is a release from life, not a release from pain. There are other measures to relieve pain. Your thinking is clouded by pain and you cannot think clearly. Let others help you.

There is a false belief among the population that turning to a psychiatrist, psychotherapist, or psychologist is something shameful and entails social consequences. During the period of mental and psychological problems, it is necessary to think about health, quality of life, and not follow false beliefs.

In difficult life situations

CALL EMERGENCY SERVICE

PSYCHOLOGICAL HELP

Emergency psychological help phone numbers

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Mogilev (24 hours a day): (8 – 0222) – 71 – 11 – 61

Crisis rooms:

"Mogilev regional center of social services for the population"

(8 – 0222) – 22 – 10 – 11

"Center for Social Services for the Population of the Leninsky District of Mogilev"

(8 – 0222) – 74 – 41 – 79

"Center for Social Services for the Population of the Oktyabrsky District of Mogilev"

(8 – 0222) – 73 – 92 – 32

National hotline for victims of violence

(from 8 – 00 to 20 – 00): (8 – 801 – 100 – 8 – 801)

Causes of suicidal behavior

Many factors influence a person's desire to commit suicide. They can be divided into 5 groups.

1. Personal relationships:

• childhood psychological and physical trauma;
• cruel or indifferent attitude of parents;
• growing up in a single-parent family;
• cases of suicide among loved ones;
• living with alcoholics, drug addicts, and seriously ill patients;
• misunderstanding on the part of loved ones, conflicts in the family;
• divorce and separation from a loved one;
• parental divorce;
• death of a loved one;
• cheating partner;
• unhappy or unrequited love;
• sexual incompetence;
• non-acceptance of one's own sexual orientation or gender;
• experience of sexual violence.

2. Social interaction:

• problems and bullying in the team;
• excessive stress at work and study;
• inability to establish contact with others;
• influence from groups and individuals praising death;
• forced social isolation.

3. Antisocial behavior:

• fear of criminal liability;
• an attempt to avoid shame due to an act committed;
• desire for self-punishment.

4. Material and everyday difficulties:

• job loss;
• loss of money;
• low material income in the family;
• living in unfavorable living conditions.

5. Physical condition:

• chronic pain;
• incurable pathologies;
• appearance features;
• mental illness.

There are many other reasons for suicidal behavior. A combination of several factors increases the risk of wanting to commit suicide.

Suicide

No one will dispute the fact that death is the door through which everyone will have to go. Living, rejoicing and welcoming life, we certainly encounter non-existence and death. Death finds a certain path to everyone: through the natural process of aging, serious illness, external violence, accident, and one’s own intervention in the life process. What problems push people to violent death, not through the fault of circumstances or external forces, but by decision of their own will?

Suicide is intentional self-harm with fatal outcome (taking one's own life). The psychological meaning of suicide most often lies in reacting to affect, relieving emotional stress, and avoiding the situation in which a person finds himself, willy-nilly. People who commit suicide usually suffer from severe mental pain and stress, and feel unable to cope with their problems.

Suicidal behavior is a manifestation of suicidal activity - thoughts, intentions, statements, threats, attempts, attempts. Suicidal behavior occurs both normally (without psychopathology), and in psychopathy and with character accentuations - in the latter case, it is a form of deviant behavior.

A suicide person is a person who has attempted suicide or demonstrates suicidal tendencies.

From the point of view of clinical practice, suicidal behavior is usually divided into internal and external forms.

Internal forms:

• Antivital experiences are reflections on the lack of value of life without clear ideas about one’s death.
• Passive suicidal thoughts are fantasies about one’s death, but not about taking one’s own life.
• Suicidal ideation – development of a suicide plan.
• Suicidal intentions - the decision to carry out the plan.

External forms:

• Suicide (suicide) is the intentional, conscious and rapid taking of one’s own life.
• A suicide attempt (parasuicide) is an intentional self-harm or self-poisoning that does not end in death, which is aimed at realizing the changes desired by the subject due to physical consequences.
• An interrupted suicide attempt (aborted parasuicide) is an act undertaken with the goal of intentional self-harm or suicide, but interrupted before actual self-harm by external circumstances (for example, the intervention of strangers prevented physical harm: a person was “removed” from the rails before the train passed, the act of self-hanging was interrupted, etc.). P.).
• Abortive suicide attempt (abortive parasuicide) is an act undertaken with the purpose of deliberate self-harm or suicide, but interrupted before actual self-harm directly by the subject himself.

The following types of suicidal behavior are distinguished:

• Demonstrative behavior. This type of suicidal behavior is based on the desire to draw attention to oneself and one’s problems. Show how difficult it is to cope with life situations. This is a kind of request for help. As a rule, demonstrative suicidal acts are not committed with the goal of causing real harm to oneself or taking one’s life, but with the goal of scaring others, making them think about problems, and “realize” their unfair attitude towards him. With demonstrative behavior, methods of suicidal behavior most often manifest themselves in the form of cuts to the veins, poisoning with non-toxic drugs, and depictions of hanging.
• Affective suicidal behavior. Suicidal acts committed under the influence of strong emotions are of the affective type. In such cases, he acts impulsively, without a clear plan for his actions. As a rule, strong negative emotions (resentment, anger) overshadow the real perception of reality and the suicidal person, guided by them, commits suicidal actions. With affective suicidal behavior, they often resort to attempts at hanging, poisoning with toxic and potent drugs.
• True suicidal behavior. True suicidal behavior is characterized by a well-thought-out plan of action. The suicidal person is preparing to commit a suicidal act. With this type of suicidal behavior, they often leave notes addressed to relatives and friends, in which they say goodbye to everyone and explain the reasons for their actions. Since the actions are deliberate, such suicide attempts often end in death. In cases of true suicidal behavior, they often resort to hanging or jumping from a height.

Suicide is too unnatural and a drastic step, so the decision to commit it does not mature immediately. As a rule, it is preceded by a more or less long period of experiences, a struggle of motives and a search for a way out of the current situation.

Dynamics of development of suicidal behavior.

The first stage is the stage of questions about death and the meaning of life. Before committing a suicidal act, in most cases there is a period characterized by a decrease in adaptive abilities. During this period, suicidal thoughts themselves are formed, which can manifest themselves in the form of statements that “I’m tired of this life,” “I wish I could fall asleep and not wake up,” the emergence of interest in the problems of life and death, etc. At this stage, passive thoughts about taking one’s own life or suicide arise. This stage is also characterized by ideas, fantasies and thoughts about one’s death, but not on the topic of taking one’s life. An example is statements like: “It’s better to die than live like this,” “I want to fall asleep and not wake up,” etc. At the same time, the meaning of such statements is underestimated or perceived in a demonstrative and blackmailing aspect. Almost everyone who seriously thinks about suicide, one way or another, makes it clear to others about their intention. Suicides often do not occur suddenly, impulsively, unpredictably, or inevitably. They are the last straw in the cup of gradually worsening adaptation. Among those who intend to commit suicide, from 70 to 75% disclose their desires in one way or another. Sometimes these will be subtle hints; Often the threats are easily recognizable. It is important that most people who commit suicide seek opportunities to speak out and be listened to. However, very often they do not meet a person who will listen to them.

