It is so hard to watch a loved one obsess over suicide. It’s especially scary when you don’t know what to do. This is probably why two people asked me about it recently. And while there are many things you can do to help a person who is obsessed with suicide, the most important thing is probably to get them professional help. Here’s how to get help and what kind of help might work for a loved one who is suicidal.
What does it mean when a loved one is obsessed with suicide?
Suicidal obsession can mean a number of things. It can mean that the person is depressed to the point of wanting to die, sure, but it can also mean that a person is suffering from obsessive thought patterns that include suicide.
For example, when a person is depressed, suicide may be a symptom. This can mean that a person feels a burden to others and that the world would be better off without them. It may seem to the depressed person that suicide is a reasonable act, given their pain and the effects it has on others. This can lead to obsessive thoughts about suicide.
On the other hand, some people suffer from obsessive suicidal thoughts, even though they don’t want to act on them. This can be suicidal visions or ideas that appear without warning or provocation (intrusive thoughts). I have found that obsessive thought patterns are common in people with bipolar disorder, but it can happen to others as well.
Of course, no matter why your loved one is obsessed with suicide, they need help.
When your loved one is suicidal, make sure they are safe
The first priority in helping a loved one who is obsessed with suicide for whatever reason is to make sure they are safe and cannot or will not act on their obsessions. Many people focus on being the personal obstacle to their loved one’s suicide. In other words, they don’t leave the person alone, hide lethal means, etc. While I understand why this is the focus, people who are truly suicidal may need more help than this to stay safe.
A person who is obsessed with suicide can be a danger to themselves no matter what you do, and in these cases, you should consider inpatient care. I realize this is not something anyone runs to, but it can be a critical part of the care infrastructure. I have been hospitalized for suicide. It’s not fun. But he kept me safe, and that was what I needed at that moment. Remember, it is much better for your loved one to be alive and angry with you than not to be alive at all.
If your loved one is in danger, the best thing to do is to contact their doctor and arrange for hospitalization as soon as possible. However, this may not always be possible due to how quickly someone can become a danger to themselves. In these cases, call 9-8-8 or even 9-1-1 and ask for an ambulance if needed. Trust me, I know how much fun this is. But again, their safety is the most important thing.
Please understand that no matter how hard you try, sometimes you just can’t keep your loved one safe without help. That doesn’t make you a bad person. That makes you human.
When your loved one is obsessed with suicide, get them professional help
Previously, I wrote about how to help someone who is suicidal. This is a good holistic view of how to help someone in this situation. However, it does not go into detail about professional help for your loved one who is obsessed with suicidal needs.
If your loved one is obsessed with suicide, they definitely need professional help. This is not a problem that you or they can handle alone. It is serious and can lead to death. You need to get help from people who are specially trained to deal with it.
If your loved one is not receiving mental health care
If your loved one isn’t already taking care of their mental health, they need to now. You should talk to your loved one’s family doctor about getting this for them. The GP may choose to start treatment (for example, they may prescribe an antidepressant if the person has been diagnosed with depression) at that time, or they may refer your loved one to someone else, such as a psychiatrist, for appropriate treatment. Remember, when a mental health problem is serious, the doctor is generally not qualified to treat it long term.
If your loved one is receiving mental health care
If your loved one is being treated for suicidal ideation, their current treatment is clearly not working. After all, a cure’s first job is to keep you alive. This means you need to make sure your loved one’s health care provider (who should be a psychiatrist if your loved one has bipolar disorder) is aware of the condition. The best way to do this is to attend your loved one’s doctor’s appointments. The suicidal person may not be as honest as they need to be without your help. It’s very hard to sit in front of a doctor and say how suicidal you are, but having a loved one there can make it easier.
It is important that the doctor knows how serious the problem is and that there should be a treatment plan to deal with it immediately. You have to be 100% upfront about it. Don’t mince words. Don’t use euphemisms. Say your loved one is at risk of suicide. Don’t leave without a plan to deal with it.
If you can’t make the appointment, perhaps because your loved one isn’t comfortable with it, you can still talk to their doctor about how suicidal your loved one is. In this case, the doctor will not be able to tell you anything about your loved one for privacy reasons, but they can listen to you.
What treatments work for a person who is obsessed with suicide?
As I said earlier, hospitalization is very likely to be needed if a person is obsessed with suicide. This is not indicative of anyone’s failure. It is only indicative that the person needs intensive help. If this is what it takes to help your loved one, then this is what you should do.
It should be noted that many places will only accommodate one suicidal person for 72 hours. In my experience, if a person is severely depressed or has other symptoms of serious mental illness, that is not enough time to stabilize the person. You may need to advocate strongly with doctors or insurance companies for additional hospitalization. It’s possible that you and your loved one’s doctor can work together to try to push for longer treatments if insurance gets in the way (which is often the case).
Another thing to be aware of is that lithium is the only mood disorder drug known to have anti-suicide effects. (Clozapine has also shown antisuicidal activity, but is not usually prescribed outside of schizophrenia.) Lithium is not without its risks and difficulties, however (including the risk of overdose), so its effects should be carefully considered.
Ketamine and esketamine (Sprovato) may have immediate but small antisuicidal effects, but research is ongoing.
Electroconvulsive therapy (ECT) is often an option for someone whose life is in serious danger. Again, this is not an easy treatment, so the risks and benefits must be carefully considered before going this route.
More details on the above can be found here.
Psychotherapies may also help reduce suicidal ideation. Cognitive behavioral therapy (CBT) appears to reduce suicide attempts, suicidal ideation, and hopelessness. Dialectical behavior therapy (DBR) may also reduce suicidal ideation, but evidence is more limited.
You might be surprised if you don’t see antidepressants on the list. This is because antidepressants may increase the risk of suicide in young people in the short term, and the evidence that they reduce it in the long term is of low quality. That doesn’t mean they don’t work, but it does mean they may not be short-term enough for someone obsessed with suicide.
A multifaceted approach is likely required if your loved one is obsessed with suicide.
If your loved one is obsessed with suicide, remember this
If your loved one is obsessed with suicide, remember that the road back can be long and bumpy. Suicide does not tend to appear overnight, and the risk it presents does not tend to disappear overnight. Be prepared to support your loved one long term.
Because of this, you may need your own support when helping your loved one. That is OK. It doesn’t mean you are weak or inadequate. It just means that you are dealing with something very difficult. Talking to others who have been there can help. Contact local mental health organizations or National Alliance on Mental Illness (NAMI) to find out about possible support options or to seek psychotherapy yourself. You cannot help them effectively if you are in crisis.
Also, remember that there is nothing wrong with your loved one who is suicidal – something is wrong with their brain. Suicide is incredibly scary, and you may have no frame of reference for why it’s happening. The important thing to understand is that it happens to people sometimes and you can help them deal with it.
Finally, remember that your loved one can get through this. Just because your loved one is suicidal today doesn’t mean they always will be. People overcome such crises. And they’re starting in a good place because they have your help.
