It’s so hard to see a loved one obsessed with suicide. It’s particularly scary when you don’t know what to do. This is likely why two people have asked me about it lately. And while there are many things you can do to help a person who is obsessed with suicide, the most important thing is likely getting them professional help. Here’s how to go about getting help and what kind of help might work for a suicidal loved one.
What Does It Mean When a Loved One Is Obsessed with Suicide?
A suicide obsession can mean various things. It may 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 involving suicide.
For example, when a person is depressed, suicidality can be a symptom. This may mean that a person feels like 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 logical act, given their pain and the effects that they have 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 could be visions or ideas of suicide that pop up without warning or provocation (intrusive thoughts). I’ve found that obsessive thought patterns are common in people with bipolar disorder, but it can happen to others, too.
Of course, no matter why your loved one is obsessed with suicide, they need help.
When Your Loved One Is Obsessed with Suicide, Make Sure They Are Safe
The first priority in helping a loved one who is obsessed with suicide for any reason is to make sure they are safe and can’t or won’t act on their obsessive thoughts. Many people focus on being the personal impediment 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 obsessed with suicide may need more help than that to remain safe.
A person who is obsessed with suicide may be a danger to themselves no matter what you do, and in those cases, you need to consider inpatient treatment. I realize this isn’t something that anyone runs towards, but it can be a critical part of the care infrastructure. I have been hospitalized for suicidality. It’s not fun. But it kept me safe, and that was what I needed at that time. Remember, it’s much better that your loved one be alive and angry with you than not alive at all.
If your loved one is in danger, the best thing to do is to contact their doctor and arrange for inpatient treatment as soon as possible. However, this may not always be possible due to how quickly one can become a danger to oneself. In those cases, call 9-8-8 or even 9-1-1 and ask for an ambulance if you have to. Believe me, I know how not fun this is. But again, their safety is the most important thing.
Please understand that no matter how much effort you put into it, sometimes you 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 state. However, it doesn’t go into details about the professional help your loved one who is obsessed with suicide needs.
If your loved one is obsessed with suicide, they absolutely need professional help. This is not a problem that you or they can deal with alone. It is serious and can result in death. You need to get help from the people who are specifically trained to deal with it.
If Your Loved One Is Not Getting Mental Health Care
If your loved one isn’t already getting care for their mental health, they need it immediately. You should talk to your loved one’s GP about getting this for them. The GP may choose to initiate treatment (for example, they may prescribe an antidepressant if the person is diagnosed with depression) at that time, or they may refer your loved one to someone else, like a psychiatrist, for appropriate treatment. Remember, when a mental health problem is severe, a GP is not generally qualified to treat it in the long term.
If Your Loved One Is Getting Mental Health Care
If your loved one is being treated and is obsessed with suicide, their current treatment obviously isn’t working. After all, a treatment’s first job is to keep you alive. This means you need to ensure your loved one’s healthcare provider (which should be a psychiatrist if your loved one has bipolar disorder) is aware of the situation. The best way to do this is to attend your loved one’s doctor’s appointments. The person who is obsessed with suicide may not be as forthright 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 a loved one being there can make it easier.
It’s critical that the doctor be aware of how severe the problem is and that there must be a treatment plan to deal with it immediately. You need to be 100% upfront about this. Don’t mince words. Don’t use euphemisms. Say that your loved one is at risk of killing themselves. Do not leave without a plan to deal with it.
If you can’t attend the appointment, perhaps because your loved one isn’t comfortable with that, you can still talk to their doctor about how suicidal your loved one is. In this situation, the doctor won’t be able to tell you anything about your loved one for privacy reasons, but they can still listen.
What Treatments Work for a Person Who Is Obsessed with Suicide?
As I said earlier, it’s quite possible that inpatient treatment may be needed if a person is obsessed with suicide. This is not indicative of anyone’s failure. It’s only indicative that the person needs intensive help. If that’s what it takes to help your loved one, then that’s what should be done.
It should be noted that many places will only hold a person who is suicidal for 72 hours. In my experience, if a person is severely depressed or experiencing other severe mental illness symptoms, this isn’t enough time to stabilize the person. You may need to advocate strongly with doctors or insurance companies for additional inpatient care. It’s possible that you and your loved one’s doctor can work together to try and force longer treatments if insurance stands in the way (which it often does).
Something else to know is that lithium is the only mood disorder medication we know that has an antisuicide effect. (Clozapine has also shown an antisuicide effect, but it’s not typically prescribed outside of schizophrenia.) Lithium is not without its risks and difficulties, though (including the risk of overdose), so its impacts should be carefully considered.
Ketamine and esketamine (Sprovato) may have immediate but small antisuicide effects, but research is ongoing.
Electroconvulsive therapy (ECT) is often an option for someone whose life is acutely at risk. Again, this is not an easy treatment to do through, so careful considerations of the risks and benefits need to be made before going down this road.
More details on the above can be found here.
Psychotherapies may also help reduce suicidal ideation. Cognitive behavioral therapy (CBT) seems to reduce suicide attempts, suicidal ideation, and hopelessness. Dialectical behavior therapy (DBR) may also reduce suicidal ideation, but the evidence is more limited.
You may be surprised not to see antidepressants on the list. This is because it may be that antidepressants increase the risk of suicide in young people over the short term, and evidence that they decrease it over the long term is of low quality. This doesn’t mean that they don’t work, but it means they may not be enough in the short term for someone who is obsessed with suicide.
In all likelihood, a multi-pronged approach is likely called for 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 a long and bumpy one. Suicidality doesn’t tend to occur overnight, and the danger it presents doesn’t tend to go away overnight, either. Be prepared to support your loved one over the long term.
Because of this, you may need your own support when helping your loved one. This is okay. It doesn’t mean you’re weak or inadequate. It just means you’re dealing with something really difficult. Talking to others who have been there can help. Reach out to local mental health organizations or the National Alliance on Mental Illness (NAMI) to find out about possible support options or look into getting psychotherapy yourself. You can’t effectively help them if you’re in crisis yourself.
Also, remember that there is nothing wrong with your loved one who is suicidal — there is something wrong with their brain. Suicidality 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 through it.
Finally, remember that your loved one can get through this. Just because your loved one is suicidal today, it doesn’t mean they always will be. People get through crises like this. And they’re starting from a good place because they have your help.
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