Stage 1 is the “ideation” stage, during which a depressed person finds him/herself thinking about suicide more and more. However, the fear of suicide still outweighs its attraction. Therefore, the person may be thinking dark thoughts (“my family would be better off without me”), obsessing over dark music (i.e., playing the same depressing song over and over again), or expressing thoughts of death, suicide, pain, and hopelessness through artistic expression, but has not yet begun to formulate a specific plan.

2. Planning stage, during which the person’s dark thoughts begin to turn to formulating a specific plan for suicide. Friends and family may notice the person’s depression worsening, and observe their loved one begin to withdraw from touching others or from being touched by others, or they may stop verbalizing their pain and suffering while seeming to be in more pain than ever. 
People in Stage 2 are not imminently lethal, although they are in critical need of effective psychological care.
It rarely lasts longer than several months because it is a very psychologically painful place to be. The person feels compelled to make a decision to suicide (thus moving into Stage 3) or not to suicide at that time; a decision that most people do not discuss with loved ones and often wrestle with in isolation.

Stage 3 begins when the suicidal person makes the decision to suicide. The moment the decision is made, it goes “unconscious” and the person goes on what we call “auto-pilot.” They seem more “normal” than they have seemed in a long time.   At this point, the depression seems to suddenly lift because the person has made the decision to die and is no longer wrestling with the decision.  People on “auto-pilot” typically attempt suicide within the next 48 hours.

Be alert when a depressed patient who doesn’t seem to improve after months of intervention suddenly seems to get better. Instead of relaxing, we should become more vigilant when we see a sudden, overnight improvement.

We should listen closely to any indication that the individual has decided to end their life and mobilize support among family.

#Suicide Awareness Month #Reach Out #We care