As suggested above, suicidality is often described as occurring along a continuum of potential lethality and intent. Lethality has to do with how likely some action is to cause death. Intent has to do with how determined you are to succeed. The more you are determined to kill yourself, and the more lethal the methods you choose to end your life with, the more dangerous is your situation.
Your moment-to-moment level of risk is influenced by multiple factors, including: whether you have a specific and defined plan for committing suicide, easy access to the tools you need to carry out your plan, and a history of past suicidal gestures. All of these things increase your present risk of committing suicide.
Your psychological state is, of course, a vital component in determining your risk. If you are in a good place in life, your risk is lower than if you are experiencing a stressful life crisis. Further, if you are able to cope and manage the degree of stress you are currently experiencing, your risk is lower than if you are feeling overwhelmed by circumstance. We will discuss other factors that contribute to your suicide risk in a later section of this document. Right now, it's important to understand that people often move backwards and forwards across this spectrum of suicide-danger-risk as the circumstances that trouble them change and their related emotions wax and wane.
The Suicide Crisis
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Suicidal ideation is relatively common and is not necessarily associated with a crisis situation. Instead, it may be a symptom of an ongoing problem that is difficult to address without outside assistance (such as depression). In contrast, suicidal gestures typically occur in the context of crisis periods, or periods that are associated with overwhelming stress, seemingly unbearable and unendurable emotional and/or physical pain, and which seem to have no possible solution other than suicide.
The stresses endured by people in a suicidal crisis are undoubtedly severe and overwhelming, but they are not typically unsolvable or permanent. They seem that way to people who are experiencing the crisis, however, because their strong emotions overwhelm, interfere with and degrade their ability to think rationally and to place their problems in perspective.
The thinking of people who are experiencing a suicidal crisis is typically clouded and negatively biased, intensely self-focused, and highly emotional. As discussed previously, homicidal feelings may intermingle with suicidal feelings if there is a sense that someone else has deliberately caused harm. Feelings of loneliness, isolation, alienation, anger and rage are common, as well as the following kinds of thoughts:
- A sense that things will never get better
- A feeling of inability or lack of motivation to change the situation
- A belief that your emotional pain is permanent or too much to bear
- A sense of personal worthlessness, self-hatred or self-loathing
- A sense that all meaning has been removed from life
- A sense that suicide is the only way to make the stressors stop (founded upon the utter sense of hopelessness described above).
Even though it is very hard to believe it in the moment of crisis, the following statements are almost always true:
- Suicidal crises are temporary conditions.
- The intensity and urgency associated with suicidal crises tends to disappear or diminish with time.
- People CAN be helped through suicidal crises if they are open to accepting appropriate help and treatment.
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