The second stage is suicidal ideation. This is an active form of manifestation of the desire to commit suicide, it is accompanied by the development of a plan for the implementation of suicidal plans, the methods, time and place of committing suicide are thought out. Statements about your intentions are noted.

The third stage is suicidal intentions and the actual suicide attempt. A formed decision (attitude) and a volitional component are attached to the idea of ​​suicide, inducing the direct implementation of external forms of suicidal behavioral acts.

The period from the onset of thoughts of suicide to attempts to carry them out is called pre-suicide. Its duration can be calculated in minutes (acute presuicide) or months (chronic presuicide). In acute presuicides, an immediate manifestation of suicidal thoughts and intentions is possible immediately, without previous steps. After a suicide attempt, there comes a period when they are treated with increased attention and care. During this period, recurrence of suicidal acts is unlikely. After three months, seeing that he is outwardly calm, does not express thoughts of suicide and does not try to repeat the attempt, they cease to be attentive and pay due attention to him, and begin to lead their usual lifestyle, because... They believe that the crisis has been overcome and everything is fine. But, if the situation that led to the suicidal action has not been worked out, there is still a risk of making a second suicide attempt. And at the moment when loved ones stop worrying about the state of the suicide, as a number of researchers note, repeated suicide attempts are made. Therefore, it is necessary to observe him for a long time, provide him with support, talk with him and carry out other preventive actions.

Recommendations for those who are close to a person who is suicidal.

1. Don't push him away if he decides to share his problems with you, even if you are shocked by the situation.
2. Trust your intuition, if you sense suicidal tendencies in a given individual, do not ignore the warning signs.
3. Don't offer something you can't do.
4. Let him know that you want to help him, but you don't see the need to keep things secret if any information could affect his safety.
5. Stay calm and don't judge him no matter what he says.
6. Speak sincerely, try to determine how serious the threat is: asking questions about suicidal thoughts does not lead to attempts to commit suicide, in fact, they will help you feel relief from recognizing the problem.
7. Try to find out his plan of action, since a specific plan is a sign of real danger.
8. Convince him that there is a specific person to whom he can turn for help.
9. Don't offer simplistic solutions.
10. Make it clear that you want to talk about feelings and that you don't judge him for those feelings.
11. Help him understand that severe stress prevents him from fully understanding the situation, unobtrusively advise him on how to find a solution and manage the crisis situation.
12. Help find people and places that could reduce the stress experienced.
13. At the slightest opportunity, act in such a way as to slightly change his internal state; Help him understand that the present feeling of hopelessness will not last forever.

State of high suicidal risk

1. Persistent fantasies about death, non-verbal “signs”, thoughts, direct or indirect statements about self-harm or suicide.
2. State of depression.
3. Manifestations of guilt/severe shame/resentment/severe fear.
4. High level of hopelessness in statements.
5. Noticeable impulsiveness in behavior.
6. The fact of a recent/current crisis/loss.
7. Emotional-cognitive fixation on a crisis situation, the object of loss.
8. Severe physical or mental suffering (pain syndrome, “mental pain”).
9. Lack of socio-psychological support/unaccepting environment.
10. The patient’s reluctance to accept help/inaccessibility to therapeutic interventions/regrets about “being alive.”
11. The dominance of the doctor’s negative feelings that disrupt the communication process: anxiety, hostility, powerlessness and hopelessness, idealization or devaluation of the patient.

Algorithm of behavior in case of high suicidal risk.

1. Immediate monitoring of the patient must be ensured and additional personnel must be recruited.
2. Limit access to places and methods of committing suicidal acts.
3. If it is impossible to organize a consultation with a psychiatrist, you must call 101.
4. Organization of compulsory psychiatric care for persons at risk of suicide (Article 19 of the Law on Psychiatric Care).
5. It is necessary and important to establish contact with relatives and other emotionally significant persons.

Compiled by emergency hospital psychologist O.V. Kiruta.

Detection of suicidal behavior

If you look closely at a loved one, you may notice signs that indicate he or she is suicidal. The behavior of suicide victims varies, but its unnaturalness is always striking.

Most often, someone who decides to commit suicide becomes withdrawn and silent, trying to isolate himself from everyone. He loses interest in his surroundings and reacts poorly to external stimuli. He is characterized by unemotionality, inappropriate actions and statements.

Unusual aggressiveness, prudence and composure often manifest themselves. Some become hyperactive, cheerful for no reason, and fussy. Elevated mood quickly gives way to lethargy. Lost appetite. Nightmares cause sleep disturbances.

A person who is suicidal begins to talk often about death and suicide. He directly or indirectly hints at his decision to die. There is an interest in books and films with death motifs. A potential suicide person constantly views depressive images and listens to sad music. He is often under the influence of alcohol or drugs.

A suicidal person searches the Internet and print media for information about methods of suicide. A large number of pills or poisonous substances can be found in his personal belongings. Preparation for death also consists of putting things in order, reconciling with enemies, and giving away things of personal value.

Suicide attempt

A suicide attempt, which indicates a person's intent, is a powerful predictor of subsequent completed suicide. There is nothing more dramatic and painful than a cry for help from a suicidal person who has committed suicide. Some suicide attempts are not taken seriously. For example, a girl takes sleeping pills, confident that her attempt will be discovered. Or a man cuts himself in such a way that it cannot possibly end in death. Often family and friends take it easy. This also applies to cases where a person who tried to poison himself seeks to justify his behavior. Often people react to these events with an irritated remark: “She just wanted attention.” The point is that every suicide attempt should be taken seriously, no matter how harmless and frivolous it may seem. The most vulnerable are people who have attempted suicide in the past or have had close contact with someone who has attempted or accomplished this. Statistics show that 12% of those who make a suicide attempt, no later than two years later, definitely repeat it and achieve what they want. Four out of five suicide victims had attempted to do so in the past. After the first failed attempt, many conclude: “I’ll do it better next time.” And they remember this when they are in a state of crisis.

Signs of suicidal behavior in minors and children

Children are more likely to act impulsively. A fragile psyche, coupled with the inability to cope with problems, can lead to dire consequences due to any difficult situation. Spontaneous suicides usually occur before the age of 14. Teenagers carefully prepare for them.

