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What Makes a Suicide Attempt?

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Posted (edited)

I'm going to use some examples below of common suicide means that may be triggering.  Without examples I don't know if I can get my point across.  That part of my post is hidden below.

 

I battle with suicidal ideation a lot.  I think of suicide pretty much all the time.  But one thing that's always been on my mind is whether I'm actually made a suicide attempt.  I've read a definition of a attempt as, "A non-fatal, self-directed, potentially injurious behavior with an intent to die as a result of the behavior; might not result in injury."  But when is that line crossed?  When does a behavior become "potentially injurious," particularly when you voluntarily stop either before injury or before the act becomes absolutely potentially injurious?  I know sometimes when people attempt it's without question, particularly when you perform an act that can be deadly but you did not die for reasons outside of your control.

Spoiler

 

For example, you take a lethal dose of pills, pass out, and someone finds you and takes you to the hospital.  Or maybe you took what you thought was a lethal dose, but ended up waking up the next morning.  But what about the times that you backed out?  Is that still an attempt?  Examples (all with an intent or desire to take your life):

You drive to a bridge with intent to jump, but turn around without getting out of your car.

You drive to a bridge, get out of your car, stand on the ledge, and change your mind and go back home.

You go to a secluded place in the woods with a rope, but you don't pick it up or begin to tie a knot.

You hold a knife to your wrist, but don't make a cut.

You cut your wrist, but stop before going deep enough to be lethal.

You go to a secluded place in the woods with a knife, but you don't take it out of your pocket.

You dump a bottle of pills into your hand, count them, think about swallowing them, but put them back in the bottle instead.

You start taking pills, but stop after swallowing only a few.

 

I have done some things that may be considered a suicide attempt, and I don't know if I should dismiss them or embrace them in order to better understand myself and be more alert to warning signs of dangerous behavior.  My fear is that if I don't take past actions seriously enough, I may get myself into trouble in the future.  Thanks for your input.

Edited by patents

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I took a ton of lithium once, but my mom showed up and called the squad.  Not a pleasant experience.  Had to eat charcoal and drink this crap to make me puke.  I spent a couple weeks in the hospital. 

I've done some other things I don't want to mention. 

I've come to the conclusion that life is already so short.  Why make it any shorter.  In my opinion suicidal attempts and success are a trick of the beast to steal souls.  Fuck that, I don't want to have anything to do with that existence anymore.  I don't even want to participate in the beasts system anymore.  It's a complete waste of effort to be brutally honest. 

Don't fall for his tricks, he is just jealous of us.  Always has been, always will be. 

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I think a suicide attempt is when you actually do go through with something that could be fatal. The other things you mention would count as suicidal ideation and planning. In ALL cases, it needs to be brought to the attention of your pdoc and tdoc because it is very serious.

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I have done things like this. I don't really think of them as suicide attempts but a form of suicidal ideation/behavior. They should definitely be taken seriously though.

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imo, suicidal ideation has a few levels of intensity. a first, mild level would maybe be suicide jokes. in high school i used to joke that my life plan was to graduate, go to college, get a job, and clock out by 30. i presented it as "dark humour", but on some level, i meant it, even if i wasn't actively wishing to be dead or planning anything. i really thought my future included me being dead in my 20s.

next level might be tangible thoughts of wishing to be dead or otherwise gone, including those thoughts like "i don't really want to be dead, i just don't want to exist" or "if i got a horrible disease and was in the hospital then i wouldn't have to go to work tomorrow".

a third level might be looking at situations and seeing how you could die in them. being in a tall building, you notice that if you jumped out a window, it'd probably kill you. when you drive, you think about going off the guardrail.

following that, the thoughts become physical actions that aren't yet harmful. you count your pills and look up to find out if that dose would kill you. you google how to tie a noose and think of places in your dwelling you could string one.

i think after that, you get into actual planning, meaning where, how, and when you're going to do it, and begin gathering supplies. at this point it's ideation forming the base of an attempt. the attempt itself is you performing the action that you plan will kill you. note that the attempt doesn't have to realistically been likely to kill you to count. if you're doing it with the intent of dying, it's an attempt. a moderate SSRI overdose is unlikely to kill you, but in the moment, if you taking them is you trying to end your life, that's an attempt.

if you have a plan, or make an attempt, the standard advice is to consider hospital/go to ER. all those levels of suicidal ideation, though, usually don't mean you're in active danger, but indicate you're in a bad place and need help. talk to your tdoc/pdoc about any kind of ideation, and any changes in the severity of it. it's an important indicator of how well/unwell you are.

