Withdrawing from social interactions, extreme mood swings can be hidden suicidal signs; here are warnings to look out for

By Dr Ambrish Dharmadhikari

Ajay recently turned 33 but he was already tired of life. He had climbed ladders of success right from childhood, landing several academic accolades in his early years and bagging a handsome job as well. However, lately, things were different. Long working hours, far reaching work targets, multiple financial loans, and recently arrived parenthood were all starting to take a toll on him.

These days, the once happy-go-lucky and charming Ajay had become socially withdrawn. He would be worried most of the time, and stress over earning more money and success. He would often snap on his wife and loved ones over trivial reasons. They would overlook his behaviour, blaming it on the usual office stress, and would advise him sternly to not bring professional problems home.

Over a period of time, Ajay started drinking often and excessively; he would often talk about a bleak future, and engaged in converation about topics like the world being a myth. He became interested in the afterlife, often scouring spiritual books to learn more about the topic. His family saw it merely as a sign of him turning towards spirituality, hoping that this might help him go back to his previous happy self.

But, with every passing day, Ajay's feelings were increasing and he would get thoughts of jumping out of window of his office tower, or driving the car over a bridge into the sea.

Suicidal thoughts are often hidden and difficult to verbalise. This makes it all the more important to talk about them, and learn to identify early warning signs.

Most cases have early warning signs, and can be prevented with timely intervention.

Every suicide, like every person, is different. However, many are precipitated by intense feelings of anger, despair, hopelessness, or panic.

Multiple factors can put an individual at a higher risk of suicide. Some of these include:

- An episode of depression, psychosis, or anxiety
- A significant loss such as the death of a partner, family member, or losing a job
- A personal crisis or life stress, especially one that increases a sense of isolation or leads to a loss of self-esteem (this could even be a breakup or divorce)
- Some source of long-standing stress
- An illness or medication that triggers a change in mood
- Witnessing suicidal behaviours of others, such as friends, peers, or even celebrities

We all face crises or problems like these. The difference is that individuals who end up ending their lives, these situations cause such pain or hopelessness they can’t see any other way out. Hence, it is important to reach out to people who may be facing such crisis situations.

Talking to them about suicide, asking how they feel is good way to begin a conversation. One can spot signs of suicidal thoughts in conversations with and behaviour of people.

These signs include:

- Talking about dying, suicide — for example, making statements such as "I don’t want live anymore," "I wish I were dead" or "I wish I hadn't been born."
- Collecting the means to take your own life, such as buying excess amount of poison or stockpiling pills
- Withdrawing from social interactions and wanting to be alone
- Having mood swings, such as being emotionally cheerful one day and deeply discouraged the next
- Being preoccupied with death, dying or violence; discussing life after death
- Feeling trapped, or hopeless about future
- Increasing use of alcohol or other substances
- Changing normal routine, including eating habits (eating very less or excessive stress eating) or sleeping patterns (sleeping very less or excess)
- Indulging in risky or self-destructive activities, such as consuming drugs or driving recklessly
- Giving away precious/prized belongings or getting affairs in order when there's no other logical explanation for doing this
- Saying goodbye to people as if they won't be seen again
- Sudden change in personality or being severely anxious or agitated

Identifying signs of suicidal thoughts is vital first step to saving precious lives. It is therefore vital that everyone learns to identify these early warning signs.

Several programs like suicide gatekeeper, Youth mental health first aid (YMHFA) train in early identification and first-aid in mental health crisis situations.

* The author is a psychiatrist and Head of Medical Services at Mpower The Foundation. The example cited at the beginning is a fictional account, for representative purpose only.