Hopelessness, psychache, lethality, perceived burdensomeness, thwarted belongingness, press, perturbation, fearlessness and competence.
These words encompass suicidality. It has been shown that most of the people that are suicidal feel this way and then act on the pressure of these feelings and commit and act of suicide. When someone feels all of these at once, it is a terrible feeling. Some people might only feel a few of these things and still be suicidal. Some people will feel these things and just be depressed.
Hopelessness, the feeling of being lost in hope, that nothing is ever going to change, that things will always be the same no matter what.
Psychache is defined as despair, anguish, hopelessness, guilt, worthlessness, and psychological pain one feels. It is like pain in the heart that no one else can feel. Your heart feels heavy and you feel like a burden because of it. Nothing soothes this pain. No medication can touch it. And suicide seems like the only answer for this type of pain and anguish.
Lethality, the degree to which someone is at risk for suicide. Whether it be a loaded gun or a few bottle of pills or some cuts on the wrist. This is what determines how suicidal a person is and how they are going to act. If the risk is high and eminent, involuntary hospitalization is called for. If the risk is low, then more contact is need and assessment at every visit.
Perceived burdensomeness, the idea that you are a burden to those around you but in reality you are not,
Thwarted belongingness, the idea that you don’t belong anywhere and feel the need to belong somewhere. It is a very awkward and lonely place that hurts very badly. Everyone wants to feel like they belong somewhere or to something and when that need is not met, they feel detached and alone.
Press, similar to stress. It is as if the building of the press is similar to the pressure of a volcano ready to explode. It can lead to further perturbation and make things worse.
Perturbation, the need to feel or do something to ease the pressure and anguish and despair they are feeling and to feel better. It can lead to want to do something but the idea is that you need to do something to relieve the pressure of the feelings on your chest.
Fearlessness, the absence of fear. In this regard, it means that people may be fearless when trying to take their life, like a type of Russian roulette.
Competence, the meaning is the level of competence to carry out the means for their suicidal plan. Examples include rope for hanging, gun handling and shooting, knowledge of drugs, etc. High competency is a high risk factor.
All these elements can lead to a suicidal crisis. It is imperative that these elements be asked about on a consistent basis. Talking about the pressures of work or home life is important. If someone is saying they are a burden and wish they were dead is a huge tip off that something is going on and the elements I have just described are in full play. All of the elements depending on their degree, is an important indicator of how suicidal a person is. Merely asking about being suicidal is NOT enough as most suicidal individuals fear hospitalization or a thwarting of their plans and therefore will not be honest about their intention to commit suicide.
copyrighted 2013, Collerone, G