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Posted (edited)
11 hours ago, echolocation said:

imo, suicidal ideation has a few levels of intensity. a first, mild level would maybe be suicide jokes. in high school i used to joke that my life plan was to graduate, go to college, get a job, and clock out by 30. i presented it as "dark humour", but on some level, i meant it, even if i wasn't actively wishing to be dead or planning anything. i really thought my future included me being dead in my 20s.

next level might be tangible thoughts of wishing to be dead or otherwise gone, including those thoughts like "i don't really want to be dead, i just don't want to exist" or "if i got a horrible disease and was in the hospital then i wouldn't have to go to work tomorrow".

a third level might be looking at situations and seeing how you could die in them. being in a tall building, you notice that if you jumped out a window, it'd probably kill you. when you drive, you think about going off the guardrail.

following that, the thoughts become physical actions that aren't yet harmful. you count your pills and look up to find out if that dose would kill you. you google how to tie a noose and think of places in your dwelling you could string one.

i think after that, you get into actual planning, meaning where, how, and when you're going to do it, and begin gathering supplies. at this point it's ideation forming the base of an attempt. the attempt itself is you performing the action that you plan will kill you. note that the attempt doesn't have to realistically been likely to kill you to count. if you're doing it with the intent of dying, it's an attempt. a moderate SSRI overdose is unlikely to kill you, but in the moment, if you taking them is you trying to end your life, that's an attempt.

if you have a plan, or make an attempt, the standard advice is to consider hospital/go to ER. all those levels of suicidal ideation, though, usually don't mean you're in active danger, but indicate you're in a bad place and need help. talk to your tdoc/pdoc about any kind of ideation, and any changes in the severity of it. it's an important indicator of how well/unwell you are.

How about walking down the middle of an unlit street at night, hoping to be hit by a car? But ultimately getting out of the way when the car gets close?

Edited by Juniper29

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Very good points everyone has made.  I agree that the examples would likely not be actual "attempts."  A lot of my wondering has come from what I've read/heard from others.

Here's one more hypothetical:  Say you take your bicycle up a mountain and find a tall cliff.  You take off your helmet and ride full speed towards the cliff with intent to careen off the cliff and die.  At the last second you hit the brakes and stop.  What do you think about this one?  It's actually a pretty good analogy to something I've done, but I don't want to share the circumstances of what I did.  I once met someone who did the same thing I did and it really freaked me out since it isn't a common method at all.

All this said, I do understand how dangerous these behaviors are.  My pdoc and tdoc are well aware of my suicidal ideation and behaviors.  We've come up with crisis plans and when and how I should activate those plans.  So far it's worked because just this week I had to take action, which was to call someone on a list of people who know of my issues and know why I would be calling.  My thinking and planning was going too far.

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Posted (edited)

patents - Look closely at the definition you found. The key phrase is "with an intent to die". Whether you have made what could be considered an attempt has everything to do with your intent. The details are unimportant. Whether what you did had a realistic chance of killing you, or whether it actually did or did not harm you, is immaterial; if you took the action with the intent and expectation that you would not be alive at the end of it, you made an attempt at suicide.

Suicidal ideation is never a product of a well mind. It is always a signal of illness, and a clear sign that you are symptomatic when you feel it. You do not have to endure this. Call your pdoc right away and ask if there are other meds that may be more effective in managing your ideation. Your current meds regime is clearly ineffective, and something else needs to be tried. Crisis management is good, but living from crisis to crisis is not. There is relief available. Remember, suicide can't give you a better life - or any life at all.

