Signs of Suicide in the Context of Serious Depression

Seek help as soon as possible by contacting a mental health professional or by calling the
National Suicide Prevention Lifeline at 1-800-273-TALK (8255) if you or someone you know exhibits any of the following signs:

• Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself
  
• Looking for ways to kill oneself by seeking access to firearms, available pills, or other means
  
• Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person
  
• Feeling hopeless
  
• Feeling rage or uncontrolled anger or seeking revenge
  
• Acting reckless or engaging in risky activities - seemingly without thinking
  
• Feeling trapped - like there's no way out
  
• Increasing alcohol or drug use
  
• Withdrawing from friends, family, and society
  
• Feeling anxious, agitated, or unable to sleep or sleeping all the time
  
• Experiencing dramatic mood changes
  
• Seeing no reason for living or having no sense of purpose in life

For more information, or if you think you or a loved on may attempt suicide, please contact the American Foundation for Suicide Prevention immediately,
at (800) 273-TALK (8255) or http://www.suicidepreventionlifeline.org/help/default.aspx

It is vitally important that the patient get a good psychiatric evaluation by a board-certified psychiatrist who specializes in personality disorders before treatment begins. It is worthwhile to do this because the course of the patient's entire treatment may be determined by an initial evaluation. Local chapters of mental health organizations (i.e. the American Psychiatric Association) can help patients and families find such a practitioner in the patient's general geographic area.

By the time a family member has been diagnosed as suffering from a borderline personality disorder, so much stress has been generated in the family that everyone is affected. For this reason, it is advisable for the entire family to seek support services.

If outpatient therapy reaches a stalemate or is interrupted by repetitive suicide attempts, or if the patient cannot stay consistently with a therapy and continues to disrupt his or her own life and that of others, the family and patient may want to seek consultation in a center specializing in the treatment of borderline personality disorder. A thorough assessment may lead to the recommendation of a more specific individual therapy, adjunctive group or family therapy, referral to substance abuse treatment, or more intensive treatment in the form of hospitalization or a day hospital program.

Day hospital treatment, where the patient is committed to attending daily therapy sessions and workshops but resides at home, is helpful both in enabling patients to understand their problems and how these affect others, and also in bringing patients into close daily contact with others who are working on those problems. Borderline patients tend to support each other–sometimes in a negative way, to be sure, but more often in a very positive way. Articulate, candid and forthright, they are often extremely effective in cutting through the denials and excuses and the blaming of others that so hamper a person's ability to see his or her own problems. The recognition of the illness and the determination to overcome it have everything to do with successful treatment.

Without adequate treatment, the illness is lifelong, and all too often ends in suicide. With good treatment, the outlook is very favorable indeed in many cases. Among the 500 borderline patients studied by Dr. Michael Stone at the Columbia Psychiatric Institute over more than 20 years, 4 out of 10 are clinically recovered 10-20 years after their point of entry into the study during hospitalization. Seventy-five percent are self-supporting and doing reasonably well. The suicide rate was 7% as of 16 years post-admission. The patients who recovered tended to be those who persisted in psychotherapy over many years.

Please refer to our Treatment Page here.