suicide threats- how do you tell?

Trauma Columnist · Jul 15, 2006

I would never take the chance that it wasn't "for real." I would always call an emergency. However, I would not be friends with this person either...you have to have boundaries.

CharlieRN · Jul 16, 2006

How do you know (as a friend not as a nurse) when a threat is real? Is it possible? If said perosn has a history of claiming to have overdosed but hasnt according to blood tests and having had her stomach pumped, how do you know when this time she is for real?
Is it best to call paramedics every single time and feed her drama or to tell her to seek medical help and hope she does, she is an adult, its her choice and not your responsibility? And how do you set boundaries around such threats when they are ignored despite you not running when wolf has been cried?

TraumaRUs gave you good advice. 50% of people who attempt suicide give some warning such as threats, of course that means that 50% do it with no warning at all, but that's not our problem. So yes call the EMT's the next time she does it.

But people are entitled to a fair warning. She needs to be told in no uncertin terms that this trick has gotten old. That you do not appreciate being emotionally jerked around like this. If she wants to continue playing games she will have to find another playmate. Make it plain that she needs to get professional help. (No, don't give her Dr Kavorkin's phone number, that's playing too rough.) Seriously do tell her that the next OD whether real or not will be fatal for your friendship.

carroll · Jul 16, 2006

thanks, was a silly question really, its never possible to tell i guess. if she doesnt want to accept professional help then i cant do anything more than what i do/have already done. ive reinforced and set other boundaries again, i hadnt thought to tell her that next time i wont stick around, i will do that as enough really is enough.

cat123 · Jul 17, 2006

thanks, was a silly question really, its never possible to tell i guess. if she doesnt want to accept professional help then i cant do anything more than what i do/have already done. ive reinforced and set other boundaries again, i hadnt thought to tell her that next time i wont stick around, i will do that as enough really is enough.

wow I hope there really is help for this person. The state I am in wouldn't help this person they would make the problem worse. There just isn't always money available, so they pick and choose who they help. But, I would rather believe that it's her fault so I could have a clear mind. Out of sight out of mind. Get rid of her quick.

GooeyRN, ADN, BSN, CNA, LPN, RN · Jul 17, 2006

If its a first time thing I would call 911. BUT... if she continually cries wolf I would end the friendship. I would not want to be in that position where she feeds into the attention of a 911 call and ambulance ride, nor would I want to be responsible if she did off herself after threatening to do so and I did nothing about it. I would gently end the friendship, but gradually becoming less available over time, taking days to return phone calls, etc. Until I was forgotten and she found the next "friend" to manipulate. I know, thats harsh, but I don't like games and being put in that position.

cat123 · Jul 18, 2006

If its a first time thing I would call 911. BUT... if she continually cries wolf I would end the friendship. I would not want to be in that position where she feeds into the attention of a 911 call and ambulance ride, nor would I want to be responsible if she did off herself after threatening to do so and I did nothing about it. I would gently end the friendship, but gradually becoming less available over time, taking days to return phone calls, etc. Until I was forgotten and she found the next "friend" to manipulate. I know, thats harsh, but I don't like games and being put in that position.

I would never do that to a real friend. I doubt any one likes games and I doubt that she is playing games. Something is really wrong here. Maybe a support group of some sort. You can always give her the suicide hotline number without giving up the friendship. This is a life of a "friend" not some street person. Not knowing all the facts I can't just condone dumping her.

sbic56, BSN, RN · Jul 18, 2006

If there is a 24 hour crisis hotline in your area, call them and let them take over. She needs professional help; I would be stepping asside of this "friendship" and fast.

GooeyRN, ADN, BSN, CNA, LPN, RN · Jul 18, 2006

I would never do that to a real friend. I doubt any one likes games and I doubt that she is playing games. Something is really wrong here. Maybe a support group of some sort. You can always give her the suicide hotline number without giving up the friendship. This is a life of a "friend" not some street person. Not knowing all the facts I can't just condone dumping her.

I do agree some. If she were a "real" friend, such as one I had for a long time and is not a manipulative person (in other area's), I don't think I would end it. But if she was manipulative in other area's, or not a close friend is what my last post was referring to. A suicide hotline number would be a great idea.

I had a boyfriend who always threatened suicide when I tried to leave him. (always sitting with gun in hands). I later found he always did this to his ex as well. It took me a few years to get away. The last straw was when he threatened to kill me, my family, and himself if I left him. I was so sick of the manipulation by that time I didn't care if he killed me (I figured I would be better dead than stuck with him and his manipulations or himself. I just had to get away. (BTW, he did not kill himself, me, my family or friends)So I guess I would be quick to get out of a friendship if I felt the person was attention seeking or trying to be manipulative to get something they wanted. I now have a low tolererance for that. But if the friend did seem truly depressed, I would not abandon him/her. I am not as heartless as my last post seemed.

carroll · Jul 18, 2006

If its a first time thing I would call 911. BUT... if she continually cries wolf I would end the friendship. I would not want to be in that position where she feeds into the attention of a 911 call and ambulance ride, nor would I want to be responsible if she did off herself after threatening to do so and I did nothing about it. I would gently end the friendship, but gradually becoming less available over time, taking days to return phone calls, etc. Until I was forgotten and she found the next "friend" to manipulate. I know, thats harsh, but I don't like games and being put in that position.

