It’s really hard to watch a loved one obsessing about suicide. It’s really scary when you don’t know what to do. That’s probably why two people have asked me about this lately. And while there are many things you can do to help a person who is obsessed with suicide, the most important thing is probably to get them professional help. Here’s how to get help and what kind of help might work for a suicidal loved one.
What does it mean when a loved one is obsessed with suicide?
A suicidal obsession can mean a number of things. It can mean that the person is depressed to the point of wanting to die, of course, but it can also mean that the person suffers from obsessive thought patterns that involve suicide.
For example, when a person is depressed, suicidality may be a symptom. This may mean that the person feels like a burden to others and that the world would be better off without them. Suicide may seem like a logical act to the depressed person, given their pain and the effects it has on others. This may lead to obsessive thoughts about suicide.
On the other hand, some people have obsessive thoughts about suicide even though they don’t want to carry them out. These may be visions or thoughts of suicide that appear without warning or provocation (intrusive thoughts). I have found that obsessive thought patterns are common in people with bipolar disorder, but they can happen to other people as well.
Of course, no matter why your loved one is obsessed with suicide, they need help.
When your loved one is obsessed with suicide, make sure they are safe
The first priority when helping a loved one who is obsessed with suicide for whatever reason is to make sure they are safe and unable or unwilling to act on their obsessive thoughts. Many people focus on being the personal deterrent to their loved one committing suicide. In other words, they won’t leave the person alone, they hide lethal means, etc. While I understand why they focus on this, people who are truly obsessed with suicide may need more help than that to stay safe.
A person who is obsessed with suicide can be a danger to themselves no matter what you do, and in those cases, you should consider inpatient treatment. I know it’s not something anyone turns to, but it can be a critical part of the care infrastructure. I’ve been hospitalized for suicidal tendencies. It’s not fun, but it kept me safe, and that’s what I needed at the time. Remember, it’s much better for your loved one to be alive and angry at you than not to be alive at all.
If your loved one is in danger, the best thing you can do is contact your doctor and request hospital treatment as soon as possible. However, this is not always possible due to how quickly one can become a danger to themselves. In such cases, call 9-8-8 or even 9-1-1 and ask for an ambulance if necessary. Believe me, I know this is not fun, but again, your safety is the most important thing.
Please understand that no matter how hard you try, sometimes you can’t keep your loved one safe without help. That doesn’t make you a bad person, it makes you a human being.
If your loved one is obsessed with suicide, get them professional help
I previously wrote about how to help someone who is suicidal. This is a good holistic view of how to help someone in this situation. However, it doesn’t go into detail about what professional help your loved one who is fixated on suicide needs.
If your loved one is obsessed with suicide, he or she needs professional help. This is not a problem that you or your loved one can deal with alone. It is serious and can lead to death. He or she should get help from people who are specifically trained to deal with this problem.
If your loved one is not receiving mental health care
If your loved one is not already receiving mental health care, they need it right away. You should talk to your loved one’s GP about providing it. The GP may choose to start treatment (for example, they may prescribe an antidepressant if the person is diagnosed with depression) at that time, or they may refer your loved one to someone else, such as a psychiatrist, for appropriate treatment. Remember that when a mental health problem is serious, a GP is usually not qualified to treat it long-term.
If your loved one is receiving mental health care
If your loved one is receiving treatment and is obsessed with suicide, then the current treatment is clearly not working. After all, the first goal of treatment is to keep him or her alive. This means that you need to make sure that your loved one’s health care provider (which should be a psychiatrist if your loved one has bipolar disorder) is aware of the situation. The best way to do this is to attend your loved one’s medical appointments. The person who is obsessed with suicide may not be as forthcoming as they should be without your help. It is very difficult to sit in front of a doctor and tell them that they are suicidal, but having a loved one present can make things easier.
It is critical that the doctor knows the severity of the problem and that there must be a treatment plan to address it immediately. You must be completely honest about it. Don’t beat around the bush. Don’t use euphemisms. Say that your loved one is at risk of suicide. Don’t leave without a plan to address it.
If you can’t make the appointment, perhaps because your loved one isn’t comfortable with it, you can still talk to your doctor about how suicidal your loved one is. In this situation, the doctor won’t be able to tell you anything about your loved one for privacy reasons, but you’ll still be able to hear from them.
What treatments work for a person obsessed with suicide?
As I said before, inpatient treatment may very well be necessary if a person is obsessed with suicide. This is not an indication of anyone’s failure. It is just an indication that the person needs intensive help. If that is what it takes to help your loved one, then that is what needs to be done.
It should be noted that many places will only hold a suicidal person for 72 hours. In my experience, if a person is severely depressed or experiencing other serious symptoms of mental illness, this is not enough time to stabilize them. You may need to strongly advocate with doctors or insurance companies for additional inpatient care. You and your loved one’s doctor may be able to work together to try to force longer treatments if insurance prevents this (which is often the case).
Another thing to know is that lithium is the only known medication for treating mood disorders that has an anti-suicidal effect (clozapine has also been shown to have an anti-suicidal effect, but is not commonly prescribed outside of schizophrenia). However, lithium has its risks and pitfalls (including the risk of overdose), so its effects need to be carefully considered.
Ketamine and esketamine (Sprovato) may have immediate but small antisuicidal effects, but research continues.
Electroconvulsive therapy (ECT) is often an option for people whose lives are at serious risk. Again, it is not an easy treatment to carry out, so the risks and benefits need to be carefully considered before choosing this option.
More details on the above can be found here.
Psychotherapies can also help reduce suicidal ideation. Cognitive behavioral therapy (CBT) appears to reduce suicide attempts, suicidal ideation, and hopelessness. Dialectical behavior therapy (DBT) may also reduce suicidal ideation, but the evidence is more limited.
You might be surprised not to see antidepressants on the list. This is because antidepressants may increase suicide risk in young people in the short term, and the evidence that they reduce it in the long term is low quality. This doesn’t mean they don’t work, but it does mean they may not be enough in the short term for someone who is fixated on suicide.
A multi-pronged approach will likely be necessary if your loved one is fixated on suicide.
If your loved one is obsessed with suicide, remember this
If your loved one is fixated on suicide, remember that the road back can be long and bumpy. Suicidal tendencies don’t usually appear overnight, and the danger they pose doesn’t usually disappear overnight either. Be prepared to support your loved one in the long term.
So, you may need your own support to help your loved one. This is okay. It doesn’t mean you’re weak or incompetent. It just means you’re dealing with something really difficult. Talking to other people who have been through the same thing can help. Reach out to local mental health organizations or the National Alliance on Mental Illness (NAMI) To find out about possible support options or to seek psychotherapy yourself. You cannot help them effectively if you are in crisis yourself.
Also, remember that there’s nothing wrong with your loved one who is suicidal – there’s something wrong with their brain. Suicidal tendencies are incredibly scary, and you may not have a frame of reference to explain why it’s happening. The important thing is to understand that it happens to people sometimes, and that you can help them through it.
Finally, remember that your loved one can get through this. Just because your loved one is suicidal today doesn’t mean they will always be suicidal. There are people who get through crises like this and start from a good place because they have your help.
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