Edited by Cerberus

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Posted (edited)
15 hours ago, echolocation said:

was to graduate, go to college, get a job, and clock out by 30. i presented it as "dark humour", but on some level, i meant it, even if i wasn't actively wishing to be dead or planning anything. i really thought my future included me being dead in my 20s.

 

This was my "dream" too. When I was 15 I used to tell people I didn't want to be alive by my mid twenties. Internally - at the time-  school was fun/okay, but pointless. I couldn't envision a future for myself where I was happy. Working a dead end job until I have enough money to retire? No thank you.

When I was 22 or so I did try and make that dream come to life - and cut the chord. I thought about loads of different methods and remembering finding documents that went into a lot of detail about how most suicide methods and fail, and that many methods of suicide - if failed will leave you impaired. Which I think many would consider a fate worse than death.

At the time I kept telling my OT about it. About the thoughts and idealisation - as well as my anxiety and one day she turned around and was like "you need to find someone else to talk about this with because this isn't how occupational therapy works". She knew I didn't have anyone else to talk to about it, but for whatever reason didn't make any effort to refer me to someone or a group etc.

Eventually I did try and take an overdose - but it failed like 97% of prescription overdoses do. Luckily left me unharmed.

"Suicidal idealisation is never a product of a well mind." @Cerberus well said dude. The more it consumes you the more you need to talk to a doctor. And not fucking OT or a support officer - a doctor. I found a lot of people who don't have the medical training (nor the hands on/head first experience such as a psychiatric nurse) don't understand WTF you are going through. They will talk about how you can trust them, and will say they are there for you, and when you call on them and say "I want to kill myself/I keep considering suicide" they will have no idea what to say or how to treat you and try and will get rid of you as quickly as possible - as if that's the support you asked for.

Edited by StarCrazy

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Posted (edited)

Going back on topic - its easy to get lost in semantics/linguistics.
A suicide attempt generally is when someone fails to take their own life but makes an effort to. Like taking way too many prescription drugs, falling from a building, drowning etc.

But, hypothetically... Lets say you put a plastic bag over your head, and try to suffocate yourself. But you remove the bag and don't die. Once you catch your breathe you have no obvious issues. No one besides yourself ever really knows about it.

Now, how many seconds does that bag need to be over your head for it to count as a suicide attempt?
Someone may say at least 20 seconds, at least a minute, at least a 5 minutes etc.
In my opinion the fact that it went on your head for 1 second is an action experimenting with the thought of taking your own life. And thus, is experimenting with suicide - even if its just conceptually.

Similarly if you feel low,and walk across an incredibly high bridge, because you are considering suicide, but then do NOT make any effort to jump - you're still planning and preparing and intending for a suicide attempt even if you don't go through with the attempt itself.

IMO a much better question is: when is it time to be wary of suicidal thoughts. And those thoughts include my above examples of experimenting/preparing/planning etc.
And while its hard to say specifically, I know when they start getting in the way of my plans, and they preoccupy me - thats when its too much for myself and when its time to see a Dr.

Edited by StarCrazy

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Y'all have a lot of great insight.  I try not to get caught up in semantics but sometimes I do.  If someone asks me if I've ever attempted suicide, I've never known what to say.  I'm pretty sure the answer is yes based on this conversation.  And of course, there have been many times I've planned it and started to execute parts of the plan.  My tdoc says I have an addiction to suicidal thoughts.  He's right.  I know it's not healthy, but I also know that I haven't been taking those thoughts seriously enough.

A couple of you mentioned that you had thoughts of checking out by age 30 or mid-twenties.  Well, I just turned 39 this week... it doesn't take a rocket scientist to imagine what's been going through my head.

I'll see my tdoc next week and I need to see my pdoc in the next three weeks for refills (he requires a face-to-face office visit every three months).  I'm safe and well right now.  My moods haven't been very stable, I can go days with no depression whatsoever (like today), and then crash into a serious low the next day.  For the last couple months it's been more low than baseline, and I'm getting tired of it.  I really want to be manic right now but of course that's out of my control.

