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Suicide has long been a serious public health problem. That is why we need to talk about suicide and keep talking about it. This subject remains taboo for many people even though suicide attempts are significantly more frequent than we think...

- Some precisions -

Suicide is often associated with a specific event, whereas a single event is not enough to explain the act. However, this event can be the last straw, the final element in a negative spiral. The suicidal act is not spontaneous, it is part of a process where repeated attempts to solve the difficulties are less and less effective. Despair sets in and the person comes to believe that suicide is the only way to end the suffering.

Talking about ourselves and our difficulties is often difficult. Many people prefer to keep quiet, hoping to get out of trouble on their own or hoping for better days ahead. Withdrawal and isolation can aggravate a sense of failure, but also increase the loss of confidence and self-esteem. Unfortunately, the signs that this path is being followed are very often hidden and therefore almost invisible to others. However, in some cases, a series of more or less subtle clues may attract the attention of those around them and make possible to express concern in order to initiate a dialogue. However, the suicidal process lasts for different lengths of time for different people, so for those with an impulsive nature, it can be reduced to a few days or hours.

When suicidal ideation takes hold, behaviours and speeches that may seem banal need to be decoded :

Loss of self-esteem and self-confidence ;

Communication of suicidal thoughts or despair, direct or indirect : « I want to end this, I would like to fall asleep forever, you would be quiet without me, my life is useless...» ;

Disinterest or overinvestment in everyday reality ;

Irritability, depression, lack of reaction to a major event ;

Somatic persistent complaints ;

Behavioural change : hyper activity or withdrawal ;

Abuse of medication, drugs and/or alcohol ;

Etc.

The suicidal person wants to end their suffering, not their life. In fact, the suicidal person is ambivalent about their desire to live and their inability to continue suffering. Understanding this ambivalence and using it to find a hopeful solution is one way to intervene :

RECOGNIZING THE SUFFERING : When we are subjected to suffering, our whole organism goes into action to face it. But it is the compassion (not the pity) of loved ones that is the bond that makes us human, individual, sensitive and connected. Let’s not be afraid to say : « I realize that you are going through difficult times... that you believe that you will not be able to..., that you feel..., that you are thinking about suicide. ».

STAYING AUTHENTIC : We are responsible for our attitudes and for what we offer to others, but we are in no way in control of the choices and decisions of our fellow human beings. So, if what the other person confides in us disturbs us, we can answer : « I would like to help you but I do not know how to do it, so let's go together and find other people to turn to. ».

NOT STAYING ALONE : Whether we are the one in suffering or the listener, we need to refer to professionals and others for support : « Let's take the time to talk to other people about what you are going through. Together, we will have more resources. ».

A suicidal person may appear momentarily relieved and look better, but care should be taken as this does not mean that the danger has passed. On the contrary, a sudden good mood may indicate a high degree of urgency :

• either the person is trying to reassure those around him/her ;
• or the person feels a real relief at having arranged everything for their death.

- The aftermath of a suicide attempt -

Most suicide attempts are not fatal, but this does not mean that everything is resolved : the problems that existed before the attempt are still present. Understanding the emotional consequences of an attempt, and being aware that it may be repeated, are necessary to help survivors recover and protect themselves from future harm.

The emotions that follow a suicide attempt can vary widely :

There are those who say they had immediate doubts/regrets after the first actions of the attempt, followed by an intense sense of relief at the realization that they survived ;

There are those who feel that they have been given a new lease of life and that they are able to return to their life, with more foresight and strength ;

There are those who report feeling that a burden has been lifted, as their secrets, sufferings and thoughts have been revealed to those close to them, as if they had « come out » of their despair ;

And then there are those who are disappointed, ashamed, empty, more depressed than before, and overcome with immeasurable anger.

Although some evidence suggests that these feelings/beliefs will dissipate, for the majority of survivors they should be taken into account as the individual is still at risk. This is why anyone who has attempted to end their life, as well as those around them, must consult a mental health professional.

- Getting help after a suicide attempt -

Persistent suicidal thoughts are a reality for some : the thoughts can be continuous, or they can temporarily fade and return. Regardless of when they arise, it is imperative to seek help as soon as possible, either by calling a local emergency number or a suicide prevention centre.

There is no shame in it, most survivors lead a full and meaningful live. After a suicide attempt, it is normal to experience many strong and conflicting emotions, to deliberately isolate ourself or to try to hide what happened. But the social bond is particularly important and can be powerfully healing, as it can help to identify certain problems, to give meaning and/or a purpose to life. Therefore, joining a support group can be helpful.

Beyond that, nothing should be overestimated, there is no sudden acquisition of superpowers to face life, only a mental health professional can guide, help strengthen and give the weapons that were lacking to face the past, the present and the future, whether the need arises or not.

- Supporting someone after a suicide attempt -

When a loved one attempts suicide, it is normal to be confused, scared or angry. It is difficult to know what to say or do in the aftermath of a suicide attempt, but one should not try to reassure or anticipate/lock the actions and words, one should just be present. If an opportunity to talk about the suicide attempt arises, one has to make an effort to listen with empathy and without judgement.

In the aftermath of a suicide attempt, it is common for people to beat around the bush or act as if it never happened, which can make the situation worse for both the survivor and those around especially in the long term).

- Surviving death -

Depending on the closeness and attachment to the deceased, those around them will experience the mourning process with varying degrees of intensity. After the shock of the news, the refusal to believe it and the time of the funeral, those close to the deceased may be tormented by questions about the reasons for the suicide and by feelings of guilt. They may experience intense feelings of grief, sadness, insecurity, revolt, confusion, shame, fear... They may become lost in time : the time when the « other » was alive. Sleep, appetite and daily life may be disrupted. They will feel that they are « apart » and will often feel misunderstood. During this ordeal and for many months afterwards, they will need, as well, the listening and support of those around them, and professional help.

Conclusions

Suicide is a disturbing subject that is difficult to talk about. However, it is by talking about suicide that we can demystify it and help a person in distress. Asking directly if a person is thinking about suicide is not suggesting the idea, but opening up the possibility of expressing the suffering.

We must avoid underestimating the subject or praising someone who has committed suicide as brave, or conversely damning them as a coward. Attention should also be paid to the media coverage of suicide, as it is often romanticized and can create a fascination.

It is essential to consider that people who have already had suicidal thoughts, who are bereaved following a suicide or who are close to a suicidal person, may express a greater need for help, which is why it is important to lift the veil on the subject, and not to hesitate to call on a professional.

What do you think?