"Talk about suicide openly!"

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Every year 10,000 people in Germany take their own lives. What are the warning labels and what can I do if I suspect someone is suicidal? An interview with the psychiatrist Dr. Iris Hauth *.

Dr. Iris Hauth

Dr. Iris Hauth is chief physician at the Clinic for Psychiatry, Psychotherapy and Psychosomatics at the Alexianer St. Joseph Hospital in Berlin-Weißensee. She is also President of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN).

Miss Dr. Hauth, you have 30 years of experience dealing with the mentally ill. How can I, as a non-expert, know that a person is harboring thoughts of suicide?

There are usually some clues. These people are very restricted in their thinking and behavior. You feel like you have few options left. Things that were important to you before are no longer considered. Above all, they withdraw from their interpersonal relationships. Even if someone only looks pessimistically into the future and makes statements that reveal hopelessness, this can indicate suicidality.

So if someone says: “It doesn't make any sense”, you should pay attention.

Right. Especially if someone has changed before and has appeared joyless and listless for a long time. It is also typical for severely depressed people that they feel worthless or useless and therefore develop feelings of shame and guilt.

Why is that?

These patients often have very high demands on themselves, they always want to do everything 110 percent. If you then realize that you are depressed and can no longer live your life as before, then you are ashamed. You then often think: "The way I am now, I can no longer expect my partner, my family, the world, that's why I leave". They might then say things like: "You would be better off without me." Or: "I'm not good for anything anyway."

So it is not true that people who talk about suicide do nothing to themselves.

On the contrary. Such utterances can be a cry for help. You always have to take that very seriously.

When depressed people make the decision to take their own life, they often seem much more relaxed than before.

That's right, if the patient suddenly seems to be feeling better after a long period of depression, this can be a warning sign. If the rope is already in the trunk, that is a relief for the time being. The awareness, “I can do it anytime” is a relief - but it doesn't go away with the depression and makes suicide even more likely.

What specifically can I do if someone around me is depressed and I am afraid that they will harm themselves?

It's important to be open about this. Say straightforwardly, “I'm worried, I can see that you've changed. How are you, what do you think, what do you feel? ”When someone confirms that they are feeling bad, the next step is to clearly address possible suicidal thoughts. Say, “If you've been feeling this bad for a long time, I can well imagine that you sometimes think about killing your life. Is that so?"

Doesn't that make someone really think about suicide?

No. You used to have this idea, but that's not true. If someone wants to take their own life, they have this idea beforehand. So don't be afraid to broach things. Find the conversation! It relieves those affected that they are no longer alone, it can help to get out of this one-way street.

So openness helps.

I can only encourage that. Many patients have told me that they were glad that I had addressed this in such a neutral way. This helps to see it as a normal part of the disease. Sufferers realize that they are not bad people because they feel that way and have these kinds of thoughts. You notice: That is part of it and you can talk about it.

What do I do if someone confirms they are thinking of suicide?

Then it is important to distinguish whether someone only has suicidal fantasies or already has specific ideas about how they want to do it. To think from time to time that you no longer want to live is a warning sign. But if someone has already planned their death, they need professional help immediately. You have to make that clear to him. Say, “This is so serious now, you need help right away. We're going to a clinic together and get advice on how to get out of there. "

Who is particularly at risk of suicide?

Suicide is the second leading cause of death in young people. Even so, most of the people who commit suicide are older. Men over 65 are particularly at risk, as the curve goes up dramatically. But older women are also more likely to be suicidal. Especially in old age, psychosocial factors often reinforce the desire not to want to live any longer. Older people often no longer have a job and are lonely. Their friends die away or they can no longer really take part in social life due to physical limitations.

And younger people?

Even at a young age, psychosocial factors can be decisive: losing one's job, breaking up relationships, all of which can trigger suicidal thoughts. As a friend, relative or colleague, be vigilant and always take possible suicide signals seriously!

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