In order to prevent suicides we generally think of suicide risk factors and how to remove them or treat them when the risk factor is a mental health condition. Something that generally does not come to mind is that a suicide attempt is often the first outward sign that a person suffers from a mental health issue. This can be especially true in veterans who learn to be self-sufficient and rely on their own skills and devices in order to solve problems including personal issues.
Suicide As the First Sign of Mental Illness
What we know is that some mental health conditions come with an increased suicide risk. These include depression, post-traumatic stress disorder, and substance abuse disorders. By no means do all people with these mental health issues contemplate suicide. In reality, many people think about suicide with no real intent to carry out the act. To the extent that a mental health condition increases the risk of suicide there are protective factors which can reduce suicide risk. These are social support, a sense of connectedness, counseling, and other mental health care measures.
While suicidal thoughts and even planning for suicide can evolve in a person who is depressed, suffers from PTSD, or has a substance abuse problem, it is very often not clear to others that the person is suffering from a specific mental health problem nor that they are having thoughts of suicide. Negative thinking, a low mood, excessive anxiety, and even psychosis can exist without it being clear to others that the person is suffering from any of these things. Because the person suffers alone in their struggle against memories of past trauma, a sense of helplessness and hopelessness they are more prone to decide that there is no way out of their dilemma except to end their life. The sad fact is that there are therapies and there are people ready to help if they only know that the person is in trouble.
Observable Warning Signs of a Suicide Attempt
Because people who intend to commit suicide rarely say so out loud, one needs to infer the intent to commit suicide by what they otherwise say, do, or do not do or say. Expressions of hopelessness or helplessness are cues as are comments indicating an overwhelming sense of shame or guilt.
When irrational or bizarre behavior or similar changes to appearance or personality happen, they are also tip offs. Missing work or school is a cue, as are changes in eating or sleeping routines. People who lose interest in things they previously enjoyed, loss of interest in the future are cues that occur before the person indicates by works or actions that suicide is on their mind. When someone is “putting their affairs in order” this can be normal for an older person who is normally near the end of their years but when it occurs in a younger person and especially a younger person it can be a warning sign of suicidal thoughts that are congealing into suicide plans. Likewise a troubled person who is suddenly at peace can be a sign that they have made a decision to end their life and not that their troubles have gone away.
Suicide Attempt As the First Sign of Mental Illness
A significant percentage of people with coronary heart disease have a heart attack before any other signs or symptoms develop. The same is true with mental health conditions that predispose to suicide. For example, a socially isolated young military veteran has trouble finding work and reintegrating into civilian society. No one is close enough to them to notice any warning signs of trouble. The first time any anyone, including treatment professionals, have any clue about their troubles is when they arrive in the emergency room after an unsuccessful suicide attempt. This pool of individuals does not get any initial help from advances in psychedelic medicine research for treating risk factors of suicide like depression, PTSD, or substance abuse problems. They do not get help from outreach programs for vets at risk because they “seem” OK and do not show up on anyone’s radar. What is truly important in these individuals is to recognize that the strongest warning sign of suicide is a previous attempt. These folks whose mental health and suicide issue come to the fore all at once are at the greatest risk and in the greatest need of help.