Fortunately, only 1 case of suicidal behavior out of 100 results in death. But it is still necessary to be attentive to a child with similar tendencies. If the problems that led to the desire to commit suicide are not resolved in time, suicide attempts will be repeated. And the deeper the depression, the more serious the mental trauma will be.

A child who is thinking about death is constantly sad and cries. He locks himself in his room and refuses to communicate with relatives and friends. Lost interest in games and other activities that were previously enjoyable. Irritability and hostility arise.

Absence from school is increasing. The child stops doing homework and his academic performance drops sharply. Loss of sleep and appetite. There may be periodic complaints of physical discomfort, such as headache.

The presence of at least 2-3 symptoms should alert parents and teachers. In this case, you should immediately seek help from a psychologist. A specialist will assess the severity of depression and the level of suicide risk and help you sort out the problems.

Signs of suicidal behavior and ways to prevent it - Institution "Kruglyanskiy RCSON"

Figures and facts

• Most suicide attempts are made when a person is temporarily depressed and may never happen again. • Three times more women than men attempt suicide, but four times more men than women kill themselves. This is due to the fact that men are more likely to try to kill themselves with firearms. Firearms are predominantly a “male” way of reckoning with life. • Every 8 out of 10 potential suicides receive advance warning about suicide. Therefore, a person who threatens to commit suicide must be taken seriously. • There are many more elderly people at risk of suicide than teenagers. The highest rates of suicide occur in the spring. This is believed to be due to changes in natural light levels. • One in three deaths is due to alcoholism. Suicide rates are highest in rich countries. For example, Latin America and Brazil have the lowest rates, while Russia, Japan and France have some of the highest. Only 1 in 20 suicide attempts are successful. • Suicides peak on Monday, the most stressful day for most people.