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One term that a therapist I had used was "aborted suicide attempt" to describe an action I took. I feel like this captures the fact that I began something that I hoped would kill me, but stopped myself before I did anything that I thought could kill me. I feel it validates the severity of the suicidal intent while still acknowledging that I did ultimately decide to stop and keep living.

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On 8/8/2018 at 7:36 AM, Juniper29 said:

How about walking down the middle of an unlit street at night, hoping to be hit by a car? But ultimately getting out of the way when the car gets close?

i think that'd fall into the level where your thoughts start bleeding into your actions. not an attempt, but a flirtation with what it might be like to actually attempt. i'd bring it up to pdoc/tdoc definitely.

On 8/8/2018 at 12:16 PM, StarCrazy said:

And while its hard to say specifically, I know when they start getting in the way of my plans, and they preoccupy me - thats when its too much for myself and when its time to see a Dr

you have a lot of wisdom. this is a good hard line, if one were to draw one.

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10 hours ago, echolocation said:

i think that'd fall into the level where your thoughts start bleeding into your actions. not an attempt, but a flirtation with what it might be like to actually attempt. i'd bring it up to pdoc/tdoc definitely.

Thanks. This was several years ago, I’ve just never known how to classify it, except that I was obviously not in a good place.

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Posted (edited)

What makes a suicide attempt? Actually wanting to die and it sincerely failing not by choice I’d say. Pretty triggering what I’m about to say next.

a few week ago i said goodbye to my gf in a massive benzodiazepine induced haze, hung my belt from a closet pole. I don’t even fully remember what happened. Apparently I was so i was so high I couldnt even hang the belt on a proper thing that could hold my weight. I came crashing to the ground un harmed. Gf during this time had apparently called the cops. Cops came mental health acted my ass and I spent a week in the psyche ward. Got a lot a heavy stuff going on like most it would seem these days. Snapped for a second. Don’t think I’d do it again.

that was a honest kill me now moment. Zero cry for help. I tried to fight the cops off didn’t work out to well. 5 of them 1 of me 

Edited by Chrisalt87

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I did the last thing on your list, and stopped because someone came into the room I was in - I considered that an attempt given my intent when I sat down and started swallowing. I think intent is key here. 

I don't know how to hide content so I've just done a spoiler below. 

Spoiler

I've done a few other things that I've wondered whether they are attempts. I don't try to dwell on my past unnecessarily, but I do try to see whether I've minimized things in the past in order to protect myself in the future. In my early 20s, I was physically pulled and barricaded from balconies and bridges, and walked into oncoming traffic before being shoved out of the way of cars. Would these count? If so, I guess that's a reminder that I really need to put effort into my crisis plans in case things somehow go back to how horrible they were. Life is a lot better these days and I want to fight with everything I can. 

 

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On 8/19/2018 at 4:02 AM, survivingbp said:

I did the last thing on your list, and stopped because someone came into the room I was in - I considered that an attempt given my intent when I sat down and started swallowing. I think intent is key here. 

I don't know how to hide content so I've just done a spoiler below. 

  Hide contents

I've done a few other things that I've wondered whether they are attempts. I don't try to dwell on my past unnecessarily, but I do try to see whether I've minimized things in the past in order to protect myself in the future. In my early 20s, I was physically pulled and barricaded from balconies and bridges, and walked into oncoming traffic before being shoved out of the way of cars. Would these count? If so, I guess that's a reminder that I really need to put effort into my crisis plans in case things somehow go back to how horrible they were. Life is a lot better these days and I want to fight with everything I can. 

 

I would think those things were likely attempts, as long as you also had an intent to die.  You had a high probability of dying if not for external factors (people) outside of your control.

I'm like you, I wonder about my past actions in order to put in place appropriate plans to protect myself going forward.  Either way, I think it's best to err on the safe side and take such actions seriously and have crisis plans in case of the worst.

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