Depression/Suicide Intervention

John Brunelle, Ph.D., Student Counseling Center, Davidson College

Warning Signs:

• Changes in Appearance – disheveled, lack of hygiene, worn/tattered clothing, monotonous facial expressions
• Changes in Behavior – no longer doing/enjoying usual activities; hyperactivity; social withdrawal; extravagant spending; overzealous social activity
• Changes in Personality – sad, withdrawn, irritable, anxious, tired, apathetic, indecisive; diminished concentration and attention
• Changes in Sleep Patterns and Eating Habits – insomnia, hypersomnia, early or late rising; loss or gain of appetite, drastic change in diet
• Statements of…hopelessness, worthlessness, helplessness, meaninglessness, low self-esteem
• Recent Loss – death, divorce, relationship, job, money, status

Interventions:

• Listen Actively to what the person is saying to you – restate and reflect content and emotion. Remain calm and validate what they are feeling without judgment.
• Ask the person – “Are you thinking of suicide?”
  Ask them if they have a plan and if they have the means. Asking someone if they are suicidal will NOT make them suicidal. Most likely they will be relieved you asked.  
• Reassure the person that there is help for his/her problem, but do not talk them out of feeling the way they are. And reassure them that they are NOT “crazy” or “bad” because they are thinking of suicide.  
• Help the person break down the problem into more manageable pieces. It is easier to deal with one problem at a time. Help them explore other ways to solve their problems.
• Do not agree to keep the person’s suicidal thoughts a secret – Helping someone who is suicidal is very stressful and should never be done alone. Make it clear to the person that you may need to incorporate the help of others.
• Make a referral to counseling services – Stay with the person until an appropriate referral is made.

Taking Care of Yourself:

• Be selfish – Airplane Metaphor (Put on your own oxygen mask before helping others put theirs on.)
• Know and work on your own stuff
• Don’t be a martyr…Don’t be a superhero…Don’t be a therapist

Typical Emotional Reactions to Watch Out For:

• Fear and Anxiety
• Overwhelming Responsibility
• Feelings of Inadequacy/Incompetence
• Could trigger your own lingering issues
• Could trigger generalized/existential feelings
• Distractability/mania/insomnia/loss of appetite

Helpful Links:

• QPR Institute – Question. Persuade. Refer. 
• Applied Suicide Intervention Skills Training (ASIST)