11 signs of suicidal behavior

Loss of previously characteristic energy

- usually manifests itself as a constant feeling of boredom and fatigue.
Prolonged sleep and appetite disturbances.
A person is haunted by terrible dreams; pictures of cataclysms, catastrophes, accidents with the death of people or one’s own death or ominous animals are possible.
It is also possible to have a disturbance in appetite or a complete absence of it. Excessive self-criticism or constant feelings of guilt.
It can also manifest itself as a pronounced feeling of failure, shame, and self-doubt.
Also, this syndrome can be masked under deliberate bravado, defiant behavior, and insolence. Fear, anxiety and aggression.
Depression manifests itself both in melancholy and in restlessness, insomnia, and anxiety that were previously unusual for a person.
It is this type of depression that more often leads to suicide, because the nervous system is constantly tense, and the person “gets tired of living.” Long-term health problems.
Loss of health and independence, vision and hearing problems can lead people to think about ending their suffering.
Depression
is the surest companion of suicidal behavior.
The stronger the depression, the harder it is to see the light in life and find reasons to live. In a state of depression, the risk of death actually increases 20 times! Clear signs of depression are a sad mood, despondency, loss of interest in previous hobbies, or, conversely, increased nervousness. A sudden change in mood
- literally in a second a person becomes joyful, as if a very cheerful thought had visited him.
Putting your affairs in order,
sudden interest in relatives whom you have not seen for a long time, checking on them. Talking about suicide. The person often talks about this topic and shows too strong and constant interest in this topic. Transparent hints about the imminent end of one’s life, conversations about suicide; Phrases like “I would be better off in another world”, “I wish I wasn’t here.” Purchasing mutilation products is the most obvious sign. For example, having a gun increases the risk of suicide in the home by 10 times. Firearms account for 10% of all suicide attempts. Moreover, firearms are a “male” way of reckoning with life. IMPORTANT: Parents of depressed teenagers should review their website browsing history to look for information about suicide and, if found, immediately seek specialized help. Searching for information about suicide (on the Internet, in books, in the press, in cinema). Topics that interest a person are reflected in what surrounds him and what he is interested in. Take a closer look at what book a person reads, what films he watches, what websites he visits. It is important to pay attention to this if your loved one has been in a state of despondency for a long time. Use of alcohol or drugs. You should especially worry if the person was not previously prone to these addictions, and also if the state of drug intoxication allows the person to feel emotionally better. A previous suicide attempt or an example of suicide - for example, in close circles, especially from parents or friends. A family history of depression increases the likelihood that offspring will also suffer from it by 11%. Ways to prevent suicidal behavior 1. Look for clues to suicide. Help consists not only of the care and participation of friends, but also of the ability to recognize the signs of impending danger. Your knowledge of its principles and desire to have this information can save someone's life. By sharing them with others, you can help break down the myths and misconceptions that prevent many suicides from being prevented. Look for signs of possible danger, detect signs of helplessness and hopelessness, and determine whether the person is lonely and isolated. The more people who are aware of these warnings, the greater the chances of suicide disappearing from the list of leading causes of death. 2. Accept the suicidal person as a person. Allow for the possibility that the person is indeed suicidal. Do not assume that he is not capable and will not be able to decide to commit suicide. It is sometimes tempting to deny the possibility that anyone can stop a person from committing suicide. This is why thousands of people of all ages, races and social groups commit suicide. Don't let others mislead you into thinking that a particular suicidal situation is not serious. If you believe someone is at risk of suicide, act in accordance with your own beliefs. The danger that you will become confused by exaggerating a potential threat is nothing compared to the fact that someone may die because of your non-intervention. 3.Establish caring relationships. There are no comprehensive answers to a problem as serious as suicide. But you can take a giant step forward if you adopt a position of confident acceptance of a desperate person. In the future, a lot depends on the quality of your relationships. They should be expressed not only with words, but also with non-verbal empathy; In these circumstances, it is more appropriate not to moralize, but to support. Instead of suffering from self-judgment and other worries, an anxious person should try to understand his feelings. For a person who feels that he is worthless and unloved, the care and concern of a sympathetic person is a powerful encouragement. This is the best way to penetrate the isolated soul of a desperate person. 4. Be an attentive listener. Suicidal people especially suffer from a strong sense of alienation. Because of this, they may not be inclined to accept your advice. Much more they need to discuss their pain and what they say: “I have nothing worth living for.” If a person suffers from depression, then he needs to talk more to himself than to talk to him. Realizing that someone you care about is suicidal usually causes the caregiver to fear rejection, unwantedness, powerlessness, or uselessness. Despite this, remember that this person has difficulty focusing on anything other than his hopelessness. He wants to get rid of the pain, but cannot find a healing way out. If someone tells us they are thinking about suicide, don't judge them for saying it. Try to remain calm and understanding as much as possible. You might say, “I really appreciate your honesty because it takes a lot of courage for you to share your feelings right now.” You can be of great help by listening to the person's feelings, whether sadness, guilt, fear, or anger. Sometimes, if you just sit quietly with him, it is proof that you are interested and caring. Both psychologists and non-specialists must develop the art of “listening with the third ear.” This means penetration into what is “expressed” non-verbally: behavior, appetite, mood and facial expressions, movements, sleep disturbances, readiness for impulsive actions in an acute crisis situation . Although the main warning signs of suicide are often hidden, they can nevertheless be recognized by a receptive listener. 5. Don't argue. When faced with a suicidal threat, friends and relatives often respond: “Think about it, you live much better than other people; you should thank your fate.” This answer immediately blocks further discussion; Such remarks cause an already unhappy person to become even more depressed. By wanting to help in this way, loved ones contribute to the opposite effect. Another familiar remark can often be found: “Do you understand what misfortune and shame you will bring on your family?” But, perhaps, hidden behind it is precisely the thought that the suicide wants to carry out. Never become aggressive if you are present during a conversation about suicide, and try not to express shock at what you hear. When you enter into a discussion with a depressed person, you may not only lose the argument, but also lose him. 6. Ask questions. If you ask indirect questions such as: “I hope you are not contemplating suicide?”, then they imply the answer that you would like to hear. If a loved one, a person, answers: “No,” then you most likely will not be able to help resolve the suicidal crisis. The best way to intervene in a crisis is to thoughtfully ask a direct question: “Are you thinking about suicide?” It will not lead to such a thought if the person did not have it; on the contrary, when he contemplates suicide and finally finds someone who cares about his experiences and is willing to discuss this taboo topic, he often feels relieved and is given the opportunity to understand his feelings. You should calmly and clearly ask about the disturbing situation, for example: “Since when do you consider your life so hopeless? Why do you think you have these feelings? Do you have specific ideas about how to end your life? If you have thought about suicide before, what stopped you?” To help a suicidal person understand his thoughts, you can sometimes paraphrase, repeat his most significant answers: “In other words, you are saying...” Your agreement to listen and discuss what they want to share with you will be a great relief for a desperate person who is experiencing fear, that you will condemn him, and is ready to leave. 7. Don't offer undue reassurance. One of the important psychological defense mechanisms is rationalization. After hearing someone say they are suicidal, you may be tempted to say, “No, you don't really think so.” There is often no basis for these conclusions other than your personal anxiety. The reason why a suicidal person shares his thoughts is to create concern about his situation. If you do not show interest and responsiveness, the depressed person may consider a statement such as “You don’t really think so” as a sign of rejection and mistrust. If you conduct a conversation with love and care, it will significantly reduce the risk of suicide. Otherwise, he can be driven to suicide by banal consolations just when he desperately needs sincere, caring, frank participation in his fate. Suicidal people disdain remarks like, “It’s okay, it’s okay, everyone has problems like you,” and other similar clichés, because they stand in stark contrast to their torment. These conclusions only minimize, destroy their feelings and make them feel even more unnecessary and worthless. 8. Offer constructive approaches. Instead of telling the suicidal person: “Think about the pain your death will bring to your loved ones,” ask him to think about alternative solutions that may not have occurred to him yet. One of the most important goals of suicide prevention is to help identify the source of mental distress. This can be difficult because the breeding ground for suicide is secrecy. The most appropriate questions to stimulate discussion might be: “What has happened to you lately? When did you feel worse? What has happened in your life since these changes occurred? Which of those around them were they related to?” The potential suicide person should be encouraged to identify the problem and, as precisely as possible, determine what is aggravating it. A desperate person needs to be reassured that he can talk about feelings without embarrassment, even negative emotions such as hatred, bitterness or the desire for revenge. If the person is still hesitant to express his innermost feelings, then you may be able to prompt a response by noting: “I think you are very upset,” or: “But I think you are going to cry.” It also makes sense to say: “You are still excited. Maybe if you share your problems with me, I will try to understand you.” A current psychotraumatic situation may arise due to the breakdown of relationships with a spouse or children. The person may be suffering from unresolved grief or some physical illness. Therefore, all his feelings and troubles should be taken into account. If the crisis situation and emotions are expressed, then the next step is to find out how the person resolved similar situations in the past. This is called "evaluating the means available to solve the problem." It involves listening to a description of previous experiences in a similar situation. To initiate, you can ask the question: “Have you had similar experiences before?” There is a unique opportunity to collaboratively uncover ways in which a person has dealt with crisis in the past. They can be useful for resolving real conflict. Try to find out what remains, nevertheless, positively significant for the person. What else does he value? Notice signs of emotional excitement when it comes to the “best” time of his life, especially watch his eyes. What things that are meaningful to him are achievable? Who are the people who continue to worry him? And now that the life situation has been analyzed, have any alternatives arisen? Is there a ray of hope? 9. Instill hope. Working with self-destructive depressed people is serious and demanding. Psychotherapists have long found the value of focusing on what they are saying or feeling. When troubling hidden thoughts come to the surface, troubles seem less fatal and more solvable. A person tormented by anxiety may come to the thought: “I still don’t know how to resolve this situation. But now that my difficulties are clear, I see that perhaps there is still some hope.” Hope helps a person come out of preoccupation with thoughts of suicide. In recent history, an example is the behavior of the Jews during the Holocaust, when Hitler sought to completely exterminate them. Before 1940, the average monthly number of suicides was 71.2. In May of that year, immediately after the Nazi invasion, it increased to 371. People committed suicide out of fear of ending up in concentration camps. The Jews who did not escape this terrible fate initially retained faith in liberation or family reunification. As long as there was at least a spark of hope, relatively few suicides occurred. When the war began to seem endless and rumors began to reach about the Nazis’ reprisals against millions of people, suicides among camp prisoners took the form of epidemics. The loss of hope for a decent future is reflected in the notes left by suicides. Self-destruction occurs when people lose their last drop of optimism, and their loved ones somehow confirm the futility of hopes. Be that as it may, hope must come from reality. It makes no sense to say: “Don’t worry, everything will be fine” when everything cannot be fine. Hope cannot be built on empty consolations. Hope does not arise from fantasies divorced from reality, but from the existing ability to desire and achieve. A deceased loved one cannot return, no matter how much you hope and pray. But his loved ones may discover a new understanding of life. Hopes must be justified: when a ship crashes on rocks, there is a difference between hoping to "sail to the nearest shore or to reach the opposite shore of the ocean." When people completely lose hope for a decent future, they need supportive advice, to offer some kind of alternative. “How could you change the situation?”, “What outside interference could you resist?”, “Who could you turn to for help?” Because suicidal people suffer from internal emotional discomfort, everything around them seems gloomy to them. But it is important for them to discover that it makes no sense to get stuck on one pole of emotions. A person can love without denying that he sometimes experiences outright hatred; The meaning of life does not disappear, even if it brings mental pain. Darkness and light, joys and sorrows, happiness and suffering are inseparable, intertwined threads in the fabric of human existence. Thus, the basis for realistic hope must be presented honestly, convincingly, and gently. It is very important that if you strengthen the person's strength and capabilities, instill in him that crisis problems are usually transitory, and suicide is not irrevocable. 10. Assess the risk of suicide. Try to determine the seriousness of a possible suicide. After all, intentions can vary, starting from fleeting, vague thoughts about such a “possibility” and ending with a developed plan for suicide by poisoning, jumping from a height, using a firearm or rope. It is very important to identify other factors, such as alcoholism, drug use, the degree of emotional disturbances and behavioral disorganization, and feelings of hopelessness and helplessness. An indisputable fact is that the more the suicide method has been developed, the higher its potential risk. There is very little doubt about the seriousness of the situation, for example, if a depressive teenager, without hiding, gives someone his favorite tape recorder, with whom he would never part. In this case, medicines, weapons or knives should be removed away. 11. Do not leave a person alone in a situation of high suicidal risk. Stay with him for as long as possible or ask someone to stay with him until the crisis is resolved or help arrives. You may have to call an ambulance or contact the clinic. Remember that support imposes a certain responsibility on you. 12. Turn to the specialists for help. Suicids have a narrowed field of vision, a kind of tunnel consciousness. Their mind is not able to restore a complete picture of how to solve intolerable problems. The first request is often to provide assistance. Friends, of course, can have good intentions, but they may not have enough skill and experience, in addition, they are prone to excessive emotionality. For those experiencing suicidal trends, a priest may be a possible assistant. Many clergymen are excellent consultants - understanding, sensitive and worthy of trust. But there are among them those who are not prepared for crisis intervention. By moralizing and teaching banalities, they can push the parishioner to greater isolation and self -accusation. The source of assistance is doctors. They are usually well informed, can correctly assess the seriousness of the situation and direct a person to a knowledgeable specialist. At first, while the patient did not receive qualified assistance, the doctor may prescribe him drugs to reduce the intensity of depressive experiences. In any case, with a suicidal threat, the help of psychiatrists or clinical psychologists should be underestimated. Thanks to their knowledge, skills and psychotherapeutic influence, these experts have unique abilities to understand the innermost feelings, needs and expectations of a person. During a psychotherapeutic consultation, desperate people reveal their suffering and anxiety deeper. If a depressive person is not inclined to cooperation and does not seek the help of specialists, then another treatment is family therapy. In this case, the "patient" does not say about the desperate. All family members receive support, express their intentions and grief, constructively developing a more comfortable style of life together. Along with the constructive removal of emotional discomfort during family therapy, personal changes in the environment can be made. Sometimes the only alternative to help with a suicid, if the situation is hopeless, is hospitalization in a psychiatric hospital. Dressing can be dangerous; Hospitalization can be relieved by both the patient and the family 13. The importance of maintaining care and support. If the critical situation has passed, then experts or family cannot afford to relax. The worst may not be behind. For improvement, they often take an increase in the patient’s mental activity. It happens that on the eve of suicide, depressed people rush into the whirlpool of activity. They ask for forgiveness from everyone who was offended. Seeing this, you sigh in relief and weaken vigilance. But these actions may indicate a decision to pay off all debts and obligations, after which you can commit suicide. And, indeed, half of suicids commit suicide no later than three months after the start of the psychological crisis. Darkness and light, joy and sadness, happiness and suffering are inseparable, intertwined threads in the fabric of human existence. It is very important if we help to strengthen the strength and capabilities of a person who have fallen into trouble, impressing and showing him that crisis problems are usually transient, and suicide is not irrevocable.

