How to get past suicidal ideations: Signs, triggers and positive actions you can take

Death by suicide is a major health concern. The World Health Organisation (WHO) estimates that more than 730,000 people die by suicide every year. Death by suicide is ranked as the fourth leading cause of death among 15 to 19 year olds around the world. Out of all global deaths by suicide, low and middle income countries account for 77 per cent of cases.

According Ms Diana Woche, a consultant psychologist at healthcare aggregator Ponea Health, suicidal ideations are often symptoms of depression. “When depressive symptoms go untreated for a long time, they degenerate and start pushing the patient towards suicide,” she says. This makes death by suicide the end result of depression that has gone untreated.

Signs a loved one is having suicidal ideations

Death by suicide is preceded by certain signs. Ms Woche says someone who is contemplating it may be preoccupied with death. “They may give away their belongings, or start making statements such as ‘I wish I were dead’ or ‘I wish I hadn't been born’.”

This will be followed by active planning and ideation. For example, they may start withdrawing from social interactions and avoiding people, or seem suddenly calm after a lengthy period of intense distress. They may start saying goodbye to those close to them. 

Ms Woche says that while some patients might portray overt suicidal ideations, others may not show any signs. “People who show minimal signs do not want to appear weak or do not want to face the social stigma that is associated with mental ill-health or suicide,” she says.

Who is at risk? 

Men are about four times more likely than women to die from suicide. However, women are more likely to express suicidal thoughts, and to make non-fatal or less violent attempts than men. 

Ms Woche adds that additional risk factors include feelings of loneliness, alcohol and/or drug abuse, a history of depression or other mental illnesses, chronic illness, a family history of death by suicide or violence, and major life stressors like divorce or the loss of a loved one.

How can someone who has previously attempted death by suicide prevent a relapse?

If you have previously had suicidal ideations, Ms Woche says you can prevent a relapse by being aware of your triggers and warning signs. “You need to have a high level of self-awareness over your emotions and behaviours.

In this instance, one must quickly connect to a health professional if they have emotional or mental health difficulties. Once emotionally situated, addition measures include reducing alcohol and/or substance intake; exercising; eating healthy, and seeking social support.

Join mental health social groups, more so those that target patients who have struggled with suicidal ideations and depression.

Beyond these groups, enlist the help of a licensed psychiatrist or mental health professional such as a psychologist to walk the journey with you. There are also charitable organisations focusing on suicide prevention that offer free emotional support.

These include Befrienders Kenya (0722 178 177 or [email protected]), Niskize (0900 620 800), Kenya Red Cross (1199), Emergency Medicine Kenya Foundation (0800 723 253) and LVCT Health (1190).

Prevention and control

Death by suicide is preventable. According to Ms Woche, recognising the signs and symptoms and reaching out for help from mental health professionals or trusted family members are the initial steps in the prevention of death by suicide.

“If you feel as if you’re tilting towards suicidal ideation, develop a crisis plan that can include compiling lists of triggers or early signs of your suicidal thoughts,” she says.

This plan should also include simple coping strategies that are easy to implement, and the contact information of a trusted family member, close friend, or a mental health care professional you can reach out to.

“Find positive distractions that can keep you occupied. These can range from taking a nature walk, watching a favourite movie, or re-reading your book,” says Ms Woche. Importantly, seek out mental professional support to help you work through a depression treatment plan.

Family and close friends also have a major role to play in the prevention of a relapse. They should pay close attention to the language and behaviour their loved one portrays, and offer a space where they can feel safe to share their feelings and fears. They should also limit access to the means of death by suicide (for example, pesticides, firearms, certain medications).

“Be present when offering a helping hand. Spend time with them and give them a listening ear. If possible, make time for psycho-education on mental health to better understand and help the patient,” says Woche.

Suicide stigmatisation in Kenya

Suicide is criminalised in Kenya. A mental health patient who attempts to take their life can be arrested, presented before a court of law, and sent to serve time in jail. Ms Woche says this perpetuates stigma surrounding depression and death by suicide.

“Cultural barriers undermine conversations about mental health in our society,” she says. “Most people have been socialised to stigmatise people with mental health disorders. It is worse where death by suicide is involved.” 

According to Ms Woche, mental health awareness campaigns, both at the general public and family levels, will go a long way towards destigmatising depression and death by suicide.

“Suicidal ideation boxes a patient into a corner where they feel there’s no other solution. The stigmatisation of mental ill-health and death by suicide means patients have no space to open up over their fears,” she says. “Mental health awareness can go a long way in ending the stigma and providing helpful alternatives to patients.”