OCD is a chronic mental illness that is associated with significant disability and suffering. Indeed, people with OCD often report serious difficulties in relationships and problems at work. For some people, living with OCD can become overwhelming and can cause them to lose hope and to contemplate or even attempt suicide. If a family member or friend with OCD is exhibiting the potential warning signs of suicide, it is important to know what to do.
OCD and Suicide
Although it has long been known that the risk of suicide is higher for people who are affected by mood disorders and schizophrenia, the relationship between anxiety disorders, such as OCD, and suicide has been less clear. However, recent studies suggest that between 5 and 25% of people with OCD have attempted suicide at some point in their lives. Actively thinking about suicide (sometimes called suicidal ideation) also appears to be relatively common among people affected by OCD.
Factors that predict whether someone with OCD will attempt suicide include the severity of their OCD symptoms, the co-occurrence of depression, feelings of hopelessness, the presence of a personality disorder such as obsessive-compulsive personality disorder, and a prior history of self-harm (such as cutting).
Potential Suicide Warning Signs
It is not always easy to know if someone is going to commit suicide, but there are a number of potential warning signs that can signal that someone is thinking about harming themselves.
Increased hopelessness: The person may talk openly and at length about feeling hopeless, helpless, or that "they can't take it anymore."
Speaking of death or suicide: Out-of-character remarks about death, speaking openly about suicide, or an expressed desire to commit suicide should always be taken seriously. In some cases, this may be the individual's way of asking for help.
Increased depression: The person exhibits symptoms of depression, such as withdrawing from others, crying all the time, loss of interest in hobbies or activities, disrupted sleep, and lack of appetite.
Preparing for death: People actively contemplating suicide will sometimes take out an insurance policy, adjust and/or create a will, or advise someone close to them of their final wishes.
Changes in behavior: A normally cautious individual may engage in reckless or impulsive behavior and express little fear of the consequences of such behavior. In another example, someone who is depressed may suddenly act cheerful for no apparent reason.
Giving away possessions: It is not uncommon for individuals who are actively contemplating suicide to give away prized possessions to trusted friends or family members.
What You Can Do
If a family member or friend with OCD is exhibiting the potential warning signs of suicide, it is important to know what to do.
Keep communicating: Talk openly and frankly about what the person is feeling -- talking about suicide does not make it more likely that the person will harm themselves. As well, do not be afraid to express your own feelings. If you are scared and worried about the person, then it can be helpful to say so.
Although it can be uncomfortable, frankly asking questions about whether they are thinking of killing or harming themselves, as well as other details such as how and when they are considering do it, whether they have access to a weapon or large amounts of medications, and other relevant concerns, may help ensure that suicide does not become an "untouchable" subject.
Empathize - don't minimize: As you might imagine, admitting suicidal thoughts or a suicide plan is often an extremely difficult, embarrassing and painful experience. Simply telling the person to "stop thinking about it," "think good thoughts," or even "get over it" may make the person feel even more rejected, insecure and/or depressed. Make sure you let the person know that you hear them and that you understand how difficult this experience must be for them.
Get help: Suicide is a very serious problem that often requires hospitalization and the assistance of qualified professionals. In cases where you feel the person is an immediate danger to themselves, you may want to accompany the person to the local hospital emergency department or wait with them until help (e.g., police or ambulance) arrives. In less urgent cases, you may want to help them locate and/or access resources such as a crisis line, support group or a mental health professional they trust.
Alonso, P., Segalas, C., Real, E., Pertusa, A., Labad, J., Jimenez-Murcia, S., Jaurrieta, N., Bueno, B., Vallejo, J., & Menchon "Suicide in patients treated for obsessive-compulsive disorder: A prospective follow-up study" Journal of Affective Disorders 2010 e-published ahead of print.
Balci, V., Sevincok, L. "Suicidal ideation in patients with obsessive-compulsive disorder" Psychiatry Research 2010 175:104-108.
Kamath, P., Reddy, Y.C.J., & Kandavel, T."Suicidal behavior in obsessive-compulsive disorder" Journal of Clinical Psychiatry 2007 68:1741-1750.