Diagnosis of suicidal behavior

To identify suicidal tendencies, a psychologist conducts conversations with a potential suicide victim and his immediate circle. The degree of risk is assessed based on personal and situational factors.

1. Personal factors.

• low self-esteem;
• lack of self-confidence;
• an urgent need for sincere and warm relationships;
• the need for understanding and support from others;
• difficulties in making decisions;
• lack of independence;
• inadequate reaction to failures;
• tendency to self-flagellation;
• inability to build relationships in society;
• infantilism.

2. Situational factors:

• unfavorable environment in the team or family;
• frequent changes of housing, study, work;
• systematic consumption of alcoholic beverages;
• participation in sects;
• significant anniversaries;
• family or personal history of suicide attempts.

During a personal conversation with a suicidal person, a psychologist assesses the strength of the anti-suicidal barrier. This is a combination of factors that shape the will to live:

• a positive attitude towards life and a negative attitude towards death;
• fear of hurting yourself;
• strong attachment to someone;
• parental obligations;
• increased sense of duty and responsibility;
• belonging to a religion that condemns suicide;
• having dreams and plans for the future.

The more of these factors there are, the less likely it is to commit suicide, and vice versa.

The following techniques are also used to identify suicidal tendencies:

• depression scale score;
• assessment on the aggression scale;
• methods for identifying and preventing suicides;
• analysis of drawings;
• studying personal pages on social networks;
• method of unfinished sentences;
• psychological games.

Glossary of terms

In this section we have collected all the terms that you might encounter in this article. Gradually, we will collect from these explanations a real dictionary of a narcologist-psychiatrist. If some concepts remain unclear to you, leave your comments under the articles on our site. We will definitely help you figure it out.

Demonstrative behavior

- human behavior caused by the desire (or need) to attract the attention of others.
It can be caused by both mental disorders (for example, megalomania
) and the need for someone else's participation (for example, with
depression

suicidal
tendencies ).

Parasuicide

– a demonstrative attempt at suicide that does not have the goal of actually leaving life. Often used by children and teenagers as a tool to blackmail adults and draw attention to their problems.

Suicide attempt

– actions of the patient aimed at taking his own life, but did not lead (for various reasons) to death.

Selfharm (also Self-Harm)

– deliberate damage to one’s body for internal reasons, without the intention of dying. Selfharm is considered a symptom of many mental disorders. Typically, self-harm involves cutting the skin, scratching oneself, burning the skin, pinching limbs, picking wounds, pulling out hair, and so on.

Suicide is the same as suicide. Deliberate and conscious taking of one's own life, often associated with a variety of mental disorders.