That is exactly what i did a couple of years ago with another friend, she was diagnosed as borderline i later found out, but i could not deal with all her games and she wasnt a close friend. This friend is treading on very thin ice at the moment, i cannot keep allowing her to break boundaries i set for my own well being but i am very reluctant to walk away while she is having a hard time, though i have been backing off a lot over the past year. It took me a long time to spot the manipulations and mind games she was playing, or maybe i just did not want to see them, either way i have bene pointing out to her for the past 6 or so months when i catch her at it. She knows i do not like it, and today i ahve told her that if it does not stop, or if she does not start to make an effort to change her attitude/behaviour then i would not continue to be her friend. I agonised over that decision before telling her, i know what it feels like to be extremely depressed and suicidal and be dumped by your friends, i had vowed i would never do that to a friend. On the other hand i have given her as much of my time and energy as i am able. I have set boundaries around unanounced visits, and calling 20 times until i give in and answer the phone. I have spent the last two years listening to her and her woes, making sugestions as to what might be helpful etc etc. I am not a mental health nurse, nor a counselor or whatever. I have compassion and empathy, but i can only take so much. I am fed up of watching her turn down professional help, skip appointments, refuse to take prescribed meds, playing games with everyone around her, and having tantrums when she doesnt get her own way. I am hopeing that this time she see's the light so to speak. She is going into a psychiatric ward again (i dont think they gave her much choice following this weekend). If she makes the most of it and starts to work with them and the community teams she has access to then no i wont walk away from her, yet. Unfortunatley i honestly don't believe her when she says she will make use of them. I have heard it all before and do not want to hear it anymore after this time. I am at this point incredibly thankful that she is a friend and not a member of my family i would be compelled to stick wiht and deal with. If i need to i can dissapear from her life, and then figure out how to deal with the guilt for doing so. Thank you for all your advice especially not knowing many of the facts.

NurseyBaby'05, BSN, RN · Jul 18, 2006

A phone number change while she is hospitalized would probably be a good thing. You say she is a friend, but friendship is a two way street and you have been the one making all the effort. Maybe when she realizes you aren't mesing around, she will wise up. If you let her stay around, she'll suck the life out of you. And that's not what friends do.

cat123 · Jul 18, 2006

That is exactly what i did a couple of years ago with another friend, she was diagnosed as borderline i later found out, but i could not deal with all her games and she wasnt a close friend. This friend is treading on very thin ice at the moment, i cannot keep allowing her to break boundaries i set for my own well being but i am very reluctant to walk away while she is having a hard time, though i have been backing off a lot over the past year. It took me a long time to spot the manipulations and mind games she was playing, or maybe i just did not want to see them, either way i have bene pointing out to her for the past 6 or so months when i catch her at it. She knows i do not like it, and today i ahve told her that if it does not stop, or if she does not start to make an effort to change her attitude/behaviour then i would not continue to be her friend. I agonised over that decision before telling her, i know what it feels like to be extremely depressed and suicidal and be dumped by your friends, i had vowed i would never do that to a friend. On the other hand i have given her as much of my time and energy as i am able. I have set boundaries around unanounced visits, and calling 20 times until i give in and answer the phone. I have spent the last two years listening to her and her woes, making sugestions as to what might be helpful etc etc. I am not a mental health nurse, nor a counselor or whatever. I have compassion and empathy, but i can only take so much. I am fed up of watching her turn down professional help, skip appointments, refuse to take prescribed meds, playing games with everyone around her, and having tantrums when she doesnt get her own way. I am hopeing that this time she see's the light so to speak. She is going into a psychiatric ward again (i dont think they gave her much choice following this weekend). If she makes the most of it and starts to work with them and the community teams she has access to then no i wont walk away from her, yet. Unfortunatley i honestly don't believe her when she says she will make use of them. I have heard it all before and do not want to hear it anymore after this time. I am at this point incredibly thankful that she is a friend and not a member of my family i would be compelled to stick wiht and deal with. If i need to i can dissapear from her life, and then figure out how to deal with the guilt for doing so. Thank you for all your advice especially not knowing many of the facts.

doesn't sound like she was really a friend to begin with. I recently called to see if I could get some one to talk to because of all the problems that I am going through and was told that without insurance they couln't help me. The county mental health just isn't up there for what I need.