How can I tell if someone is really suicidal?

My wife has a mood disorder, and she gets depressed often. Sometimes when she gets very depressed she will say things like "I was driving home and I thought if a deer jumps in front of me that's OK." or "The only thing that keeps me from hurting myself is my son."

If I ask her flat out if she really means this, she'll almost always backtrack and say she wouldn't do anything to hurt herself.

She is seeing a psychiatrist on a regular basis, and is compliant with her medication.

So the question is, should I get concerned when she says these things? She hasn't ever tried suicide, but of course I don't want it to get to that point. How can I tell if it's different this time?

One thing is that I'm worried about myself that I would dismiss all the signals, until it's too late.

Yes, you should be concerned. The best rule of thumb is to take any suicidal speech/tendencies very seriously.

It is always better to take remarks like that too seriously than to not take them seriously enough.

I'm no professional, so this is just based on the people I know....

If someone talks about being suicidal but mentions that they haven't done anything because of how it would affect a child or another loved one, I take it as meaning there is little danger. The person is in a lot of pain, and they need to talk about how they're in so much pain that they want to die. But the fact that they have something motivating them to stay alive is a hopeful sign in my book. I would be more worried if someone was no longer concerned about how their death would affect their loved one(s). And I would be the most worried if they had a plan to kill themselves and the means to carry them out.

Even if there is little immediate danger, frequent depression and suicidal thoughts are a reason to be concerned. If your wife is getting very depressed despite being on meds, it is possible that the dosage or medication needs to be changed. Or there may be other factors interfering with her treatment such as a lack of sleep, poor diet, or a medical condition like hypothyroidism or sleep apnea. Ideally, treating a mood disorder should encompass all of these things to minimize a person's suffering.

The problem is that her moods shift so quickly that by the time she sees the doctor, the feeling has usually passed, and I think she might even feel embarrassed to talk about it to the doctor.

And when the moods shift, then I start to doubt myself, and feel silly, thinking that maybe I was just overreacting. A few rounds of this, and of course I won't take it seriously. It's like the boy who cried wolf.

I have mentioned it to the psychiatrist myself, but of course I don't see him often enough to talk about this. One of the definite signs he mentioned was planning. If a person has actual plans for it. But given how quickly her moods change, I doubt that she would do much planning anyway.

Originally Posted by suomalainen

The problem is that her moods shift so quickly that by the time she sees the doctor, the feeling has usually passed, and I think she might even feel embarrassed to talk about it to the doctor.

And when the moods shift, then I start to doubt myself, and feel silly, thinking that maybe I was just overreacting. A few rounds of this, and of course I won't take it seriously. It's like the boy who cried wolf.

I have mentioned it to the psychiatrist myself, but of course I don't see him often enough to talk about this. One of the definite signs he mentioned was planning. If a person has actual plans for it. But given how quickly her moods change, I doubt that she would do much planning anyway.

I have bipolar disorder- which is under the category "mood disorder" and I do go through periods of suicidal ideation and attempts. Though, for me it seems to be only a choice when I think about it. I get spontaneous impulses at certain times that I cannot control. I have been driving on the highway and had an urge to turn the car into oncoming traffic. It came completely out of no where. Luckily, my friend was sitting in the passengers seat and she turned the wheel to the shoulder of the highway and she drove us the rest of the way and back. Suicide has been a theme in my life and generally with mood disorders there's no escapism. It must be hard for a family to watch their loved one do these things but believe me, it's hard for us too. I look at them loving me so much and I just want to stop the ideation, but it controls me. Telling when someone is really suicidal is tricky business. Mood disorders make it very up and down. I may not be able to tell you signs because there have been times that I have come across so happy when I have been suicidal that if I actually kicked the bucket- no one would have seen it coming. I'm not telling that to worry you. I can tell you how to help. Support. Truly, the love and support that my friends and family give is amazing. Understanding. Building understanding of the mood disorder itself can truly help. I really appreciate it when people take the time to learn about my illness. Proper help. If I had not gotten the help I have received, I wouldn't be typing this right now. If her doctor isn't helping, search for someone who will, someone who has a background in mood disorders, someone who can really handle her case. Finally, don't be afraid to talk to a psychiatrist/psychologist yourself. Problems such as these can really cause stresses and fear for the other parties involved. Don't neglect yourself. I know it's easy to do during a problematic time/situation. But you can't help if you get overwhelmed, even if you desperately want to. I hope I helped shed some light on a dark topic. Good luck.

you dont... not until the worst happens. Best bet is to get her help and let her know how you feel when she makes morbid jokes. Let her know how much you would miss her if she was in an accident and if she makes a really scary statement you may have to call a shrink. A lady i met while changing my oil was telling me her life story, basically her daughters husband said "im gonna go kill myself" her daughter replied "go ahead" because she was mad at the time, maybe he said things like that too often or they were just at the end of their wits... but he killed himself by putting a bag over his head in the bathroom. She had to find him like that and now beats herself up over and over about the last conversation they had. Its not your fault if it happens. I wish you look.

If it were my spouse I would try to avoid being too heavy handed about making an issue of it. Also, the shrink would have told your wife on day one that if he/she suspects that hurting herself or another is emanate then they are duty bound to have her taken into protective custody.

The very last thing you want is for her to keep her feelings bottled up inside.

Find ways to enhance the family's quality, and especially the bond between her and your son.

Best wishes.

In general, dismissing suicidal behavior can really trigger it even more- on top of snide jokes, ridicule or bullying.

This topic reminds me of how sometimes you'll randomly run across websites where people ask for help because they really want to commit suicide, and people make insensitive remarks like "quit being a crybaby and feeling sorry for yourself. that's selfish."

Can you imagine if you feel like you are at your lowest low and someone does not acknowledge it, worse off, pretends like the person is being a nuisance? I personally have someone in my family who ended their life through suicide, and the pain they went through.

Yes- they are serious when they say it. It hurts like no other. When someone feels that way, what helps is to listen to really understand and validate it by being there.

I think you should always take it seriously and respond as constructively as possible. Its good that she say's it out loud and she feels ok telling you, its important to encourage that. The worst situation she could be in is if she just thought these things and bottled it up. My mum can get depressed quite often I find if she goes unusually quiet during a depression its because its gotten much worse or I haven't been responsive enough. I'm not a professional though so take this with a pinch of salt.