Psychology of suicide

According to WHO, one suicide occurs every 40 seconds in the world, and more than 800 thousand suicides occur annually. At the same time, men commit suicide twice as often as women, and women are four times more likely to attempt suicide than men. In Russia, an average of 19.5 cases of suicide occur annually for every 100 thousand inhabitants of the country, but the situation varies greatly by region: if in Moscow an average of 4 to 6 suicides occur for every 100 thousand inhabitants, then in Siberia and the Far East it occurs more than 30, and in Altai, Buryatia, Tuva and the Nenets Autonomous Okrug and Chukotka - more than 60 cases of suicide for every 100 thousand people. These figures could be much lower if relatives of people who attempt suicide noticed the psychological problems of their loved ones in a timely manner and sought psychological help from specialists. Despite the fact that, according to statistics, only one out of 20 suicide attempts ends in death, one cannot blindly hope that suicidal behavior will not lead to a tragic end. Most suicide attempts in adults are the result of serious mental disorders - major depression, schizophrenia, bipolar disorder, dementia, psychopathy and other mental pathologies. In adolescents, suicide attempts are most often provoked by a desire to attract attention. Regardless of what made a person think about suicide, the desire to commit suicide does not happen immediately: they are always preceded by a certain period of time during which the person’s behavior from normal becomes suicidal. Suicidal behavior has the following characteristics:

• Previously unusual fatigue, lethargy, indifference or sudden calm.
• Chronic sleep disorders, insomnia, loss of appetite, psychological problems.
• Anxiety, aggression, fear, psychological imbalance.
• Neglect of one's appearance.
• Talking about suicide and death, increased interest in suicide cases, visiting sites with descriptions of suicide.
• Use of alcohol or drugs.
• Purchasing means that can be used to commit suicide (firearms, medicines, etc.).
• Previous or recent suicide attempts.
• Cases of suicide in the family or close circle.
• Hereditary predisposition to depression or mental disorders.

Types of suicidal behavior There are five main types of meaning of suicide: “protest”, “appeal”, “avoidance”, “self-punishment”, “refusal”. “ Protest ” is the desire to punish offenders, to harm them, at least by the fact of one’s own death. “ Call ” is a cry for help, for lack of attention. The meaning of suicide of this kind is to evoke sympathy and compassion from those around you through your death. “ Avoidance ” sets the goal of avoiding suffering or punishment. So, for example, a man who has squandered the public treasury shoots a bullet in the forehead. “ Self-punishment ” is something like a dialogue between two “I”: the judge and the defendant. The moral meaning of such suicide is atonement for guilt (“no, after such an act I am not worthy of living”). “ Refusal ”: here the purpose of suicide and the motive of behavior almost coincide, and therefore the meaning of self-destruction can be characterized as complete surrender. Analogues of suicidal behavior All identified types of suicidal behavior are analogues of general behavioral strategies in situations of conflict, and they correspond to the same types of moral and psychological positions of the individual: protest and accusations of others; call for help; avoidance of struggle and flight from difficulties; self-accusation; renunciation and surrender. If we analyze the individual style of behavior and conflict resolution of many, it becomes clear that in life situations their reactions usually gravitated towards the type of solution that they chose as suicide. What happens before suicide? Crisis states preceding suicide can be called a “blocking” of sources of life meaning: there is a blockade of life goals, the idea of ​​​​the impossibility of self-realization, a gap between what “should” and what is, between one’s own life and the surrounding life. As a result, life meaning, interest in life, prospects, and, consequently, incentives for activity are lost. There is alienation and hopelessness, a feeling of burdensomeness and hopelessness of life. Such conditions can arise not only as a result of one serious traumatic event, but also as a result of a series of life difficulties. The main mechanism specific to suicidal behavior and triggering the act of suicide is an inversion (reversal) of attitudes towards life and death. Life loses all degrees of positive regard and is perceived only negatively, while death changes its sign from negative to positive. From this moment, the formation of a suicide goal and the development of a plan for its implementation begins. Psychological assistance for suicidal behavior Timely psychological assistance for suicidal behavior will help not only prevent suicide and save the patient’s life, but also find out the reasons that caused such behavior. If you notice a psychological imbalance in the behavior of one of your loved ones, the signs described above or other psychological abnormalities, do not waste time and urgently seek psychological help from a psychotherapist. The sooner you seek advice, the easier and faster it will be possible to correct the patient’s behavior and return him to normal life. Psychological assistance from a specialist in this situation consists of early diagnosis of psychosomatic diseases, neuropsychiatric disorders and mental disorders that cause suicidal thoughts and actions, clarification of the reasons that can lead to suicide, correction of identified disorders and associated psychological problems with behavior. The risk of suicide is especially high if the patient has previously received treatment for a mental illness, has a history of suicidal thoughts, or has ever refused or interrupted treatment for a mental illness in the past. The risk also increases with relapses of mental illness and critical changes in the life of such a patient. Suicidal behavior in adolescents Timely psychological assistance is especially important for suicidal behavior in adolescents. We must not forget that in adolescence, the psychological motives that push a teenager to suicide can be completely insignificant from the point of view of adults and completely inadequate relative to the size of the problem. Such “tragedies” as a bad grade and the threat of punishment for it, a cruel joke or bullying by peers, a parental ban on friendship with a certain person or on using the Internet can dramatically change a teenager’s behavior and lead him to an impulsive decision to commit suicide. It is quite difficult to assess disturbing psychological abnormalities in childhood and adolescence without the help of a psychologist or psychotherapists: children often mix play and real life, and suicidal intentions may go unnoticed. It must be remembered that the risk group includes teenagers from dysfunctional families, children with emotional instability and increased suggestibility, prone to impulsive and rash actions, as well as teenagers who use alcohol, drugs and other toxic substances. Parental propensity for depression, psychosis and other mental disorders also increases the likelihood of suicide in a teenager. Poor relationships with parents also increase the likelihood of suicidal thoughts. There is another important factor that provokes psychological imbalance and dangerous psychological changes in adolescents - Internet addiction. If a teenager has practically stopped communicating with “real” friends and spends all day on the Internet, this is a very alarming signal. Internet addiction is similar to drug addiction and can also lead a teenager to irreparable tragedy. There is one very important point: often teenagers perceive death unrealistically - not as the end of life, but simply as a transition to another state, like a dream, after which you can wake up and return to life again. There is another important factor that must be taken into account: suicidal behavior in adolescents is contagious. If one of your youth idols, friends or acquaintances commits suicide, this often provokes a surge in suicidal feelings among an entire group of youth, and as a result, a number of tragedies due to group behavior can occur. If a teenager begins to show aggression, withdraws into himself, loses his appetite or stops taking care of his appearance, if he spends too long on the Internet, this is a sign that it is time to seek the help of a psychologist. Dangerous signs are also the teenager’s unsociability, lack of friends, delinquency, participation in informal groups, unconscious desires to hurt himself (biting nails and fingers, pulling out hair, frequent cuts, scratches and bruises), as well as a tendency to take reckless risks - for example , excessive passion for extreme forms of entertainment. A difficult situation in the family (divorce of parents, appearance of a stepfather or stepmother, conflicts between parents or close relatives, etc.) can complicate the situation. Signs that a teenager is beginning to develop suicidal tendencies may include the following:

• Passivity and indifference to what is happening.
• Low self-esteem, dissatisfaction with oneself, one's position among peers and one's appearance.
• Inability to find an interesting activity or hobby.
• Psychological or emotional disturbances: imbalance, aggressiveness, impulsive behavior, psychological imbalance
• Mental disorders: depression, obsessions, phobias, etc.
• Gloomy moods, tragic thoughts, conversations about death, increased interest in deaths and tragedies in films, literature and news.
• Negative assessment of the present and pessimistic sentiments about the future
• Social rejection (lack of friends at school, poor relationships with parents, bullying by peers, etc.).
• Difficulty concentrating, absent-mindedness, forgetfulness.
• Taking drugs, spice, any toxic substances or alcohol.

