Suicide Prevention - Know the Warning Signs

I am a victim of suicide.

When I was 14, my sister died. One early morning, she decided to drink Liquid Sosa, a household cleansing product used to unclog drains, sinks and pipes. Immediately after ingesting it, she coughed up blood. When she did, she woke up our eldest sister to tell her she was feeling unwell. Our big sister then woke up our brother and together they brought her to the nearest hospital. My sister died days after in the ICU. She was only 17.

I narrate this with automated recitation as an attempt to curtail the emotion because, even though it has been 20 years, looking back at what happened to my sister - to my family - still brings me deep pain. I don't believe my sister really wanted to kill herself. Otherwise, she wouldn't have woken up our eldest sister to ask for help. Still, I feel guilt for not having been close enough to my sister - physically and emotionally (as sisters should have been) - to see the warning signs and prevent any harm to come to her. The "what if I had just," "I could have" and "I should have" are thoughts that often accompany memories of my sister's death.

My biggest regret is that I wasn't there for her - not when she got sick, when she was hospitalised, when she finally passed on. Instead, I was thousands of miles away attending school in Kenya, where my mother was working for the United Nations. My mom was in Vienna attending a conference when she received the call that my sister died. My family didn't tell me she had died until my mom and brother had picked me up from the airport and were bringing me to her wake. They were afraid that I, being continents away, would hurt myself upon hearing the news and they wouldn't be there to help me.

After my sister was laid to rest, there was an emptiness in our home, laced with a tinge of bitterness and enveloped with a great sense of loss. We pointed fingers at each other, blamed one another. And when the tears were shed and the shouts exhausted us physically and emotionally, we cried some more, prayed and healed together. We didn't undergo any grief counselling - besides, back then, seeing a psychiatrist or counsellor wasn't something our culture was accustomed to. What we did was to continue with our lives because we still had to live for each other, had to be strong for one another.

From being victims of suicide, we became suicide survivors.

And as the years passed, the pain from the memory of my sister's death and the aftermath eventually subsided to be replaced with fond recollections of what we loved most about her - her charm, beauty, sweetness, even her feistiness. I dream about her every now and then - and in my dreams she's always wearing white. I guess I like to believe that she had moved on to a better place, one where she will always be happy and at peace.

I share this story because I want others to know that suicide can be prevented. It is a disease and, thus, it can be treated. I don't want others getting caught off-guard by the sudden loss of a loved one to suicide. It's a painful experience, one I would never wish on anybody. And the first step to suicide prevention is knowing the risk factors and warning signals.

I urge you to read on by clicking "next page" to get this vital information on suicide prevention.

When actor Robin Williams died because of suicide, PR professional Nana Nadal organised an impromptu event that discussed the relationship between depression and suicide, which she called "The Scoop on Suicide" or SOS. One of the speakers, Malyn Cristobal, an addiction counsellor and founder of Living Free Foundation, shared with guests what to look out for, as well as direct and indirect warning signs of suicide.

• Prior history of suicide attempts (most potent risk factor, BUT about half of all deaths by suicide are first-time attempts)
• Family history of suicide
• History of childhood abuse (especially sexual)
• Stressful life circumstances:
  • Low level of education, job loss, continuing unemployment
  • Divorce or separation
  • Legal difficulties
  • Major and sudden financial losses
  • Social isolation, low social support
  • Conflicted relationships
• Severe substance use
• Proneness to negative affect (sadness, anxiety, anger)
• Aggression, impulsiveness
• Co-occurring mental disorder
  • Depression (including substance induced)
  • Anxiety disorders (especially PTSD)
  • Severe mental illness (schizophrenia, bipolar disorder)
  • Personality disorder (borderline and antisocial personality disorders)
  • Anorexia nervosa
• Gun ownership or access to a gun or another method

Read on to know about what are the direct and indirect warning signs of suicide.

• Suicidal communications:
  • Oral threats to hurt or kill oneself
  • Talk of wanting to die
• Seeking access to
  • Guns, pills and others
• Making preparations
  • Giving away possessions
  • Saying goodbye

• Ideation (fleeting to persistent thoughts; vague to highly specific thoughts)
• Sense of purposelessness, meaninglessness
• Chronic anxiety
• Feeling trapped
• Hopelessness
• Social withdrawal, isolation
• Chronic anger
• Recklessness
• Mood changes

On the next page learn how you can support suicide prevention.

If you detect any of the mentioned signs in a loved one, or even yourself, please tell a family member or a friend immediately. Talking is the first step to healing. However, if you would rather talk to a professional or a counsellor, you may contact these places:

• For free and confidential telephone counselling, call Samaritans of Singapore at +1800-221-4444 (24-hour) or email [email protected].
• Counselling and Care Centre deals with a wide range of issues – emotional, psychological, relationship and marital problems  Fee free to call them at 6536 6366 (Mondays - Fridays, 9am - 4pm)
• WINGS Counselling Centre - call 6383 5745 (Mondays - Fridays, 8:30am - 5:30pm and Saturdays, 9am - 1pm)