Suicide Prevention: 3 Stages to Watch Out For

By June Hunt, Op-ed contributor Wednesday, December 19, 2012

Kim Ruocco hung up the phone in her home in Massachusetts and dashed to the airport to board a last-minute flight for California.^{1 She had a bad feeling after speaking with her husband, Mike, who was preparing for his second deployment to Iraq. Mike told his wife that he planned to ask for help with some troubling issues while at Camp Pendleton where he was stationed.}

By the time Kim's plane touched down, her husband was dead.

As a marine attack helicopter pilot, Major Mike Ruocco survived 75 combat missions. Tragically, however, he was unable to overcome his secret battle with depression and post-traumatic stress disorder. Fatigue and stress from deployment and combat combined with the loss of friends and colleagues contributed to his severe emotional suffering. Mike had been afraid to seek help because he did not want to appear weak or unwilling to do his duty and serve his country. In the end, he made the tragic decision to stop his suffering through suicide.

You may regularly interact, work or even live with someone who quietly struggles with suicidal thoughts, and God may want to use you to be a source of Christlike love and support. But you may wonder, How can I truly recognize the signs that a friend or loved one may be contemplating suicide?

Suicidal tendencies or thoughts generally move through three successive stages: downcast, distressed and finally, despairing.^{2 Intervening at any of these points to offer hope, an understanding ear and a safe place to be vulnerable can halt the downward spiral toward death. As Scripture directs … "Be merciful to those who doubt; save others by snatching them from the fire …" (Jude 22-23 NIV).}

Downcast: Early Stage

• Dejection
• Anxiety
• Decline in work or school performance
• Inability to concentrate or make decisions
• Change in eating and sleeping habits
• Avoidance of family
• Boredom
• Lack of interest in the future

"Why, my soul, are you downcast? Why so disturbed within me? Put your hope in God, for I will yet praise him, my Savior and my God."
(Psalm 43:5 NIV)

Distressed: Advanced Staged

• Depression
• Withdrawal from family and friends
• Rapid mood swings
• Physical problems, self-injury, anorexia
• Self-pity
• Excessive absences from work or school
• Apathy
• Neglect of personal appearance

"What I feared has come upon me; what I dreaded has happened to me. I have no peace, no quietness; I have no rest, but only turmoil." (Job 3:25-26 NIV)

Despairing: Danger Stage

• Hopelessness
• Abuse of alcohol/drugs
• Deep remorse
• Isolation or moody behavior
• Previous suicide attempts or threats of suicide
• Distribution of personal possessions
• Organization of personal affairs; making a will
• Sudden change from depression to cheerfulness (indicating being at peace with the decision to commit suicide)

"Guard my life and rescue me; do not let me be put to shame, for I take refuge in you."
(Psalm 25:20 NIV)

The suicide rate among active duty military personnel has risen steadily over the last decade. From January to August 2012, 171 soldiers died at the hands of their enemy while serving in Afghanistan, but even more military personnel died by their own hands. During that same time period, 212 Army service members took their own lives by suicide.³

But the military is not the only segment of society that must deal with this escalating tragedy. According to a recent study, the leading cause for mortality due to injury in the United States is not car crashes, homicide or drug overdose – but suicide.^{4 And inconceivably, the age group that experienced the largest increase in suicide rates over the last decade is children ages 5 to 14, followed closely by teens and young adults, ages 15 to 24.⁵}

If suicide has not catastrophically impacted your family or friends, be thankful, but it is also essential to be prepared to help someone you love who one day may experience an emotional crisis. Helping someone who feels suicidal can be a daunting challenge. Use the following points to further equip you to give hope to the hopeless:⁶

1. Honestly Confront.

Take all talk of death and suicide seriously.
Ask the direct question, "Are you thinking about suicide?"
Express your love and concern.
Discover what is causing the pain.
Ask, "How have you been coping with the pain thus far?"

"The purposes of a person's heart are deep waters, but one who has insight draws them out." (Proverbs 20:5 NIV)

2. Offer Options.

Acknowledge and empathize that life is hard.
List alternatives to suicide on a sheet of paper.
Rank the alternatives that will best meet needs and bring hope and healing.
Communicate God's purposes for suffering, emphasizing His unconditional love and desire to use hurting people in the lives of others for mutual support and encouragement.

Remind them … "Many people are hurting just like you. They feel desperately alone, assuming that no one understands their pain. You know what it is like to hurt. Your personal pain enables you to have a ministry of compassion. You are being prepared right now to be a lifeline of hope for someone else who feels hopeless. Realize … your life has immense purpose. "

"Before I was afflicted I went astray, but now I obey your word. …It was good for me to be afflicted so that I might learn your decrees.
(Psalm 119:67, 71 NIV)

3. Enlist Help.⁷

Encourage the person to have a physical checkup.
Seek a trained, biblically-based, Christian counselor or therapist.
Call a minister.
Contact a suicide crisis center.
Help make arrangements for hospitalization.

"Plans fail for lack of counsel, but with many advisers they succeed."
(Proverbs 15:22 NIV)

4. Present a Contract.⁸

Build a relationship of trust by showing your care and willingness to help.
Ask if the person would be willing to make a contract with you: "Will you promise that if you are considering harming yourself, you will call me before doing anything?"
Be sure to obtain a signature.
Make a commitment to stay in contact.

"Carry each other's burdens, and in this way you will fulfill the law of Christ."
(Galatians 6:2 NIV)

My Contract of HOPE

The following is a solemn binding contract. This contract cannot be declared null and void without the written agreement of both parties.

I promise that if I consider harming myself, I will talk with you before I do anything destructive.

I sign my name as a pledge of my integrity.

Signature:___________________ Date:________________

Suicide is never God's will for any life. Remember the hope that Christ brings. Hold on to Him and show His love to others. … "We have this hope as an anchor for the soul, firm and secure" (Hebrews 6:19 NIV).

June Hunt, counselor, author, radio host and founder of the worldwide ministry Hope For The Heart, offers a biblical perspective while coaching people through some of life's most difficult problems. June is the author of How to Forgive . . . When You Don't Feel Like It, © 2007 Harvest House Publishers. Learn more about June and Hope for the Heart by visiting hopefortheheart.org/CP. Here you can connect with June on Facebook and Twitter, listen to her radio broadcasts, or find much-needed resources.Hope for the Heart provides spiritual guidance, heartfelt prayer, multi-media resources, and biblical wise-counseling. Call 1-800-488-HOPE (4673) to visit with a Hope Care Representative, 7:30 a.m. until 1:30 a.m. (CST).