It must be remembered that only a specialist can assess the true depth of the problem, so if alarming signs appear in a teenager, you should not waste time and urgently seek the help of a psychologist.
A psychologist will determine the level of risk of suicide in a teenager, guide him to find a way out of the current difficult situation, or help him change his attitude towards problems that cannot be solved. If a very acute situation has occurred, the only way out of which the teenager considers the passing of their lives, then in this case an emergency consultation with psychotherapists or psychiatrists is necessary, which may require psychotherapeutic or medicinal treatment. Timely provision of medical care will help not only prevent tragedy, but also return the patient to a normal, fulfilling life.

Suicide attempt: psychological assistance to the patient

Professional assistance to a suicide person—a patient who has attempted suicide—should be provided on an emergency basis and include several stages. The most effective method of bringing a patient out of a critical state is individual conversations with a psychotherapist who will comprehensively address the patient’s psychological problems.

At the first stage of psychological assistance, the psychotherapist’s goal is to establish emotional contact with the patient and provide him with the opportunity to speak out. As a rule, after an unsuccessful suicide attempt, the patient willingly pours out his feelings in a long monologue, after which his state becomes calmer, and the psychotherapist can move on to the next stage of help - finding out the reasons that caused the patient to have a deep psychological crisis. At this stage, the psychotherapist’s task is to lead the patient away from suicidal thoughts, relieve him of the feeling of hopelessness, raise his self-esteem and convince him that all his psychological problems and difficult emotional state are temporary, and all the difficulties with which he faced, is surmountable, and his death will not solve the problems, but will be a heavy blow for family and friends. After the psychotherapist convinces the patient that all his psychological problems are surmountable, the next stage of assistance begins - developing measures to overcome the crisis situation.

At this stage, the psychotherapist helps the patient pay special attention to psychological problems, believe in themselves, and draw up a plan to overcome the problematic situation. A constructive step-by-step plan for further actions that can be taken instead of committing suicide will help the suicidal person more effectively overcome the psychological problems that have arisen and quickly find a way out of a situation that, in his opinion, is insoluble. When, with the help of a psychotherapist, the patient’s condition changes from passive inaction to an attempt to independently solve the problem, the psychotherapist will support in every possible way.

Psychological assistance for suicide

If relatives did not show due attention to the suicide and failed to prevent the tragedy, then in this case the relatives may also need psychological consultations. Tragedies such as suicide always cause loved ones to feel guilty for inaction and, in turn, can lead to depression and deep emotional distress. If the suicide victim managed to survive the incident, the psychotherapist’s task is to protect the patient from repetition of suicide attempts and self-harm, improve his subjective perception of the quality of life and prospects for the future, and also reduce the feeling of hopelessness of the situation and the meaninglessness of life, which pushed him to commit suicide. desperate step.

It is also necessary to remember that only a specialist can best solve any psychological problems, so at the first alarming signs in someone close to you, you should not waste time and you should immediately seek advice from a psychologist or psychotherapist. Early identification of psychological imbalance and possible mental abnormalities will help the patient overcome the psychological crisis and save him from many problems in the future.

Your psychologist. The work of a psychologist at school.

The tradition of studying suicide dates back to ancient times. Since the times of the civilizations of Ancient Egypt, Greece and Rome, suicide has been condemned and condemned. The first psychological theories that appeared in the 19th century considered suicide as a symptom of mental illness, an abnormal behavioral act and a manifestation of a painful psyche. In the 20th century, the consideration of suicide was enriched by the understanding that not only a mentally ill person can attempt suicide, but also a mentally healthy person, in conditions of hopelessness, sees taking his own life as a way out of a difficult life situation.

Currently, the range of views on suicide has been supplemented by the cult of unfounded romanticization of suicide, popular among young people, which increases the risk of suicidal intentions and suicide attempts among adolescents with an immature, unstable psyche. The study of suicidal behavior at different times was carried out by Z. Freud, K. Jung, A. Adler, K. Horney, V. Frankl, K. Menninger, A. G. Ambrumova, A.S. Rakhimkulova, V. A. Rozanov, N. E. Antipova, D. Brent, D. Bridge and T. Goldstein and others. The concept of suicide and suicidal behavior (hereinafter referred to as SB), the causes and risk factors for the emergence of suicidal intentions, stages and types of SB, markers of suicidal activity and other aspects of SB were studied. The works of the above authors served as the theoretical and methodological basis for understanding suicidal behavior. Suicide (suicide, from Latin sui - oneself, caedere - to kill) is a conscious act of purposeful departure from life, intentional deprivation of one’s life as a result of experiencing a traumatic situation and the inability to independently find a way out of the current circumstances. Suicide in the context of the universal value of life is an unnatural and drastic step, therefore the decision and intention to commit suicide, as a rule, does not mature instantly.

Suicidal behavior (SB) is any internal or external forms of mental acts determined and directed by ideas about taking one’s own life [8, 11, 26, 32]. A suicide is a subject of suicidal behavior. Suicidal behavior is a broader concept. SP can be understood as thoughts or outwardly manifested activity, directed by intentions to take one’s own life. Suicide in this context is considered only as a deliberate action, a specific attempt to take one’s own life on the part of the subject. Suicide is preceded by a time-deployed SP. It has been established that suicide attempts are most often made by persons who have a predisposition to a suicidal reaction. A predisposition to suicidal behavior can develop under the influence of a number of genetic, biological, as well as socio-environmental factors, such as the presence of traumatic situations, defects in upbringing, burdened family history (the presence of suicide attempts and suicides among close relatives, frequent conflict situations in the family) and others (A. G. Ambrumoa, G. I. Kaplan, B. J. Sadok, E. B. Lyubov, P. B. Zotov, K. Hawton, J. Williams) [2, 3, 4, 17, 18 , 22]. An example of predisposition factors to suicidal behavior is presented in the table.

Table 1. Factors that form a predisposition to suicidal behavior

Social

Natural	Medical	Individually
demographic	typological
Floor	Season	Genetic deviations	Disharmonious personalities
Age	(spring,	nia
Location	autumn)	Aggravated heredity	Moral and ethical standards
Family status	Isolation conditions
Features inside-	Acute chronic and	Moral and religious motives
family relations	Times of Day	somatic diseases,
limiting	The heat of passion
Education	active activity	Social and mental immaturity
Socially-pro-	Mental illness
professional status	Disadvantages of education and training
Physical and mental
injuries	Media Influence “Werther Effect”

According to researchers, among the factors influencing the increase in SB are also sharp changes in the life pattern, habitual way of life and lifestyle, separation from previous traditional cultural values, and the inability to engage in any usual type of activity [22]. If difficult life circumstances or psychotraumatic situations arise in a person’s life that he cannot cope with on his own, these factors can provoke the development of a joint disorder unfolded over time. Almost all SP researchers point to the course of suicidal behavior over time in the form of phases, stages, stages. Most researchers agree on identifying three main stages of SB: the presuicidal stage (pre-dispositional phase), the stage of realization of suicidal intentions (suicidal phase) and the post-suicidal stage [3, 22, 25, 28].

Let's look at these stages in more detail.

The presuicidal stage (predispositional phase) covers the period of time from the first appearance of suicidal thoughts to the decision to commit suicide. This stage can have a different duration, which is determined both by the dynamics of the traumatic situation itself and by the personal characteristics of the potential suicide. The subject is tense, trying to independently find a way out of the current critical situation. His attention is focused on the difficulties of life, on thoughts about the impossibility of resolving the situation that has arisen independently and the lack of potential possibilities for solving the problem. At this time, a person is in dire need of support, establishing friendly relations, empathy and analysis of the situation. The apogee of intensifying the emotional state is a retrospective perception of life, a vague feeling of internal change, alienation, detachment, inner emptiness, meaninglessness of existence and hopelessness. Against this background of the internal state, a decision can be made to commit suicide as the only way to break the “vicious circle.”

According to N. E. Antipova, markers of the formed internal state of “readiness” to make a fundamental decision can be [25]: - Isolation - the feeling that no one is interested in you or understands you. - Helplessness - when a person feels that his life is beyond his control. This feeling is especially characteristic of young people who feel that others do everything for them and nothing depends on them. - Hopelessness - when the future does not bode well. - Feelings of unworthiness - when a person evaluates himself low, feels incompetent or is ashamed of himself.

If a person declares at least one of these parameters of internal state, psychological assistance is necessary. The decision to commit suicide is usually facilitated by an event, the “last straw”, additional psychological trauma, which further convinces the person of hopelessness and the inevitability of disaster. The specific time of suicide is determined by the reason - an event such as the “last straw”, under the influence of which the patient decides to commit suicide. Sometimes certain dates, such as Valentine's Day or the birthday of a deceased loved one, act as a reason, aggravating the person's painful experiences. With the decision to commit suicide, the pre-suicidal stage ends and the stage of realization of suicidal intentions begins. The stage of realization of suicidal intentions (suicidal phase). At this stage, the suicidal person has the intention to commit suicide, seeks information necessary to carry out a suicide attempt, plans upcoming actions, chooses an appropriate method of suicide, and considers the best place and time for suicide. In anticipation of suicide, he performs the last pre-suicidal actions, for example, says goodbye to loved ones (who usually have no idea about his intentions), writes a suicide note, and finally commits suicide. In other words, the stage of realization of suicidal intentions includes planning for the upcoming suicide (choosing the optimal method, place, time of committing a suicidal act), preparing for it (completion of all affairs, writing a suicide note, etc.) and sequential implementation of suicidal actions.

Post-suicidal stage. This period covers the period of time after 1-3 months of the suicide attempt. If the attempt was not completed, after drug treatment, there is a chance to analyze previous events, provide assistance to the suicide, and bring him out of the state of hopelessness. If the suicider does not manage to get out of the state of hopelessness, a repetition of the suicide attempt is likely. According to statistics, a repeated suicide attempt is most likely within 10-80 days from the moment of incomplete suicide [2, 3].

Thus, sharing the opinion of A. G. Ambrumova, N. E. Antipova and other authors, it can be argued that suicidal behavior is determined by socio-psychological maladjustment of the individual [2, 3]. At the subjective level, maladaptation can manifest itself in the form of a feeling of hopelessness, powerlessness, and the inability to resolve a conflict or difficult life situation. It is the internal state of the subject that is the main motivator (motive, reason) for the development of SP [31]. These causes must be eliminated first when providing assistance and preventing the risk of suicidal behavior. Source: Gorbushina, A.V. Suicidal behavior of adolescents: diagnosis and prevention [Electronic resource]: textbook / A.V. Gorbushina, A.S. Vlasov. - Electron. text. Dan. (3.5 MB). — Kirov: MCITO Publishing House, 2021.

Second stage - statements

When a person has formed a persistent image in his thoughts that the solution to all his problems is death, he moves on to the next stage - statements. This is a taste test of thought. A test of her viability beyond herself and another test of how the world would react. The person seems to be looking for evidence that he is on the right path and there are no other opportunities to get out of the circle of problems. In a conversation, he can reflect on death, hopelessness, and the meaninglessness of life. A common message that comes from people thinking about suicide is “nobody needs me,” “it will be better without me,” “life is meaningless.”

Sometimes people contemplating suicide may talk or write about their intentions directly. And then you can hear: “I want to die” or “I don’t want to live anymore”, “It’s better to die”, “I’ll throw myself off the roof (drown myself, cut my veins, etc.)”, “I can’t do this anymore” , “I won’t be a problem anymore.” He can ask about death and methods of suicide, talk about this topic and even joke, choosing the most painless or fastest method. In queries on the Internet, topics related to statistics, methods, and suicide groups may appear.

Important! Speaking about suicide, a person, on the one hand, wants to convince himself of this, but on the other hand, he wants to be convinced of the opposite.

He is looking for those who will tell him, or better yet show by their actions, that they need him. Without fear, he will respect his feelings, he will be able to be close, he will be able to share and understand them. Children and adolescents may have many questions about death, but it is important to remember that there was a first stage and it did not go away, i.e. the signs remained.

For example, if a child of five to seven years old or a teenager is interested in the topic of death, but at the same time he is in a great mood, he is active, calm in communication, and there are no signs described above, then this is normal. This is typical for children of this age and adolescents. But, if there are signs of the first stage, then you should pay special attention and still contact a psychologist.